3.1 Public Health Flashcards

1
Q

How did the population change between the 1700s and 1800s in England.

How else was the population changing?

A

In 1781 there was a population of 13 million which became a population of 31 million in 1871.
By 1939 it was 39 million.

As the industrial revolution opened up jobs in factories and mills people MOVED to towns to work in these jobs.

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2
Q

What were the 3 responsible factors for the increasing population between 1811 and 1841?

What was the impact of this?

A
  • The death rate fell
  • Birth rate rose
  • Marriage rate rose

This population increase meant there were larger crowds and an influx of people with inadequate public health and housing arrangements.

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3
Q

Why did the death rate fall?

A
  • The smallpox vaccine prevented many deaths from happening
  • Growth in agricultural industry provided a better quality and quantity of food.
  • The invention of soap allowed people to be more hygienic.
  • The growth of the textile industry provided materials like cotton cloth that could be easily washed.
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4
Q

Why did the birth rate rise?

A

-As the death rate fell more people got to 20s and 30s and had children. These children too went on to have children.

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5
Q

Why did the marriage rate rise?

A
  • In rural areas farmers employed fewer live-in servants so it was easier for agricultural workers to marry.
  • Industrialisation meant that unskilled workers were taking the employment of skilled craftsmen which meant they could marry as they had a job.
  • As there was no contraception it meant more babies.
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6
Q

What were the two impacts on living conditions of the industrial revolution?

A
  • Housing

- Sanitation

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7
Q

How did the industrial revolution impact housing?

A
  • bad housing was not only a product of the industrial revolution as there had been bad housing through medieval London.
  • Agricultural labourers lived in conditions no better than the animals they looked after.
  • DWELLINGS AND ATTICS- industrial revolution led to widespread overcrowding. Vacant space was adapted and new dwellings were built. People lived in attics.
  • PROXIMITY OF RICH AND POOR- middle class moved out of smut-laden pall that covered cities.
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8
Q

What was the new housing that followed the industrial revolution?

A

-Houses were fast growing but poorly built. With floors being bare boards over beaten earth.

  • Rows of industrial cottages were common in the north.
  • Back to back houses in Lancashire
  • Enclosed courtyards in Birmingham
  • Vast tenements in Glasgow.
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9
Q

What were the two aspects of sanitation?

A
  • Lavatories

- Water

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10
Q

What were the lavatories?

A
  • Lavatories were built outside courtyards and emptied out by night soil men. Who sold it on.
  • Some houses had own privies where contents were covered with Ash.
  • Middle-class had flushing privies but these flushed into nearby cesspits, that had to be emptied.
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11
Q

What was water like during industrial revolution?

A
  • Supply of water was expensive and controlled by vested interest water companies.
  • Middle-class had water piped to houses and because the supply was uncertain they stored it in large cisterns.
  • In poorer areas people queued with buckets to buy water.
  • If they could not afford they took water from streams
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12
Q

Why was life expectancy low in the first half of the 19th century

A

-Overcrowding spread by lice, which spread typhus fever. Typhus epidemics in 1837 and 1839.
Outbreak in 1847 killed 100,000 people in north west England.

  • Influenza, Scarlett fever and tuberculosis were endemic.
  • Typhoid and diarrhoea were common.

-Cholera hit Britain in 4 epidemics.
The first 1831-1832 killed 31,000 and the second in 1848-1849 killed 62,000

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13
Q

What were the two main theories of disease in the 19th century?

A
  • Miasma theory

- Germ theory

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14
Q

What was the miasma theory of disease?

A
  • You could get ill from breathing in bad air
  • This poisonous gas got you ill as it carried disease.
  • This was a popular belief for public health officials as the most foul smelling areas had the highest death rate.
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15
Q

What was the germ theory of disease?

A
  • Scientists became interested in decaying matter and the organisms that lived on it.
  • When Joseph Lister invented microscope. 1000x
  • 1867 Louis Pasteur invented germ theory when he realised specific organism was producing disease in silkworms.
  • 1880 Robert Koch proved this
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16
Q

Why was cholera a unique epidemic and when was it?

A

1832.

Could strike quickly and had 40-60% fatality.

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17
Q

What were the cholera phobia riots?

A

-30 cholera phobia riots in cities around Britain for example Birmingham, Bristol, Exeter.

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18
Q

What were the worst cholera phobia riots?

How did it end?

A
  • The Liverpool riots between 29th May and 8th June 1832. 8 major riots.
  • The riots were not against the disease but because belief that cholera victims were being taken for dissection.

-This belief was held because;
1826, 33 bodies were found at Liverpool docks.
1828 William Gill was found guilty of grave robbing system.

Ended due to the plea of local catholic clergy and doctor James collins.

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19
Q

What happened in Exeter?

A

-Exeter authorities instituted regulations for the disposal of cholera infected corpses and their clothing and bedding. People rioted and attacked gravediggers.

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20
Q

How did the government react to cholera?

A

-1831 They sent two medical commissioners to ST Petersburg in Russia to assess the outbreak. Their report and the alarm of government officials meant that a temporary board of health was created.

