Transcript Improvements in Public Health

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From the late 18th century a new type of
industrial town began to develop in northern
England. Into these towns flocked tens of
thousands of workers for the new cotton and
woollen factories. The factory owners often built
cheap back to back housing, with little or no
sanitation. The results were appalling. In 1830
the average life expectancy for factory workers in
Bolton was only 17 years. These problems went
almost unnoticed, until the first great cholera
epidemic of 1831-2, when a series of reports
were compiled into the state of towns in Britain.
By far the most important of these was written in
1842 by Edwin Chadwick.
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He was born in Manchester and became a civil
servant. In 1838, after reading a report into
the industrial towns he decided to carry out
his own research. In 1842 he published his
'Report into the Sanitary Conditions of the
Labouring Population of Great Britain'. This
proved that life expectancy was much lower
in towns than in the countryside
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Chadwick's 'Report' challenged the 'laissezfaire' attitude prevalent at the time. Chadwick
argued that it was possible for the
government to improve people's lives by
bringing about reform. He was not a 'dogooder', as some people thought he believed
that a healthier population would be able to
work harder and would cost less to support.
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In 1848, partly through pressure from
Chadwick and partly through fear of cholera,
Parliament passed the first British Public
Health Act, which established central and
local Boards of Health. However, the Act only
had a limited effect, as it did not force towns
to take action so in 1854 the Board of Health
was abolished
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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.
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Chadwick, like many people, believed that
disease was caused by air pollution. His ideas on
cleaning up towns were a step in the right
direction but his conclusions were too general
and did not address the specific causes of
disease. However, he was the first major figure in
public health and his work helped to make later
reforms possible.
Perhaps Chadwick’s greatest contribution was to
end the government’s ‘laissez faire’ attitude to
public health
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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.
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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.