Improvements in Public Health www.educationforum.co.uk

Chadwick’s Report 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.

Who was Edwin Chadwick? 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

Chadwick’s Ideas Chadwick's 'Report' challenged the 'laissez- faire' 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 'do- gooder', as some people thought he believed that a healthier population would be able to work harder and would cost less to support.

What changes did Chadwick bring about? 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

Public Health Act 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.

What was the long term importance of Chadwick? 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  

Later Public Health Acts 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.

Into the 20th Century 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.