This board of health was a London based organisation to collate information and give advice on the Cholera epidemic.

21
Q

What was the board of health and what did it suggest?

A

The board of health encouraged local governments to set up their own boards of health to deal with problems at a grass roots level.

-They often had one or more magistrates, clergymen, householders and one or more medical men.

Local boards of health appointed district inspectors to comment on food, clothing and bedding of the poor.

The local boards of health also issued advice like:

HOUSES WERE TO BE WHITEWASHED AND LIMED AND FURNITURE TO BE FUMIGATED.

STRICT QUARENTINE WAS IN PLACE.

FOOD AND FLANNEL CLOTHING WAS GIVEN TO THE POOR.

TEMPORARY FEVER HOSPITALS WERE SET UP.

22
Q

What were the successes of local boards of health

A
  • Inspectors submitted reports to local boards
  • It was the first time that the government officially recognised that cleanliness was important for public health, adequate clothing and food.
  • In 1832 temporary cholera acts were passed to allow local authorities to enforce some measures and finance them from the poor rate.
23
Q

What were the failures of local boards of health

A
  • Legality became a problem as what right did boards have
  • Local boards were temporary.
  • However, inspectors reports were mostly info gathering
  • As there was limited knowledge about the causes of Cholera it suggested remedies like castor oil, mustard plasters, bleeding by leeches and warm baths.
  • Set up quarantine and hospitals without real knowledge
24
Q

What were the 5 different considered cures for cholera?

A
  • CONTAGIONIST THEORY- The contagionist theory suggests that Cholera was spread by contact with other cholera victims. Therefore, houses and streets had to be put into quarantine. This was met with opposition that it would decrease trade.
  • MIASMIC THEORY- The miasma theory suggested that cholera was spread by “miasmic filth”. Therefore, getting rid of heaps of excrement would be a positive change
  • OINTMENTS In 1831 the lancet, a journal made by doctors for doctors highlighted that a group of Jews from Wiesniz had kept themselves cholera free by rubbing in an ointment of wine and vinegar.
  • PATENT MEDICINES- Patent medicines grew in number and multiplied. The most popular was Moxon’s effervescent universal mixture. Because many survived they grew a following.
  • PRAYER- Prayer- the Church argued that Cholera was a punishment for morally laxed behaviour so repent and all would be well.
25
Q

What were the different reports on the states of towns ?

A
  • 1832 The moral and physical conditions of the working classes of Manchester. (James Kay)
  • 1842 Report on the sanitary conditions (Chadwick)
  • 1844 Report of the Royal commission into large towns and populous districts.
  • 1845 Report of the Bradford Woolcombers Sanitary committee
26
Q

What was the report of 1832?

A

Was secretary to the board of Health.Kay personally visited each district (14) to investigate the conditions there.
-Kay’s report was one of the first on a specific group of working people.
He was one of the first to make a connection between dirt and disease.
He also assessed the moral condition of the poor as he suggested that ‘dirty habits’ led to dirty living.
His report was important as it set the scene for later on.

27
Q

When was the public health act?

Who was involved?

A
  • 1848

- Three original members of the board were Lord Morpeth, Lord Shaftesbury and Edwin Chadwick.

28
Q
  • Who was permitted to have local boards of health?

- What did local boards of health do?

A

-Local authorities were empowered to set up local boards
of health. These could be set up where:

  • Ten percent of the ratepayers asked for one
  • The death rate was greater than 23 per 1,000
  • Local boards of health were permitted to appoint a medical officer of health and pay his wages out of the rates.
  • Local boards of health were permitted to appoint a medical officer of health and pay his wages out of the rates.
  • Local boards of health were to manage sewers and drains, wells and slaughterhouses, refuse and sewerage systems.
  • Local boards of health could finance projects by levying local rates and buying land.
29
Q

What was particular about the public health act?

What did these mean in the positive and negative aspect?

A

-The act was permissive.

-POSITIVE:
because it was applied were local people wanted and there was little or no opposition to it.
Eg Sunderland used it
1850- 192 towns asked for public health regulations to be applied.

-NEGATIVES
act was permissive
-Whilst local boards had considerable powers, they were not required to take on wider public health consideration like parks and baths.

30
Q

What criteria could be used for success of public health?

What could be conclusion?

A
  • If it is implemented nationwide
  • if it faces opposition
  • If it changes attitudes to public health

Overall a failure.

31
Q

Why was there continued opposition to 1850s and 1860s public health reform?

A
  • Improvement schemes cost money and property owners loathed to pay out again via taxes for the same facilities.
  • Many people felt that the government was encroaching on their perosnal liberities telling them to remove cesspits.
  • Vested interests, directors of water companies were on local govenrment boards
  • Civil engineering problems caused delay and were not understood by lay people.
  • chadwick himself was seen as a bully.
32
Q

What were the two acts that happened together and what did they do?

A

-The local government act 1858 and the public health act 1858.

  • the general board of health was abolished
  • The powers of the general board of health was given to a new government office
  • A medical department of the privy council was set up
33
Q

When was the sanitary act passed and what did it do?

A

-1866 Sanitary Act.

