impetus for health reforms

• what was the population of Britain in 1781?

  13 million
• what was the population in 1939?

  48 million
• when was the most rapid growth in population from 1781-1939?

  rapid growth between 1811 and 1841
• give 3 reasons for rapid population growth from 1811 to 1841?

  industrialisation

  new job opportunities
• how did the distribution of the population change?

  • fairly uniform across the country
  • clustered in major cities such as Manchester , London and Birmingham
• what did the introduction of civil registration in 1837 reveal?

  • revealed a young fertile and actively reproducing population in most urban centres
• give 3 ways in which the rise of the population impacted people's living conditions?

  • widespread overcrowding
  • housing lacked drainage , sewage and regular water supply
  • demand for water increased , not equally shared
• 3 diseases caused by poor living conditions?

  • typhus fever
  • influenza
  • scarlet fever
• when were the four cholera epidemics?

  • 1831-32
  • 1848-49
  • 1853-54
  • 1866
• what caused cholera?

  dirty water
• what was miasma theory?

  disease was caused by 'bad air.' Miasma was a 'gas' that brought about disease
• when were scientists first able to see microbes?

  1830 by Joseph Lister
• why did cholera epidemic of the 1830s have a huge impact on public opinion?

  high percentage of fatalities (40-60%) among those contracting it as well as the speed with which cholera could strike
• where did cholera riots occur?

  29th May to 8th June 1832 = 8 strikes
• how did the government react to the cholera outbreak in the 1830s?

  - Board of Health set up in 1831

  • Appointed district inspectors to report on food and clothing, gave advice. Suggested remedies to stop cholera
  • 1832 = Cholera Acts. Allowed local authorities to enforce measures
• why was Louis pastures germ theory important?

  stepped away from miasma theory and showed that microorganisms caused disease not miasma
• why were many of the governments measures to stop cholera outbreaks in 1831-32 ineffective?

  • only short term solutions
  • failed to solve main issues = poor hygiene , sanitation and overcrowding
• what cures were recommended for cholera?

  • prayer
  • contagionist theory - staying away from cholera victims
  • 1831 = Lacent Journal. Rubbing self with wine, vinegar and mustard
  • patent (fake) medicines e.g Daffery's elixir
• outline the findings of James Kays reports on living conditions in towns

  demonstrated connection between dirt and disease.

  • showed how dirt and disease affected health of working people
  • dirty living lead 'dirty habits'
• what conclusions did Chadwicks report on the conditions of the labouring population in Britain of 1842?

  • disease caused by damp and filth , overcrowded dwellings and decomposing animal and vegetable substances
  • better drainage , cleaning and ventilation would remove disease entirely or reduce severity of it
• why did the poor law comissioners oppose the publishing of Chadwick's report?

  • attacked the inadequacy of existing water supplies ,sewage and drainage as well as pointed the finger at vested interests that stood in the way of improvement
• how did the government react to Chadwick's report?

  • reluctant to act on findings of private report
  • set up Royal Commissions on Health of Towns and to investigate financial side of his recommendations
• what were the recommendations of the 1844 Royal Commissions Report into the Health of Towns?

  • central gov given powers to inspect and supervise local sanitary work
  • local sanitary districts set up , had authority over drainage , sewers paving and water supplies
  • sanitary districts given powers to raise money for sanitary scheme through local rates
• what did the Bradford Woolcombers do in 1945?

  • formed a protective society and appointed their own sanitary comitte to report on their living conditions
  • mortality rate = 14 year old , 2 months
• who controlled the water supply in the 19th century?

  • private companies
• advances in toilet technology in the 19th century

  • 1775 - S-Trap. Alexander Cummings. Sealed toilet seat , prevented foul air coming up from sewer
  • 1875 - Twyford developed first 'washout' , trap water closet
• advances in sewers in the 19th century

  • 1842 - John Roe developed flushing gates that controlled flow of liquids through sewer
  • 1870s and 80s - combined with hydraulic pumps to ensure constant flow of water through sewers , make them self-flushing
• issues with private companies controlling water supply in 19th century?

  • issue of where sewers could be flushed into
  • spraying it into fields = not well received
  • discharging untreated sewage into natural water = more of a problem as how disease was transmitted was understood
• 3 examples of improvements in water supply made by private water companies

  • 1802 - Lambeth Waterworks replaced wooden pipes with iron ones
  • 1892 - Chelsea Waterworks company installed sand filtration system to purify water taken from River Thames
  • 1838 - Grand Junction Waterworks company built pumping station near Kew Bridge to house three steam pumps
• how did the work of journalists and novelists lead to changes in public attitudes to public health?

  • Charles Dickens and Elizabeth Gaskell wrote books depicting conditions
  • Novelsits focused on living conditions e.g George Orwell in 1937 novel : The Road to Wigan Pier , showed bleak living conditions of working class people in Yorkshire and Lancashire
• how did reports in local and national newspapers lead to changing public attitudes to public health?

  • Leeds Mercury - reported on local outbreaks of scarlet fever and typhoid , connection between poor living conditions and disease
  • National newspaper - greatest impact on changing attitudes with power to bring about change
  • Times Newspaper - headed campaign for effective sewage of London as result of 'Great Stink' of 1858
• how did the work of artists lead to changes in public attitudes to public health?

  • created paintings and engraving of rural and urban poor
  • pics of urban poor = more disturbing
  • attracted attention of authors writing about poor
• how did doctors , parishes and county councils cause change in attitudes toward public health?

  • improved record-keeping facilities , made connection between overcrowding and death
• how did increased scientific knowledge lead to changes towards attitudes towards public health?

  • 1844 = Health of Towns Association established
• how did the Royal Commissions lead to changes in public attitudes to public health?

  • set up Royal Commissions to investigate living conditions of poor , did investigations
  • Royal Commissions for Enquiry into state of large towns and populous districts , for example , set up in 1843 , reported in 1844
• 3 examples of how economic factors changed public attitudes?

  • Cost of public health reforms could be calculated against cost of losing productive workers to the 'dirty disease'
  • cost of poor law = escalating
  • Second Boer War (1899-1902) impacted army. Army recruitment showed poor physical condition of working men in industrial towns, impacted role of central gov
• Representation of the People's Act , 1832

  • allocated more seats to industrial towns of Midlands and North
• Municipal Corporations Act of 1835

  • ended system of closed coroporations
• Key features of 1846 Nuisance Removal Acts


  • nuisances removed
  • defined as being 'unwholesome home , accumulation of filth , foul drains and cesspools'
• key features of 1848 Public Health Act


  • local authorities = empowered to set up boards of health . Only set up when 10% of taxpayers asked for asked for one
  • Boards of Health appointed medical officer of health
  • local board of health managed sewers and drains , wells and slaughterhouses , sewage system and public baths
  • They financed projects by levying local rates , buying land