rev in public health

• impact of the industrial revolution

  • The population grew an after 1850 there were more people living in towns than in the countryside for the first time.
  • Most working people were employed in the new industrial jobs rather than in agriculture.
  • Wages were low and hours were very long.
  • Children as well as adults worked in dangerous conditions with frequent accidents.
• Theories about the causes of disease

  • Most of the theories about the causes of disease that had been around since medieval times were still in place during the industrial revolution. By the 19th century the most widely believed theory about the cause of disease was still miasma.
  • The first public health measures were based on miasma and though the idea was wrong, the measures had some effect because they focused on making towns cleaner. 
• As a result of the Industrial Revolution (1780-1850) people in towns lived close together in poor conditions. This led to terrible public health problems. During the 19th century, theories on causes and treatment of disease began to change and great improvements were made to public health.
• 19th century public health

  • towns were very overcrowded with poor quality houses crammed into a small area
  • Pay was low so it was difficult to afford to see a doctor
  • There were often no systems or rules for getting rid of waste: it was left in streets and got into water supply
  • Clean water was in short supply, so outbreaks of diseases like cholera & typhus were frequent & deadly
  • Different groups agued about whether the government should interfere. The government took a laissez-faire attitude
  • 1848 a terrible cholera epidemic scared the government into action with the first public health measures
• Key Individuals:


  Edwin Chadwick – 1842 – Report on the Sanitary Condition of the

  Labouring Population

  John Snow – linked cholera to dirty water (1848)

  Louis Pasteur – Germ Theory (1850-60)
• Government Reform:


  1848 – Public Health Act – Central Board of Health, Local boards of health

  to improve sewage and water. Not compulsory.

  1875 – 2 nd Public Health Act – Councils had to provide street lights, water,

  drains and sewage and employ medical inspectors. Compulsory

  1875 – Artisans Dwellings Act – councils could knock down slums.
• Reasons for Improvement:


  ‘Great Stink’ 1858 – Parliament forced to move from Thames due to smell.

  Cholera Epidemics – Weakened workforce and profits to industry.

  Germ Theory – Accepted in the 1860s, proved hygiene importance.

  1867 Reform Act – Working class get the vote (want improvements).

  Technology: Sewers, Lavatories, Flushing Toilets, Soap.

  Key Individuals: Farr, Snow, Chadwick, Bazalgette.
• Cholera as an agent of change

  • Cholera arrived in Britain in 1831. the symptoms were horrific and the disease spread through cramped and dirty towns at an alarming pace, killing both the rich and poor. 
  • The cholera outbreak of 1848 was worse than any other and became an agent of change as people demanded something be done, forcing the government to act.
  • After this the government introduced Public Health Acts to improve living conditions and people’s health.  
• Growth of hospitals - Florence Nightingale


  • Significant in bringing about change in hospitals
  • Witnessed high death rates in military hospitals during Crimean war then challenged standards/ cleaniness of them
  • After 6 months of her & nurses working their she reduced the death rate in hospital from 40% to 2%
  • her work was widely reported in newspapers & she published books e.g Notes on Nursing & Notes on Hospitals
• Nightingale post-war

  • She set up Britain's 1st nurse training school
  • Countries all over the world copied her ideas
  • New hospitals of the late 19th century were based on her designs