John Simon was a key mover and became first medical officer of London in 1848. As a consequence of his 1865 annual report the government passed the 1866 sanitary act.

  • Sanitary powers that had been granted to individual local boards of health were made available to all local boards.
  • Local authorities were made to remove ‘nusiances to public health’. If they failed to act central government could do the work and charge the authorities.
  • Local authorities were given power to improve or demolish slum dwellings.
34
Q

What was the major success of the 1866 sanitary act?

A

-The state could now compel local authorities to act.

35
Q

What was the 1875 Public Health Act?

What was specific about it?

A

-it codified and consolidated previous laws.

  • Every part of the country had to have a public health authority.
  • Every public health authority had to have at least one medical officer and one sanitary inspector
  • Local authorities were given wide powers to lay sewers and drains, build reservoirs.

-it was the turning point in the regulation of house building in british cities.

36
Q

What was the 1936 public health act?

A

-Consolidated previous legislation.
Addressed matters such as sanitation, nuisances and offensive trades, prevention and notification of diseases.

-Extended the food and drugs act 1938 and control of slaughterhouses was added to the list of priorities .

37
Q

What were the main acts passed by the government in the 19th 20th century?

A
  • 1848 public health act
  • 1858 public health act
  • 1866 Sanitary Act
  • 1875 public health act
  • 1936 public health act.
38
Q

In what ways did attitudes to public health change and what did this come under?

A
  • RAISING SOCIAL CONCERN:
  • Novelists,
  • National and local newspapers
  • Artists created paintings
  • Doctors keeping records
  • ECONOMIC IMPERATIVES
  • the cost of public health reform could be calculated against the cost of losing a productive worker
  • The cost of poor relief was increasing and thus reducing the poor rate could see a benefit in quality of drains.
  • A major consideration was not only to be the cost but which sections of society were to pay.
39
Q

How did novelists raise social concerns about public health?

A

CHARLES DICKENS
wrote about his experiences in London
-His novels were serialised which meant they were more accessible

GASKELL

  • Gaskell although not poor herself witnessed poverty in Manchester she wrote vivid pen pictures about housing conditions.
  • In 1848, she wrote movingly about conditions in her novel Mary Barton.

-Arnold Bennet the road to wigan pier, documented the bleak living conditions.

40
Q

How did local and national newspapers raise social concerns about public health?

A

-National and local newspapers reported on public health matters.

  • Local outbreaks of Scarlett fever and typhoid, were reported in local newspapers like the leeds mecury.
  • The times, headed a campaign for local sewerage in 1858.
41
Q

How did artists raise social concerns about public health?

A
  • Sir Luke Fildes was an artist.
  • They were hung up on middle class walls for sentimental value.
  • The rural poor were presented as Romantic Idylls and those on urban poor were more disturbing.
42
Q

How did doctors raise social concerns about public health?

A

-Doctors, parishes and county councils improved record keeping. This enabled production of statistical evidence to illustrate, the connection between population density and disease.

43
Q

What were the economic imperatives that raised concerns about public health?

A
  • The cost of public health reforms could be calculated against losing a productive worker in the workforce.
  • The cost of the nation of the poor law was escalating. When local officials set this against the cost of public health reform.
  • There was debates about who should pay for reforms, it was argued that a reduction in the poor rate as a result of providing good drains and clean water.
  • There was debate on who should pay for public health reform and it was argued that local authorities should step in to take responsibility.
44
Q

Between social and economic what was the biggest imperative?

A

-Economic imperative was central to changing public health. As the economic benefit derived from a workforce was stronger than any benefit.

45
Q

What aspects of technological advance impacted on drainage and water supplies?

A
  • Flushing toilets
  • Water supply
  • Flushing toilets.
46
Q

How did flushing toilets advance?

A

-1775 Alexander Cummings came up with the S trap that prevented foul air from coming from the sewer.

-The growing demand for toilets allowed George Jennings to start up a business manufacturing toilets.
(In 1861 he had 97 men and 18 boys working for him).
-1852 he was granted the patent

-In 1875 William Twyford developed the first wash out water closet. Throughout 1880s he was given further patents. In 1888 he applied for patent that pan was filled up with small amount of water.

47
Q
  1. How did sewerage advance?
  2. What were the major problems?
  3. What was the major break through?
A

1.-In 1842 John Roe came up with the idea of using cast iron gates that would open up when there was enough water to clear the deposits. However, this was only effective when combined with water pumps.

  1. -However, it was only until 1870 and 1880 that these were combined with hydraulic pumps.
    - An effective sewer system needed millions of bricks and cement, + transport infrastructure.
  2. In 1912 Manchester university revealed the break through that the sewage had to be biologically treated.
48
Q
  • How did water supply progress?

- What was the overall limitation with water supply?

A
  • 1802 Lambeth waterworks expanded its operation to supply kennington and replaced wooden pipes with cast iron ones.
  • 1822 Southwark water company extracted water from the river thames using steam engines.
  • In 1829, chelsea waterworks company became the first to introduce a filtration system.
  • In 1838, Grand Junction built a pumping station near kew bridge.
  • A major concern is that firms were extracting water which was contaminated with faeces and dirt.