British Public Health 1800-1914

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Cholera

- Biggest outbreaks were in 1831, 1848, 1853 and 1865

- Symptoms include vomiting, diarrhoea and bruises

- Unpredictable as no one understood what caused diseases

- Many believed that it could be caused by Gods and demons, personal contact, spontaneous generation or miasma (which were all wrong)

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Edwin Chadwick - 1842

- Believed in miasma 

- Therefore he thought that cleaning, drainage and ventilation would make people healthier

- wrote a report called 'The Sanitary Conditions of the Labouring Population' in 1842

- This pointed out the connection between the lack of sanitation and disease/life expectancy 

- The report urged the Government to make a change 

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John Snow - 1854

- He didn't believe that miasma caused cholera 

- Made a map of cholera cases and found a concentration around the Broad Street water pump

- This caused him to believe that the water in the pump was a source of cholera because people who were drinking it were more prone to cholera 

- He noticed that in the brewery near by the men did not get affected by the disease 

- He concluded that this is because they drank mainly beer and the water they did drink had been previously boiled (part of the beer making process) therefore killing the cholera germs

- He removed the handle on the pump and consequently, the surrounding area saw a decrease in cholera cases 

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Who would be FOR or AGAINST intervention?

Middle class (tax payer) -- Wanted to keep their own wealth and didn't want to help the poor
Middle class (tax payer) -- Believed that the poor were not their problem 

Working class man -- Some may have wanted financial help    
Working class man -- BUT better housing conditions meant higher rent 

Wealthy landlord -- Intervention would mean regulations they would have to follow
Wealthy landlord -- May lose profit and renters 

Journalist -- People were read by educated people who pay tax, so articles would be against

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The 1848 Public Health Act

- Inspired by Chadwick's Report 

- A 'Central Board of Health' was established 

- Three measures were outlined 
          - Provision of clean water
          - Drainage systems
          - Appoint a Medical Officer of Health 
          - Create a Local Board of Health 

- Was OPTIONAL

- The government encouraged towns to take measures but they were not forced

- Therefore not much changed 

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Strengths of the 1848 PH Act

- A new network of sewers which were cheaper and more hygienic was constructed in London 

- Some Local Boards of Health were set up around the country 

- More of an interest into health measures

- It kept Public Health in the public eye 

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Weaknesses of the 1848 PH Act

- The Act was permissive and not compulsory so not much changed around the country 

- Local authorities sometimes refused 

- People in towns resisted (they didn't like being told what to do)

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The Great Stink - 1858

- In the summer of 1858, a heat wave made the Thames smell so bad that politicians in the Houses of Parliament  had to meet elsewhere

- Human waste, dead animals, rubbish and waste from factories/slaughter houses had been dumped in the river and the heat makes the smell intolerable

- This spurred the politicians to do something about the awful conditions 

- They employed Joseph Bazalgette to design a system of waste removal for London 

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The 1875 Public Health Act0

- Local councils must improve water supply and sewage systems

- Must appoint inspectors 

- Improve standards of housing

- Fines were issued for pollution of rivers

- Improved working practices e.g workhouses

- Food standards were improves

- Education and Vaccination became compulsory 

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What was different from 1848?

- Wider powers for the government

- More focus on personal improvement 

- Not as bad for richer people 

- It was compulsory so forced towns to take action and they could not refuse it 

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Model Villages - 1880's

- Less cramped housing 

- Lots of green space 

- Hospitals

- Housing far away from roads and factories 

- More schools where kids were taught about health

- Gymnasium's so people could stay fit and healthy

Examples include:
     - Bournville 
     - Port Sunlight 

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Surveys around the country

1889
   - Charles Booth surveyed London's population 
   - Discovered that 1/3 lived below the poverty line 
   - Established a link between poverty and early death 

1901 
   - Seebohm Rowntree surveyed the city of York
   - Discovered that 43% of the population lived below the poverty line 

Both of them agreed that 
   - 30% of urban populations lived in poverty 
   - Conditions were horrifying 
   - It was impossible to get out of poverty alone 
   - The main causes of poverty were illness, ages and unemployment

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Why did the country need reform?

Industrial Decline 
   - Britains position of leading industrial power was threatened by Germany 
   - Their rapid development seemed to be linked to health 

The Boer War (National Efficiency)
   - Over half the volunteers weren't fit for service due to health 
   - It was extremely important to have a strong army  

Lack of Rights for workers 
   - No pensions 
   - No unemployment benefits or sick pay
   - The only resort was the workhouse where you received food and clothes in return for labour
            BUT it broke up families and there were horrifying conditions 

Rise of the Labour Party
   - Labour was slowly gaining popularity 
   - The Liberals needed more votes 
   - More would support them if they were healthy and happy 

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How did the reforms help CHILDREN?

Before?
   - No real system 
   - Some charity support 
   - Orphaned children when to the workhouse

Measures taken?
   - In 1906 free school meals were introduced
   - They also received medical inspections and clinics in schools 

How did it help?
   - Gave kids real food which was hot and had much better nutritional value

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How did the reforms help THE ELDERLY?

Before?
   - Charities 
   - Families 
   - The workhouse 
   - No help or money from the government 

Measures taken?
   - In 1908 pensions were introduced
   - This gave old age pensioners, who were 70+, 27p per week 

How did it help?
   - It made retirement a practical possibility 
   - Prevented starvation and going to the workhouse

Limitations?
   - Very little money was given
   - Barely anyone made it to 70 years old  

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How did the reforms help THE SICK?

Before?
   - Charities 
   - Families 
   - Workhouse 
   - No help or money from the governemnt 

Measures taken?
   - Sickness benefit was introduced
   - Made possible by National Insurance

How did it help?
   - Didn't have to go to the workhouse 
   - Given time to recover 

Limitations?
   - Didn't apply to women or children 

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How did the reforms help THE UNEMPLOYED?

Before? 
   - Only voluntary labour exchanges or workhouse 

Measures taken? 
   - Unemployment benefits were introduced 

How did it help?
   - Gave people time to look and find work again
   - Families would not suffer

Limitations?
   - Did not apply to women and children  

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Who would be FOR or AGAINST the reforms?

 The rich and wealthy -- Would reduce social divide between rich and poor 
 The rich and wealthy -- Money for reforms came out of their taxes but it didn't help them 

Conservatives -- Conservative voters were primarily wealthy land owners who wouldn't benefit 

Socialists (Labour) -- The reforms supported the working class and their interests

Socialists (Labour) -- BUT didn't think enough was being done to support the poor
Socialists (Labour) -- Hated national insurance as workers had to contribute 

Poor/Working Class -- Got pensions, benefits, rights, labour exchanges, medical care and
                                          free school meals/medical inspections 

Poor/Working Class -- BUT they had to make contributions to national insurance 
Poor/Working Class -- The taxation of tobacco and alcohol was unpopular 

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