Transcript Public Health - Alness Academy History

Public Health
What is Public Health?
http://www.bbc.co.uk/scotland/learning/bitesize/standard/history/1830_1930/pu
blic_health_rev1.shtml
• The filthy overcrowded conditions in which so many
people lived made sure that Cholera spread quickly.
• Contact with human excrement and flies which had been
in contact with human excrement was inevitable. The
worst source of Cholera was dirty water.
• Cholera attacked with terrible suddeness and victims
could die within a few hours, or after a few days of
violent pain and diarrhoea.
• Where it was waterborne whole streets and areas were
affected, entire households could die.
• There was no effective treatment and one in two of those
infected died. It was terrifying because they did not
understand that it was waterborne, - it just seemed to
move and jump from one area to another at random.
• Cholera was not the only danger - Typhus was almost as
bad.
• The huge increase in population meant cesspools were
constantly overflowing, often because emptying them was
very expensive. some were even completely open.
• In Whitechapel, London, that there were no sewers so was,
'the filthiest place you can imagine'. In Manchester, it was
normal to empty raw sewage
into the rivers.
• While the overcrowded poor
were in the most danger the
middle classes were also in
danger, from Cholera and
Typhus because it was
caught through dirty water.
Housing Problems
Housing Problems
Diseases caused
Poor sanitation –
drainage cesspools, no
running water
Shared toilets
Cholera
Dirty stairs, and so on
Typhus, diphtheria
Open sewers and
middens
Rats & vermin
Typhus
Poor diet
TB
Overcrowding
TB & typhus
Typhus & typhoid
Improvements to housing
Year
Changes
1833
Scottish Municipal Reform – this allowed rate payers to vote for local
councillors and, as a result, some corrupt councils were replaced by those
willing to improve towns.
1835
The Municipal Corporation Act – this allows councils in England to improve
lighting, sanitation & street paving – it still did nothing for slums
1855
Removal of Nuisances Act – this allowed compulsory council purchase of
slums
1875
Public Health Act meant many houses had water and sewers
1875
Artisans’ Dwelling Act – councils were given the power to pull down slums
and build new houses, but cost was a problem
1909
Housing and Town Planning Act – local authorities could prepare town
planning schemes
1919
Addison’s Act was passed to make “Homes for Heroes” but funding ran out
in 1921
1924
Wheatley Housing Act – council houses were built with electricity, gardens
and indoor toilets
1930
Green Woods Housing Act – further large-scale clearance in slums
Housing and health
Cholera epidemics:
Year
1831
1848
1854
1866
Deaths
32,000
62,000
20,000
14,000
• 1842 Edwin Chadwick- “Report on the Sanitary Conditions of
the Labouring Population of Great Britain”
• Argued that government could improve people’s lives by
bringing about reform
• Recommended: “The most important things needed are
drains, removing rubbish from streets, and purer water.
There should be improved sewers and drains, and a medical
officer of health should be put in charge of each district”
Public Health Act 1848
• A board to set up local health boards was
established
• A central board was set up to make
recommendations to the local boards
• Act not successful:
– boards had no real power
– Too few boards set up
• 1858 abolished
Dr John Snow,
1854
• Investigated
cholera
outbreak in
London
• Linked
cholera with
contaminated
water
Cholera in Scotland
• Dundee, (page 60)
• Glasgow (page 61 & 62)
Public 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.
Further measures included:
• 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.
Public Health Act 1875
• Local authorities had to appoint a Medical
Officer
• Authorities had to:
– Cover & maintain sewers properly
– Provide clean water
– Pave and clean the streets
• Local officers were appointed to check up on
slaughterhouses and take responsibility to make
sure that contaminated food was properly
destroyed.
Other factors which improved health
• Better diet – due to better transport, fresh food
reached the cities
• Cheap new materials – soap and disinfectant
reduced infections
• Cheap cotton clothes – these were easy to clean
and launder.
• Better medicines and hospitals
Developments in medical knowledge helped:
Year
Discovery
1847
James Young Simpson discovered chloroform and its uses
1864
Louis Pasteur discovered germs
1867
Joseph Lister used antiseptics in surgery
1882
Robert Koch discovered the germs that caused TB &
cholera
1895
X-rays were invented by William Roentgen
1906
Calmette and Guerlin worked on a cure for TB
1928
Alexander Fleming discovered penicillin
Individual measures
• 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.