Impetus for Public Health Reform Flashcards
How was industrialisation an impetus for reform?
- Between 1781 and 1871, the population of Britain grew from approx. 13 million to 31 million
- Most rapid period of growth between 1811 - 1841
- Sudden influx caused many people to crowd together in substandard housing with little by way of clean water or adequate sanitation
Impact on people’s living conditions?
- Influx of thousands and thousands of people into small market towns/cathedral cities had the misfortune of having one or more industries located there had been a catastrophic effect on exiting housing/sanitation provision
- Led to the explosion of ‘filthy diseases’ such as Typhoid and Cholera
How was housing an impetus for reform?
- the industrial revolution resulted in widespread, dense overcrowding in cities
- cellars and attics filled with working people and their families, they were also sometimes used as workplaces
- the absence of public transport meant that the poor had to live near their workplaces, creating further overcrowding
How was sanitation an impetus for reform?
- lavatories (privies) were usually outside in courtyards and alleys. The waste emptied into cesspits and were cleaned out, from time to time, by night soil men who sold it on to farms to use as manure.
- private water companies controlled the water supply which they sometimes took from deep, underground, reservoirs but often from the local water. The middle classes had water piped into their houses (and storage containers as the supply was unreliable)
The impact of epidemics on the health of the nation
- people living in overcrowded, unsanitary conditions and without easy access to a supply of clean water housed body lice, spread typhus fever, from which many died
- there were typhus epidemics in 1837 and 1839; an outbreak in 1847 killed 10,000 people in north west England alone
- cholera hit Britain in four massive epidemics: 1831-32, 1848-49, 1853-54 and 1866. The first epidemic killed 31,000 and the second 62,000
Miasma theory of disease as an impetus for reform
- prevalent medical theory in the 19th century that proposed that diseases, particularly infectious ones, were caused by “miasmas,” or noxious forms of “bad air”
- Miasmas were believed to come from decomposing organic matter, such as rotting vegetation, stagnant water, or decomposing bodies. These miasmas were thought to poison the air and cause diseases.
Germ theory as an impetus for public health
- Pasteur; conducted a series of experiments proving that microorganisms existed in the air and were not created by decaying material
- Discovered that a disease in silkworm was caused by different microorganisms - made the link that different microorganisms could cause diseases in people
Who built upon the theory of microorganisms and how?
Koch
Built upon the work of Pasteur and in the 1880’s/90’s he and his team identified the germs that caused most killer diseases in the 19th century
Cholera epidemic as an impetus for reform
- the cholera epidemics led to a high level of fatalities, 40-60% among those contracting the disease. Between 1831 and 1867 cholera was responsible for 128,000 deaths
- cholera symptoms were severe, including: explosive diarrhoea, vomiting, dehydration
Impact of Cholera on the population
- the fear of the disease led to 30 recorded cholera-phobia riots in towns and cities throughout Britain
The government reaction to the cholera outbreak
- a Board of Health was set up in 1831 in reaction to the spread of cholera. A Board of Health advised local government areas to set up their own Boards of Health
- district inspectors reported on the food, clothing and bedding of the poor, the ventilation and cleanliness of their dwellings, the number of people per room and the behaviour of the inhabitants
- The Board of Health issued advice such as fumigating infected furniture and clothing, people with cholera to be put into quarantine and the setting up of temporary fever hospitals.
The moral and physical condition of the working classes of Manchester,
Key information
1832
- a board of health was set up after cholera hit Manchester on 17 May 1832, and James Kay was the secretary
- State of the streets had a significant impact on the health of those living there
- Diseases often appeared in unventilated, cramped housing
The moral and physical condition of the working classes of Manchester, 1832 - impact
- One of the first detailed reports on the condition of a specific group of working people
- one pf the first to demonstrate the connection between dirt and disease and how it impacted public health of working people
Sanitary condition of the labouring population
1842
- More people died from filth and poor ventilation compared to wounds from any war which the country had been engaged in modern times
- Connection between damp/dirty living conditions and the rate of disease (more frequent)
- likelihood of diseases amongst labouring classes increased due to atmospheric impurities produced by decomposing animals
Recommendations and impact of Chadwick’s report
- Better living, drainage, proper cleansing better ventilation - means of diminishing atmospheric impurities, lessens frequency of disease
- Attacked inadequacy of existing water supplies - blamed vested interested for preventing improvement in public health
