3.2 Public health Flashcards
How did the First World War impact on housing improvements?
- During the FWW house building stopped and regulation was minimal.
- After the war Prime Minister Lloyd George promised the removal of slums.
- 1919 Parliament passed a housing act whereby government subsidies were given to local councils and private builders to make more affordable housing.
What changes were made to housing in 1920s-1930s
- Government offered councils a special slum clearance subsidy to encourage councils to pull down slums and rehouse their inhabitants at rents they could afford.
- 1933 councils were made to prepare for five year programmes of the abolition of slums.
Despite these initiatives, almost two thirds of all houses built in the interwar years were sold to owner occupiers.
Which 5 individuals were responsible for making improvements to housing and what did they do?
-GEORGE PEABODY- he was a London-based banker with the objective of providing model dwellings for the London poor.
The first block of 57 flats opened In Spitalfields in 1864 and contained water closets.
-TITUS SALT- a wealthy factory owner moved his mill from a filthy, polluted environment to the purpose built village of Saltaire.
He first built a new mill and then went on to houses, parks and even a hospital.
-OCTAVIA HILL bought up run down artisan cottages and renovated them by ensuring they were repaired, cleaned decorated connected to sewers and provided with clean water.
However, she only did this because of self help philosophy.
- EBENEZER HOWARD Wrote “To-Morrow” in which he developed the theory that people should live in harmony with nature in towns. This started the garden city movement that supported the building of Letchworth.
- WILLIAM LEVER found a new site for his soap making business and alongside had a model village built for his workers. Between 1899 and 1914 800 houses were built at the Wirral together with Allotments and schools.
In your opinion which of these 5 individuals was the most successful?
Titus Salt and William Lever were the most successful in my opinion as they made an effort to improve the conditions of their workers. This would have improved their public health and set a precedent for other factory workers.
How had housing changed from the 19th century to the 20th century. (Who was the most responsible?)
Housing and living conditions in the 19th Century were poor and they started to improve in the 20th century.
There were acts passed with the intention of decreasing the level of overcrowding.
Nuisances removal act 1855 empowered local authorities to combat overcrowding.
The sanitary Act 1866 placed limits on the occupation of cellars for living, with fines and prosecution,
Consequently, the improvement in housing in the 19th Century would have been a byproduct of these measures that worked to combat overcrowding.
How far do you agree that what is expressed in extracts 10-11 that housing improvements were made to restore.
I agree with the view overall but I think it was to restore self reliance to a greater extent as the improvements were mainly targeted at improving the independence of the working class.
What was life like in Britain’s sanatoria?
Stannington Sanatorium in Northumberland was the first purpose-built children’s TB sanatorium in the country and over the decades treated some 11,000 youngsters.
Opening in 1907, it was a place for malnourished children to get fresh air, exercise and good nutrition, with many of those admitted to the institution coming from impoverished backgrounds.
How successful were the provisions?
A lot of the surgical procedures at the sanatorium sound “very drastic” from a modern perspective, but they were a common approach in the pre-antibiotic era.
Patient records and thousands of radiographic plates dating from 1937-1952 were given to Northumberland Archives when the sanatorium closed.
In 2013, archivists were awarded £77,717 from the medical charity Wellcome Trust to part digitise these “little-used” records.
Northumberland Archives appealed for help from former patients and staff to research the history of the sanatorium and the treatment of TB before the use of antibiotics.
Ms Rushton said “fascinating stories” emerged from the appeal, which piqued the interest of academics and local historians.
What are 5 facts about John Simon?
- John Simon was appointed Senior Assistant Surgeon at King’s College in 1840
- As Parliament passed the Public Health Act in 1848.The City of London had to appoint a medical officer. As the pay was low they allowed John Simon to continue private practice. Simon applied for this position, as did 20 others.
- Simon was appointed to the position on October 19, 1848.
- Simon used his diplomatic, political and writing skills to improve the sanitation of London.
- Simons’ first annual report in 1849 called for municipal action to:
- eradicate slums
- build model dwellings for the poor
- provide public wash-houses
- take control of the water supply
- suppress offensive trades
- provide a municipal cemetery complete the drainage system, and establish a permanent sanitary inspector.
-After Snow’s “Grand Experiment” of 1854, Simon conducted his own research on cholera and published his findings in a 1856 report. The Simon study addressed the cholera epidemics of 1848-9 and 1853-4 and extended to half a million people living south of the River Thames who got their drinking water from either the Southwark and Vauxhall Company or Lambeth Company.
What are 5 facts about DR William Henry Duncan?
- Duncan started practicing medicine in Liverpool, also serving as a physician at the Central and North dispensaries. He published his analysis of the cholera cases he had attended during the 1832 epidemic.
- Duncan identified the deplorable ‘sanitary state of the labouring classes’ in Liverpool, whose population was rapidly increasing, due to migration from Ireland and elsewhere.
- In 1846 Liverpool became the first city in the world to appoint a Medical Officer of Health when it appointed Dr William Henry Duncan to this position, which he took up on 1st January 1847.
- Duncan was a pioneer in sanitary reform and he faced opposition so he robustly defended his actions and publications against criticism.
- As a result of his work there was a significant reduction in the population living in cellars and other ‘unhealthy dwellings’, and a general improvement in environmental hygiene.
