19th Century Public Health

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  • Created on: 05-06-13 13:22


The Industrial Revolution happened towards the end of the 18th century. 

This caused many people to move to the towns and cities where the factories were in search of jobs.

However, this increase in population did lead to overcrowding.

The towns could not cope with this sudden increase in numbers and conditions became worse than ever. 

Many people believed the government should take care of public health, however the government had a laissez-faire atittude towards public health at the time.

MPs were rich and therefore lived on the outskirts of cities where these conditions didn't affect them. 

There was no clean water, drainage or sewage removal. Many poor homes had privies which were emptied into cess pits, many of which overflowed into streets or rivers. 

Water for London came from the River Thames, however 237 sewers were emptied into this river and so it was highly polluted. 

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Cholera Outbreaks

Cholera first came to Britian through the port at Sunderland in 1831, and spread quickly in the years 1831 and 1832. 

As there was no understanding of the causes of disease, people believed it was caused by 'miasmas' in the air, and so they linked the disease with dirt and smells.

Many people even burned tar or juniper to purify the air. 

People did not understand that the disease was waterborne. 

There were bad outbreaks of Cholera in 1832, 1847-48 and 1854.

As the disease spread, the govenment realised it had to stop its laissez-faire policy and get involved in people's lives to stop the spread of the epidemic. 

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Edwin Chadwick


He was the secretary of the Poor Law Commission and was particularly interested in sanitations and living conditions. 

In 1838, he began making enquiries and surveys to do with living conditions.

By 1940, he began his 'Report on the Sanitary Condition of the Labouring Population in Great Britian' which was published in 1942. 

He used maps, statistics and descriptions to prove that the poor were living in awful conditions.

He believed that disease was spread by miasmas and so thought that disease could be prevented by removing sewage and waste.

He helped to pass the first public health act of 1948 and inspired the sanitary movement. 

Although some figues saw him as arrogant and he faced much opposition, he was knighted for his services to public health in 1889. 

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Report on Sanitary Conditions of Labouring classes

It was published in 1842 by Edwin Chadwick. 

The report looked at the poor living conditions of working-class people in Britian. It proved the shocking links between poverty, filth and disease. 

However, the report had little impact on opinion of public health.

After there was another large outbreak of cholera in 1848, public opinion demanded there to be a Public Health Reform. 

The government passed the first public health act in 1848. 

Other reformers also started to do similiar surveys on the condition of Britian such as William Farr who collected birth and death rates.

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William Farr

1807 - 1883

William Farr qualified as a doctor in 1832 and became fascinated with medicial statistics. 

He set up a system to record deaths and their causes and helped bring attention to the amount of disease in Britian. 

When Cholera broke out in Britian, Farr believed, like Chadwick, that it was cause by miasma. 

The data he collected was used by other reformers such as John Snow in reports on sanitation, even thought they had different theories. 

However, by 1866, Snows theory that Cholera was spread by water was so convincing that Farr sided with Snow's theory instead. 

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Public Health Act 1848

In 1848, the Public Health Act was introduced when Cholera struck again

A National board of Health was set up and local boards of health could be created in towns to help with the water supply, regulate lodging houses and to improve sewage removal.

Medical officers could also be appointed.

However, this act was optional and so most towns decided not to do it. 

Some towns did adopt local boards and improved water and waste disposal. However, the act faced much opposition. 

Some people believed the govenment shouldn't interfere with peoples lives and many companies that dealt with water and waste found their work was being made difficult by the introduction of the Health Act. 

Chadwick tried to tell people that it would be cheaper in the long run as the population would be more healthy, however many disagreed and he was forced to resign in 1854.

The National Board of Health was dismantled once the outbreak of Cholera was over.

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By 1854

- The local board of health had disbanded.

- Local authorities had been left to their own devices once again.

- However, some cities had improved things.

- Birmingham had built parks and Loverpool had a medical officer.

- But other cities still had nothing.

- There was no co-ordination of public health.

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John Snow

1813 - 1858

Snow was apprenticed to a surgeon aged 14. He joined the Royal College of Surgeons in 1838 and then the Royal college of Physicians in 1850.

He was sceptical of the miasma theory and believed that disease was caused by something else. 

He began to investigate how cholera spread and published an essay called 'On the Mode of Communication of Cholera' in 1849.

He discovered that people who drank from the River Thames became ill, which led him to believe that disease was spread by water and not air.

In 1854, there was a Cholera outbreak in Soho London. Snow made an important discovery in Broad Street where many people had been dying from Cholera. He discovered that it was only the people who used the pump in Broad street that became ill. It was later discovered that this water came from an infected site.

He had the handle of pump removed and concluded that Cholera was spread through water. 

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The Great Stink 1858

The summer of 1858 was very hot.

Due to this heat and how much rubbish was in it, the River Thames began to smell. 

As the houses of Parliament were situated next to the river, the MPs were affected by the smell and so they started to realise the extent of the problem with public health. As they lived on the outskirts of the city, they had never realised how much of a problem public health really was. 

A campaign for better public health and cleaner sewers went underway.

Sewers were created along the river to take waste out to sea.

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Why was the 1875 Public Health Act compulsory?

There were several reasons why the 1875 public health act was made compulsory:

- Other cities, like leeds, had already started to make improvements regarding public health.

- There were many scientific developments. The Germ Theory, 1861, proved that disease was spread by germs and not by miasmas. 

- The act passed in 1867 gave working men the vote. This meant that as the bad public health standards affected them the most, they would want things improved.

- The work of people such people as John Snow.

- The weakening of the govenments laissez-faire attitude.

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Public Health Act 1875

The Public Health Acts in 1872 and 1875 helped to improve sanitation in towns across the country as well as the health of the nation. 

Authorities now had to provide clean water, proper drainage and better sewers. 

Each area of Britian had to appoint a Medical Officer to oversee public health.

1875 also saw the creation of the 'Artisan's Dwellings Act' which gave councils the power to buy slum housing and knock it down to build new, better houses. 

There was now increased concern over housing and reformers such as Octavia Hill encouraged personal responsibility for hygiene in homes and made sure that landlords provided more for their tennants. 

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Octavia Hill

1838 - 1912

Hill was born into a family that did a lot of charity work and from the age of 14 worked in a ragged school for the Ladies' Guild.

She realised that the children she helped came from awful homes where landlords did little to help housing conditions, and so in order to rectify this, she became a landlord.

In 1865, she bought 3 houses. She made sure they were in good condition and visted every week to collect rent and check conditions. She got to know her tennants and made sure they didn't take on any lodgers to prevent overcrowding. 

She encouraged personal responsibility for hygiene and sanitation, which she helped to oversee. 

This system was very effective and soon she bought more property.

She left a legacy of improved housing and social reform and constantly campained for improved living conditions. 

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