Just on the subject of hygiene and health we must remember some facts in the books that don't exist real life. In the books all the wrongs in the world are fundamentally blamed on the marring of Arda by Melkor. So deseases, i imagine, are not something linked with hygiene and cleanliness but rather an evil unleashed in the world by Morgoth and his disciples. So I don't imagine middle-earth would have had a rotten peasant class like pre-industrial Europe barring, perhaps, the Orcs and the Easterlings
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"Come away, O human child!/ To the waters and the wild/With a faery hand in hand,/ For the world's more full of weeping than you can understand."
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