part 3: improvements in public health

Question 1

public health problems in industrial britain

Answer 1

• urban populations grew rapidly but public health systems in place weren’t sufficient to support them
• public health conditions were poor which contributed to spread of diseases e.g cholera and typhoid
• filth, dirt, smog, crowded

Question 2

industrialisation

Answer 2

• from 1750 people moved from rural to urban due to industrial rev
• goods were made in factories powered by steam instead of homes
• so people needed to move to where there was work
• led to towns and cities growing quickly in size
• 1801 london pop: 1 million, over 5 million by 1901

Question 3

housing and sanitation

Answer 3

• factory owners built cheap houses for workers
• back to back terraced housing common, with families living in a single room
• lack of clean running water, proper sanitation and sewage systems
• toilets shared between several houses
• water came from pumps in street with water supplied from heavily polluted rivers
• cracked pipes lead to contamination of the water with human waste from cesspits
• outbreak of disease would rapidly spread due to overcrowding and poor sanitation

Question 4

air pollution

Answer 4

• huge amounts of coal burned to power new factories
• caused air pollution
• significance damage to health as thick smog hung over towns and cities where they lived
• caused breathing difficulties and led to deaths as it damaged lungs

Question 5

disease

Answer 5

• overcrowding and lack of an effective public health system led to outbreak and spread of diseases
• cholera: first arrived in 1831 and killed 50,000
• typhoid: spread by contaminated foot or water, caused high temp and fatigue, could be fatal

Question 6

edwin chadwick work

Answer 6

• lawyer who wanted to reform the conditions the poor lived in
• researched into living conditions in different parts of country
• published research in 1842: ‘report on the sanitary conditions of the labouring population’
• said poor live in dirty, overcrowded conditions which increased illness

Question 7

edwin chadwick gov

Answer 7

• wanted gov to take actions
• said they should ensure a clean water supply for everyone and invest in proper sanitation systems
• forced to pass 1848 public health act

Question 8

laissez-faire

Answer 8

• do nothing, gov believed public health wasn’t their problem and didn’t want to interfere in individuals lives
• led to optional measures in 1848 act

Question 9

1848 public health act

Answer 9

• set up a national board of health to oversee improvement of public health
• meant local authorities could set up a local board of health to oversee public health, if mortality rate higher than 23 per 1000 they had to
• local board could then raise taxes to pay for clean water supplies and new sewers
• act limited as little funding and local boards usually not compulsory
• but important first step in gov taking action to improve public health
• shut down in 1854, partly because chadwick was quite arrogant and argumentative so lack support and councils refused to implement his ideas

Question 10

cholera

Answer 10

• spread by contaminated water or food
• caused diarrhoea and vomiting
• lead to severe dehydration and death
• epidemics in 1831, 1848, 1854 and 1866

Question 11

john snow

Answer 11

• physician who worked in london during cholera outbreak in 1854
• didn’t believe miasma theory was responsible for outbreak

Question 12

john snow’s investigation

Answer 12

• focused on cholera cases in soho
• plotted all places where people had died from cholera (700 in 10 days)
• from map he worked out they had all drunk water from same pump on broad street
• believe the water was contaminated by sewage leaking into water from a nearby cesspit
• persuaded council to remove handle from pump so it couldn’t be used
• cases stopped

Question 13

significance of snow

Answer 13

• proved cholera was a waterborne disease
• important step in disproving miasma theory
• however he couldn’t explain that there were germs in water that caused illness
• so many continued to believe cholera was caused by miasma
• germ theory provided evidence to support his work
• then led to further public health reforms
• action was taken to provide people across the country with a clean water supply
• first to explicitly tie cholera to
  dirty water, reducing deaths by informing others of the importance of sanitation and a clean water supply

Question 14

1854 outbreak

Answer 14

• in just 10 cholera outbreaks, over 700 died

Question 15

the great stink

Answer 15

• summer of 1858 was warm and dry
• consequently the water level of thames dropped
• meant the sewage and waste that were being dumped in the river were no longer being quickly washed away
• resulting smell was awful, so bad parliament was closed
• miasma theory still widely believed so people cleaned walls of their homes with lime chloride to take away smell

Question 16

consequence of great stink

Answer 16

• gov invested in the construction of a new sewerage system for london
• also resulted in end of significant cholera outbreaks

Question 17

joseph bazalgette

Answer 17

• created underground complex sewer system
• built 82 miles of intercepting sewers parallel to thames and 1100 miles of street sewers
• cost £4.2 million
• used 318 mil bricks and dug up 2.5mil m^3 earth
• originally built to serve 2.5 mil people but serving 4 mil by finish

Question 18

death of laissez-faire

Answer 18

• working men given the vote in 1867
• political parties realised that if they promised to improve conditions in towns the working class living there would vote for them
• conservatives won 1874 election largely due to working class
• soon after gov introduced many new public health reforms

Question 19

evidence for reform

Answer 19

• john snow’s work and pasteur’s germ theory was conclusive proof that cleaning up towns and cities would improve health of people who lived in them
• now clear evidence that if public health systems were improved lives would be saved
• marked a move away from laissez-faire attitude

Question 20

1875 public health act

Answer 20

• said local authorities had to appoint a medical officer in charge of public health
• authorities ordered to cover sewers, keep them in good condition, supply fresh water, collect water and build sewerage systems

Question 21

further reforms

Answer 21

• 1875 sale of food and drugs act: local sanitary inspectors appointed to look after slaughter houses and prevent contaminated food from being sold, tightened laws around food labelling
• 1875 artisans and labourers dwellings improvement act: brought in new standards for housing quality
• 1876 rivers pollution prevention act: aimed to clean up rivers and water supply

Question 22

public health timeline

Answer 22

• 1831: first outbreak of cholera in england
• 1842: chadwick’s report is published
• 1848: public health act
• 1854: snow proves cholera is a waterborne disease
• 1858: great stink prompts gov to invest in bazalgette’s sewers
• 1861: pasteur published germ theory
• 1875: public health act

Question 23

impact of gov action

Answer 23

• 1878 Act implemented all of these measures but was
  compulsory
• important, as it gave the gov responsibility for overall public
  health
• involving a sewage system and measures to ensure cholera never returned to Britain again, improving overall quality of life and public health