History- Extension study- Public Health

Problems 1350-1750
1. Towns and cities getting bigger
2. Growing population increased problems
3. Rubbish, dead animals and human and animal excrement dumped and left on streets
4. Polluted rivers/drinking water: people drank ale instead
5. Poor sanitation
6. Sewage contaminated water
Infectious disease
1. Frequent outbreaks and epidemics
  1. Deadly
    1. Poor public health provision
      1. Local authorities attempt to deal with outbreaks
        Fail due to lack of understanding
  2. 1665 Plague in London
    1. Theatres closed
    2. Large funerals banned to stop crowds
    3. Dogs and cats were killed
    4. Barrels of tar were burned in the streets
    5. Carts collected the dead who were buried in deep mass graves
    6. Household boarded into its home for 28 days if one member caught the plague
    7. Days of fasting and prayers were ordered
Toilet sanitation
1. Only richer people had privies- padded seats over a bucket for their own family's to use
2. Poorer people had to share- several families used one cesspit which had a wooden seat above
3. Chamber pots inside houses- emptied in drains or thrown out the window
4. People paid nightsoil workers or 'going farmers' to empty cesspits
  1. Contents sold to farmers as manure
5. 1596: John Harrington invented a WC
  1. Ridiculed so didn't develop properly for another 200 years
Action 1350-1900
1. Links between dirt and disease
2. By-laws to keep streets clean
3. By-laws to stop people dumping things in rivers
4. Success into piping water into towns and cities
5. Some towns had public toilets and baths
6. Water in London
  1. 1602 artificial river from the River Lee began construction
    1. Edmund Colthurst (private investor)
    2. Money ran out after just two miles
    3. 1609 Hugh Myddleton tried again-paid half the bills
      1. The rest funded by King James I
    4. Project finished in 1613
  2. 1750 most water supplied by private companies
    1. Piped direct to homes or to sandpiper on street corners
7. Link between dirt and disease wasn't proven until 1861
  1. People believed God caused disease
    1. So didn't want taxes to be spent on health provision
      1. Laissez-faire government attitude
8. Changes in government role after 1750
  1. Gin made more expensive
    1. Improved health among the poor who were drinking lots of cheap gin
    2. Improved the economy (drunk people didn't work so hard)
  2. Made small pox vaccination compulsory in 1853
  3. 1871 all vaccinations were registered
  4. Death rate of small pox declined
Industrial diseases
1. Urban diseases
2. Industrial revolution: 18th-19th century
3. Huge growth in towns
  1. People moved to find work in factories
    1. Low wages
      1. Several families shared low quality housing
  2. No laws to provide sewers, fresh water or to remove rubbish
  3. Infectious diseases spread more rapidly
    1. 1831: Cholera epidemic put pressure on authorities to take action
    2. First outbreak of Cholera in Britain killed thousands in just a few weeks
4. Edwin Chadwick
  1. The Sanitary Conditions of the Labouring Population
    1. Unsanitary and overcrowded conditions
    2. Cost of work houses is high
      1. Improved living conditions will reduce admissions to work houses and save money in the long run
  2. Work received lots of attention and some criticism
  3. Did a survey of the living conditions of working class areas
    1. Work out how to reduce taxes
Government Action
1. Public Health Act, 1848
  1. Local health boards
    1. 1/3 of towns set up a board of health
  2. Appoint medical officers
    1. Fewer than 1/3 appointed medical officers
  3. Organise the removal of rubbish
  4. Build sewer systems
  5. Allowed but did not force town councils to...
  6. Act was temporary and the General Board of health was abolished by 1858
2. John Snow
  1. Doctor and surgeon
  2. Theory that Cholera was spread through water, not 'bad air'
3. London's 'Great Stink' (1858) meant a new and expensive sewer system was built
4. 1867, Working class men got the vote and wantd politicians to take action
5. Central government passed laws and local authorities funded and carried out changes that meant by 1875 local councils had to ensure that...
  1. Clean water was provided
  2. Streets were paved
  3. Rubbish was collected
  4. Sewers were built
  5. Slum housing was demolished
  6. Food in shops was of good quality
Public health since 1900
1. 1905: Liberal government took action in response to worrying health trends
  1. Charles Brooks and Seebohm Rowntree's survey showed struggle of working classes to afford decent food and housing
  2. 1/3 of Boer War volunteers did not pass army health tests
    1. Nearly 90% failed tests in slum areas of northern cities
  3. Reforms were difficult and expensive to pass and many people objected to the increasing role of the government in people's lives
2. WW2 made people aware of importance of governments involvement in health care
3. 1948: NHS set up by Minister Aneurin Bevan
4. Since 1948 government have taken more action to prevent people getting ill
  1. Funding vaccinations
  2. Better disposal of rubbish and sewage
  3. Laws reducing air pollution
  4. Laws improving health and safety at work
  5. Environmental health officers inspecting food outlets
  6. Health education
  7. Laws banning advertising of tobacco products and smoking in public places
  8. High tax on cigarettes

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