3.3.1

Public Health & Cholera

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Public Health Problems in Industrial Britain

The Industrial Revolution happened in Britain between 1760 and 1840. It saw lots of people move to cities and begin to work in manufacturing industries (instead of agriculture).

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Urbanisation

  • Lots of people moved to cities because that is where most manufacturing jobs were located.
  • Thousands of people migrated from the countryside to cities such as London, Birmingham and Manchester.
    • For the first time, more people lived in British cities than the countryside.
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Living conditions in cities

  • Most people living in cities lived in terrible living conditions.
  • Workers lived in very small houses, houses were very close together and sometimes families lived in one small room.
  • Workers received very low wages and they often lived in poverty.
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Water and sewage

  • Private toilets were rare, most families used toilets outside the house which were shared with others. Sewage would fall into a cesspit, which was often washed away by rain or thrown in rivers.
  • Water came from local rivers, which is where sewage from cesspits often went. This was sometimes a worse situation than Ancient Rome (with its aqueducts).
  • The streets were also dirty with wastage and sewage.
  • People’s health may have been worse than any other time in history.
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Disease

  • Because of these poor conditions and overcrowding, disease was very common. Some of the worst diseases were typhoid, tuberculosis and cholera.
  • Typhoid was caused by contaminated food or water, it was spread through unhygienic conditions.
  • Tuberculosis was caused by germs spread by sneezing or coughing, it was spread through overcrowded areas.
  • Cholera was caused by contaminated water or food.
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Government

  • Local councils were usually responsible for these health problems.
  • Some people thought government should intervene but often they did not (laissez-faire approach).
  • Local taxpayers made decisions and many of these did not want to pay more money to improve health conditions (for others) in their town.

Cholera Epidemics

Cholera is a disease transmitted through water. At the time, people thought that it was produced by rubbish and human waste and was spread through the air (miasma). Streets were cleaned but water was often not clean.

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Cholera epidemics

  • Cholera epidemics affected Britain every few years between 1831 and 1866.
  • Symptoms of cholera included vomiting and having painful diarrhoea.
  • Although governments were concerned about cholera epidemics they did not know what caused cholera and, therefore, how to prevent it.
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Edwin Chadwick - report

  • After the cholera epidemics, Edwin Chadwick wrote a report on living conditions for the working classes in 1842. It was called the “Report on the Sanitary Conditions of the Labouring Population”.
  • Chadwick thought that bad health was being caused by people’s awful living conditions.
  • He thought that the disease was being caused by bad air and damp.
  • People were shocked by how bad living conditions were for the poor.
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Edwin Chadwick - recommendations

  • Chadwick suggested that laws should improve drainage and sewer systems.
  • He thought medical officers should be appointed to improve the situation for the poor.
  • Although the explanation for disease was incorrect, Chadwick recognised the need to improve public hygiene, particularly the need for clean water and streets.
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Policy change?

  • Chadwick stressed that improving public health (by raising taxes) would benefit Britain as the workforce would work harder and make more goods.
  • The government’s ‘laissez-faire’ policy meant they did not take action following Chadwick’s report. They believed that the government should not interfere in the poor’s lives.
  • Some towns like Manchester and Liverpool did improve their sewage and water systems.
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1848 Public Health Act

  • In 1848, Parliament passed an act that set up a Board of Health to encourage local councils to improve conditions.
    • But not many authorities did much. In 1872, there were only 50 Medical Officers of Health appointed.
  • It did not have a huge impact and it was not compulsory.

Cholera and the Work of Dr. John Snow

Dr John Snow (born in 1813) was a physician who examined the link between cholera and contaminated water after an outbreak of cholera in London in 1854.

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Medical statistics

  • William Farr collected medical statistics that recorded how people died.
  • Dr Snow used Farr’s statistics to see whether there was a link between water contaminated with sewage and deaths from cholera.
  • His statistics showed that deaths from Cholera seemed to be linked to specific water sources.
  • These statistics were very important to prove Dr Snow’s hypothesis.

Jump to other topics

1Medicine Stands Still

2The Beginnings of Change

3A Revolution in Medicine

4Modern Medicine

5Themes in Public Health

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