19th and 20th century Public Health

key dates and events in 19th and 20th century public health

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History ­ Public Health
19th Century Public Health
Public health provision was completely transformed as the 19th century progressed. Overcrowding,
dirt, poverty and disease went hand in hand at the century's start, but by the 1900s energetic social
reformers had comprehensively turned things round. In the early 19th century, the growing towns of
Britain were characterised by overcrowding, poor housing, bad water and disease.
In 1842, Edwin Chadwick argued that disease was the main reason for poverty, and that
preventing disease would reduce the poor rates.
In 1848, a cholera epidemic terrified the government into doing something about prevention
of disease - through both public and individual health measures.
At first the government tried - as the Romans had done - to prevent illness among the population by
public sanitation measures. The first public health measures were based upon the idea that miasmas
(bad smells) caused disease. Although the idea was wrong, the measures against the miasmas
involved a greater focus on cleanliness, and this improved public health.
In 1848 the first Public Health Act caused the setting up of a Board of Health, and gave towns
the right to appoint a Medical Officer of Health.
In 1853 vaccination against smallpox was made compulsory.
In 1854 improvements in hospital hygiene were introduced (thanks in large part to Florence
Nightingale).
In 1875 a Public Health Act enforced laws about slum clearance, provision of sewers and
clean water, and the removal of nuisances.
The benefits of these measures soon became clear, and by the late 19th century local councils were
competing with each other to provide the best public health.
When the Boer War revealed that half the population were unfit for military service, the government
accepted that it had to pass laws to improve the situation of the individual poor:
In 1906 local councils were told to provide free school meals for poor children.
In 1907 school medical examinations were ordered for all children (among these
examinations were those of the 'nitty nurse').
In 1908 Old-age pensions were introduced.
In 1911 National Insurance (free medical treatment for workers who fell ill) was introduced.
20th Century Public Health
In the 20th century, the government accepted the need to care for all its citizens 'from the cradle to
the grave', and there was a greater focus than ever before on the health of the nation.
1918: After the First World War, the British Prime Minister Lloyd George promised the
soldiers returning from the battlegrounds of Europe 'homes fit for heroes'. The government
set itself a target of building half-a-million decent homes by 1933.
1919: A Ministry of Health was set up to look after sanitation, health care and disease, as
well as the training of doctors, nurses and dentists, and maternity and children's welfare.
1921: Local authorities were required to set up TB sanatoria.
1934: Although the economic depression of the 1930s caused government to cut back on
spending, it passed the Free School Milk Act and encouraged local councils to give poor
children free school meals.
1942: During the Second World War, the need to give people something to fight for led the
government to commission up the Beveridge Report. Beveridge recommended a Welfare

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History ­ Public Health
State, which would provide social security, free health care, free education, council housing
and full employment.
1946: The New Towns Act planned new towns such as Stevenage and Newton Aycliffe to
replace the inner-city slums. The Town and Country Planning Act of 1947 set a target of
300,000 new homes a year, and identified 'green belts' where housing would not be
allowed to continue to swallow up the countryside.…read more

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