This project explores the capacity of public health infrastructure to reshape the local labor force, and consequently, the geography of inequalities in health and income. The Metropolitan Commission of Sewers, formed in 1848, was one of London’s first steps towards creating a uniform sewage network and drainage infrastructure. Using newly-collected archival sewer maps and documentation on the system’s construction, we exploit variation in the spatial and temporal rollout of this new infrastructure to study its effects on highly localized outcomes in the short and long run, including through neighborhood spillovers. In particular, we investigate age-specific complementarities between investments in sanitation and those in education. We hypothesize that for cohorts receiving new infrastructure in utero and at very young ages, access to clean water will (net of culling) raise the returns to schooling, thus raising both attendance in childhood and the cognitive skill-content of occupations in adulthood. In contrast, for cohorts exposed to clean water later in childhood, the intervention will act as a positive labor productivity shock that, by increasing the child’s health capital in the short run, raises the opportunity cost of schooling and so speeds the transition into child labor. The introduction of a series of compulsory schooling laws during this period enables us to further examine dynamic complementarity in human capital formation. In future work, we plan to investigate how the expansion of sewage infrastructure affected spatial patterns of inequality and intergenerational mobility.