1a) Evaluate with clear reference to evidence the nature of urban public health problems in the 18th and early 19th Centuries.
There were many public health problems during the 18th and early 19th centuries. One of the first contributing problems to poor health in the 18th century was the sale and consumption of Gin. It was linked to a high mortality rate in London and Hogarth (1751) depicts in his drawings the damaging effect gin had on London, a nation wide campaign to ban gin was started. However due to an outcry from people it was never fully introduced.
Another major cause for the growth of urban public health problems was due to the rapid population of Great Britain. According to Fraser (1984) the population of Great Britain doubled between 1801 and 1851, then doubled again in the next 60 years. Much of the growth was in the larger urban towns and cities. Places such as London, Birmingham & Glasgow were some of the largest. These places grew at such a rapid speed for a few reasons. One of the reasons was that people were getting married at a very young age and starting large families. The average age of marriage at this time was 17. Whilst this was a factor in the over crowding of town and cities, the biggest factor was the rapid migration of people from rural areas to towns & cities that caused even more of a problem. People were migrating to the more industrialised towns and cities in hope of work and regular wages. Such rapid growth posed enormous housing problems for the people living there.
There was a serious lack of services and amenities in these communities. Not only were the housing developments small, cramped and overcrowded. But there was no sewerage systems, drainage or a water supply. The only real way of dealing with waste was by saving it in dung heap. These would then be collected by local businessmen and sold to farmers as fertilizer. Therefor people would be more inclined to want to save their waste in order to raise money. This waste usually stayed for weeks on end, almost always in close proximity to living quarters, gardens & alleyways. As you can imagine this caused major problems.
This along with peoples poor nutritional diets, poverty and poor sanitation led to the outbreak of many diseases and illness’s within these communities. Diseases such as typhus, small pox and tuberculosis were just some of the most common ones. The biggest and most lethal of diseases was the outbreak of Cholera. One of the biggest problems with Cholera was that nobody knew exactly where it stemmed from or how it was spread. Many people believed in the miasmatic theory. They believed it was formed from decaying matter lying in the streets and spread through ‘bad air’.
There were many interventions the government tried to make in order to improve mortality rates, living conditions and risk of spreading disease. In 1831 the central board of health was established after the findings of doctors who investigated the causes of disease and illness. In 1848 the public health act was created. This act encouraged local authorities to appoint a medical officer, provide sewers, drainage and better housing conditions. The act however was later abolished.
1b) Explain what contemporaries meant in the 19th century when they referred to Laissez-Faire and interference.
Laissez-Faire is a French term for ‘leave to do’ or ‘leave it alone’ (Victorian Britain, 2004) and much of Britain had this attitude towards government and local authorities interventions. People saw this as inference and believed they were actually doing more damage than good. Due to the poor standard of living conditions, Cholera began to spread at a very high rate causing the government to panic. In 1831 the board of health gave a description of the symptoms of cholera. A newspaper in Sunderland then reprinted as it was a port and It was believed that a port was the most likely place for the disease to be found and spread. The local council found in order to protect its residents, it would place various regulations and notices up to protect people. The port was then placed into quarantine. Local fishermen and business people, who argued cholera did not enter through the port, saw this as a major interference. Which did more damage than good.
1c) Analyse the barriers, which lay in the way of reform of public health in the first half of the 19th century.
Public health reform was very slow in the early part of the 19th century, this was because there were many barriers it faced in making changes. One of the most difficult of barriers was money and paying to make the changes. The proposed health act stated that housing communities should be provided with a water and sewerage system. This was something that was costly and very time consuming which would also need to be paid for by taxpayers. Most taxpayers were local businessmen and landlords, this did not appeal to them at all as they could not see how improving this would benefit them selves.
There was also the planning side of towns and cities. They were built in such a way that there would be no room for sewerage and drainage systems to be put in place, therefore housing developments would have to be knocked down and rebuilt. Local authorities also proved to be a barrier, as they feared of centralisation. Local authorities believed they would lose power if a central run government were in sole charge, they were not keen on this idea. There was also a fear of interference by which it was argued a government who did not know what they were doing. The government acted a lot upon a report from Edwin Chadwick who believed the disease was caused by air pollution or known as the ‘Miasma theory’. This was later proven to not be the case. People were under the impression that the government did not know the real situation in towns and cities and were only getting involved in order for them to keep there place as an MP in parliament.
1d) Discuss the influences, which led to a shift towards reform of living conditions by the late 1840’s.
There were several major influences, which led to the shift towards reform. One of the most influential was the report ‘the sanitary conditions of the laboring population’ by Edwin Chadwick in 1842 (Victorian Web, 2002). This report argued strongly for the government to act. Chadwick believed the disease was caused by the miasma theory (air pollution) formed from filthy living conditions, which led to a shortened life expectancy for people who lived in industrialised towns and cities. The report recommended that towns and councils should be responsible for cleaning away rubbish, provide clean drinking water, improving sewerage and drainage and also stated that each town should have its own medical officer.
The taxpayer would also be responsible for paying for all of these improvements. William Farr bought another major influence forward in 1837. This legislation was to record every birth, death and marriage by law. Which would help to monitor public health. Great principles held by people such as Joe Chamberlain who was a successful businessman within the industrial world. Chamberlain was elected as a town councilor in 1869. Who then went on to help reform Birmingham by the clearing of the slums and re-designing of the town center. Principles also held by another man, Titus salt who again was a successful businessman, this time in textiles. Who after being elected mayor and then MP helped to build safer and more work friendly factories, three different types of housing options and hospitals and schools. Both of these men had dramatic effects towards reform as they had a voice, which was heard by government.
1e) Assess the view that the public health act of 1848 was a limited response to the need for reform.
The public health act of 1848 was very limited for a few reasons. Firstly it was only set out for 10 years, this alone was going to be a constraint. But more importantly the act only made recommendations. It was not compulsory for towns and cities to abide by. Towns and cities were reluctant to follow it, as the recommendations they proposed were very expensive. Many builders, landlords and companies complained about making the improvements. Only 182 towns set up local boards of health after recommendations to do so and only 13 of the 182 boards built sewerage and waterworks. The act was abolished after the board of health persuaded the government and Chadwick being one of the members was sacked.