Recent Advances in Public Health Flashcards
Which towns had the best public health standard - Roman, Medieval or Renaissance?
Roman.
What happened to public health standards in towns when the Industrial revolution started?
They got worse.
When was the Industrial Revolution?
About 1750.
What were medieval towns like?
Not densely packed like now - gardens for growing vegetables, keeping pigs and chickens, and orchards.
How did the Industrial Revolution change towns?
More people moved to the towns, so the spaces were filled up with factories, or cheap housing.
What governmental controls were there on building?
None - a policy of “laissez-faire”.
What was the system for providing fresh water, or removing sewage?
Inadequate - sewage went into the river, or cesspits, or into the street. Smoke went into the street. Fresh water could be contaminated.
What diseases were common in towns?
Smallpox, influenza (flu), typhus, typhoid fever.
Where did cholera come from?
Introduced from the east in 1831.
When was the cholera epidemic?
1832
How does cholera spread?
Infected sewage getting into drinking water.
How does cholera kill?
Diarrhoea that causes dehydration and loss of minerals.
What class of person caught cholera?
All, rich and poor.
What did the government do?
Started to introduce regulations about burial of the dead,
but the epidemic declined so interest was lost.
What epidemics of cholera were there?
1832, 1848, 1853-54, 1866.
What was Chadwick’s report?
“Report on the Sanitary Conditions of the Labouring Population of Great Britain”.
When did Chadwick publish “Report on the Sanitary Conditions of the Labouring Population of Great Britain”?
1842
What was Chadwick’s idea?
Improved public health, and a healthy workforce, would save money.
What was the effect of Chadwick’s report?
Some people in the privileged classes were shocked at the sickness and mortality statistics. They campaigned for improvement, in 1844 the “Health of Towns Association” was set up.
How did the government respond to the Health of Towns Association?
It introduced a public health bill. It was opposed, then passed (1848) when another cholera epidemic broke out
What was the main provision of the Public Health Act 1848?
Central and Local Health boards were set up. Local boards had to be approved by ratepayers. Central board was dismantled in 1854.
Who linked cholera to contaminated water?
Snow (1853-54), in London
How did Snow work out how cholera and water were linked?
He looked at a map, and realised that all those affected by cholera used one pump. He removed the handle and stopped the outbreak.
When did “The great stink” hit London?
1858
Why did the great stink happen?
London’s human waste was collected in cesspits; expensive to empty, they would overflow; flush toilets increased the volume of **, so more overflowed; summer of 1858 was very hot, so water level of the Thames dropped; bacteria grew in the waste, producing gases.
What was the effect of the great stink on government?
The houses of Parliament are right next to the river, so parliament stopped meeting.
What ended the great stink?
Heavy rain.
What was the governments response to the great stink?
They acted to improve the sewerage system, more quickly than planned.
What was London’s new sewage system like?
It transported sewage to the Thames estuary, away from houses; design copied over Western Europe; 1300 miles of sewer.
Who designed London’s sewage system?
Bazalgette.
When was London’s sewer system officially opened?
1865.
What discovery proved John Snow correct in his theory about the spread of cholera?
Louis Pasteur’s germ theory.
What happened to the policy of “laissez-faire” in the matter of public health?
It was felt that the government had to take more action, so in 1871 and 1872 they formed the Local Government Board and divided the country into “sanitary areas” administered by medical officers.
What act allowed for compulsory purchase of slum dwellings, and rebuilding by the council?
Artisan’s Dwellings Act
Who co-founded the National Trust, and why?
Octavia Hill, she felt people needed access to green spaces.
What was the impact of Victorian engineering on public health?
Brick lined sewer system - no sewage leaked out. Steam driven pumping systems - can pump water from further away.
What was the 1867 Reform Act?
It gave 1 million more men the vote. Mostly working class men, often living in poor conditions.
What did the new voters of the 1867 Reform Act do?
They put pressure on the government and local councils to listen to public concerns about health.
What did the 1875 Sale of Food and Drugs act do?
It stopped the sale of certain drugs, and banned the sale of food that contained harmful ingredients.
What was the act that stopped the dumping of sewage or industrial waste into the rivers?
The River Pollution Prevention Act 1876
Where were the poorest people housed at the beginning of the 20th century?
Tenements. Damp, no running water, no proper sewage. Families had one room, and shared toilets with other families.
What is a slum?
An overcrowded area inhabited mainly by poor people, with poor facilities/housing standards.
Why was/is poverty a health problem?
Unable to afford doctors or medicine; working long hours; poor housing; struggling to afford food; unable to heat house
What is a patent medicine?
A medicine available without prescription, made to a recipe that only the patent holder may use. Usually ineffective, can be harmful.
Why would the poor use patent medicines?
Unable to pay for doctor; patent medicine cheaper.
What was the infant death rate at the beginning of the 20th century?
140 per 1000 births. Now down to less than 5.
What happened to people who could not work, in the absence of a benefits system?
The workhouse. (Oliver Twist is set in one).
What benefit would there be to going to the workhouse?
Medical care; food; shelter.
What effect did war have on the health of the poor?
Boer War 1899: 40% of volunteers unfit for military service, mainly poverty related illness. Similar for WW1. Britain went back to the Roman idea of needing a healthy population for a healthy army.
Who wrote ‘Life and Labour of the People’?
Charles Booth
When did Charles Booth write ‘Life and Labour of the People’?
1889
What did ‘Life and Labour of the People’ state?
30% of people in London in severe poverty. Sometimes impossible to work. Wages for some jobs so low that could not support a family.
Who was Seebohm Rowntree?
A factory owner in York (sweets).
What did Seebohm Rowntree do because he believed that the conditions in York were better than London?
He did a survey - “Poverty, a Study of Town Life”.
When was Seebohm Rowntree’s survey published?
1901
What did Seebohm Rowntree’s survey show?
28% of people were too poor to afford basic housing and food.
Who did Seebohm’s survey influence?
David Lloyd George. (Politician, important in welfare state creation)