Summarise the importance of medical officers?
-They were highly skilled and diplomatic (many of them had been physicians in their earlier life) therefore they had the expertise to make changes.
-Both had a clear impact on the improvement of health.
Eg Duncan was able to decrease the amount of ‘unhealthy dwellings’.
-However, I view Duncan as more impactful compared to Simon as he Duncan was the first medical officer in the world so he was a pioneer.
Local Government Action.
- Key details
- Successes
- Failures
Unprecedented population growth in the 19th century brought about a slow change to local and central government in public health.
- SUCCESSES- there were many private acts of parliament obtained by local authorities. London was administered that related to public health.
- FAILURES- In 1830s many people started to criticise the corrupt nature of town improvement committees and the town corporations themselves.
Housing
- Key details
- Successes
- Failures
The health of the British public was down to the poor quality housing. However, builders could not build good quality housing for affordable prices.
- SUCCESSES- The Metropolitan Building Act 1844 gave the London authorities similar powers. It required all newly constructed buildings that were 30 feet of a common sewer.
- Individuals like George Peabody and Titus Salt provided housing for the poor.
-Common Lodgings Houses Acts 1851 and 1853 laid down that all lodging houses were to be registered and inspected by the police.
- FAILURES-
- Vested interests fought them through the local courts
- Most measures were primarily concerned with new buildings
-The Artisans’ and Labourers’ Dwellings Improvement Acts were permissive.
Vaccinations
- Key details
- Successes
- Failures
Until the mid 1830s vaccination the cost and anti-vaccination movement caused vaccination levels to be low.
Vaccines were readily available but people were reluctant to use it.
Successes- The permissive Vaccination Act 1853 made it obligatory for parents to have their children vaccinated .
The compulsory Vaccination Act 1853 made it obligatory for parents to have their children vaccinated for small pox within three months of birth. If parents failed to comply they were fined £1 and the money went towards the poor rate.
FAILURES- the emphasis on compulsion resulted in the groundswell opposition and anti-vaccination movement.
They feared government intervention in local affairs
Medical officers of health.
- Key details
- Successes
- Failures
-Most town councils were elected on the promise keeping the rates low.
-Leeds did not appoint a medical officer until 1866, Manchester 1868 and Wolverhampton did not have a full-time.
The public health Act 1875 made the appointment of a medical officer obligatory for all local sanitary authorities.
Successes- medical officers of health had to be professionally qualified. The Local Government Act 1888 laid down that all medical officers of health in districts with a population of over 50,000.
Failures-
The medical officers received a low wage which made it only a supplementary income.
The 1875 legislation was poorly implemented.
Many were chosen as they pledged to keep the expenditure low.
TB and Sanatoria
- Key details
- Successes
- Failures
TB was the biggest killer in the 19th Century. It spread rapidly because of poor housing conditions in industrial cities.
Local officers of health took some immediate action leaflets issuing to prevent spitting.
Successes-Local officers of health could give people advice on how to improve public health.
Central Government ordered the pasteurisation.
Further acts made this widely available.
Sanatoria (places of isolation) were set up by 1930 there were 500.
Failures Antibiotic cures for TB did not come until after the SWW.
Surgery for the effects of TB was still a frequent requirement.
Local medical officers took on the responsibility a lot more than national government (national government only really for children with TB).
Children
- Key details
- Successes
- Failures
The education of (Provision of meals)-This act allowed local authorities to provide free school meals for the children of needy parents.
The education act 1907.
Set up a school medical service run by local authorities.
They were aware of what the medical inspections would reveal.
Children and Young person act 1908.
This act was brought forward after lobbying by the National Society for the prevention of cruelty to children.
Successes
- Established that the state could take on the role of the parents.
- Children were made protected persons and which made it possible to persecute their parents for neglect or cruelty.
- Poor Law authorities were made responsible for visiting and supervising children who had suffered neglect.
- Nursing homes were inspected.
Failures
- Local governments took responsibility rather than local ones.
- It was difficult to impose in some areas.
Define the word initiative:
challenge: examples of initiatives that helped public health.
When there is action to cause or address something.
Pubic health act 1875.
Challenge: which initiative was the most effective?
In my opinion the vaccination initiative was the most effective as pandemics were the greatest killers as they could spread through the population. Consequently, Vaccines would act like blockers to this spread.
Why were the national government more effective?
- Some local governments were run in an oligarchy and corruption.
- In order to get a coordinated response it had to be on national level as as if for example only part of the population was vaccinated this would not benefit the country.
Why were local governments more effective?
- They would take more ownership and responsibility.
- It was difficult to impose things on a national scale so it was therefore easier to focus on the local towns.
- All initiatives started on a local level.
Plan: “Vaccinations were the most successful initiative for public health”
- Judgement, they were the greatest factor.
- Other factors, Local Governments, Housing.
Two criteria- if it benefitted national public health.
If it was a fast solution to public health.
Plan: “Local governments were more successful than national governments”
Judgement- local governments were more effective.
Local governments- took responsibility in public health and were able to give a more tailored response.
Negative for local governments- the work of one town was negligible if the entire country did not do it.
Positive - the national government had better access to funding.
National Government- negative it was slow to be enforced.
