The Rise of Public Health in England and Wales

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Overview

The Rise of Public Health in England and Wales, 1805–1900

This collection curates selections from the British National Archives, making previously rarely accessed records accessible to online researchers. The nineteenth century is a particularly noteworthy era given industrialization, urbanization, and the appearance of public health as a concept. Crises such as the arrival of cholera in Britain in 1831 tested the government's ability to respond to public health concerns.

Public health, as the World Health Organization defines it, encompasses “organized measures (whether public or private) to prevent disease, promote health, and prolong life among the population as a whole,” with public health campaigns targeting wide-ranging issues such as family planning, nutrition, safe drinking water, and workplace conditions. This collection offers a look into this diversity of public health meaning and application, with records spanning a view of public health from national policy to individual care.

The individual records accompanying the governmental holdings in this collection offer a valuable perspective on the lives of the common people of Great Britain. Researchers interested in nutrition, for example, can find information from governmental as well as individual sources on changing perspectives on dietary recommendations, clean water, human proximity to livestock, and protections against...

The Rise of Public Health in England and Wales, 1805–1900

This collection curates selections from the British National Archives, making previously rarely accessed records accessible to online researchers. The nineteenth century is a particularly noteworthy era given industrialization, urbanization, and the appearance of public health as a concept. Crises such as the arrival of cholera in Britain in 1831 tested the government's ability to respond to public health concerns.

Public health, as the World Health Organization defines it, encompasses “organized measures (whether public or private) to prevent disease, promote health, and prolong life among the population as a whole,” with public health campaigns targeting wide-ranging issues such as family planning, nutrition, safe drinking water, and workplace conditions. This collection offers a look into this diversity of public health meaning and application, with records spanning a view of public health from national policy to individual care.

The individual records accompanying the governmental holdings in this collection offer a valuable perspective on the lives of the common people of Great Britain. Researchers interested in nutrition, for example, can find information from governmental as well as individual sources on changing perspectives on dietary recommendations, clean water, human proximity to livestock, and protections against food adulteration—the latter an especially significant issue that captured public attention on repeated occasions throughout the century.

The documents included in this collection helped determine government policy and medical practices into the twentieth century; in fact, the very concept of public health emerged from the efforts of the British government to determine the health needs of the nation in the early nineteenth century. For that reason, some of the most significant documents in the collection are the records of the governmental boards opened and decommissioned throughout the century in changing attempts to respond to public health concerns. Infectious diseases are “caused by pathogenic microorganisms, such as bacteria, viruses, parasites or fungi” (WHO) and spread from one person to another, as opposed to zoonotic diseases, which humans contract from nonhuman animals. Sanitation is the field of public health concerned with safely disposing of human waste, although it also extends to garbage and wastewater arrangements. Given the cholera epidemics that shook nineteenth-century Britain, infectious disease prevention and sanitation were central to the public health movement of that era.

Population growth throughout Great Britain in the nineteenth century posed new public health considerations, which urbanization only exacerbated. London became a test case for urban growth, seeing its population double in the first four decades of the century. Concurrent industrialization forced working-class populations into ever-denser living conditions as they crowded into slums near the factories. These factors led to an increased emphasis on infectious disease and sanitation. This collection allows researchers to trace the implementation of policies in response to urbanized living conditions that posed public health threats. In response to the problems arising from these factors, the government twice established temporary Boards of Health, the second time following a cholera outbreak.

Those interested in public health governance will be particularly interested in the records of the two temporary Boards of Health in place in 1805–1806 and 1831–1832 together with the longer-lived Poor Law Commission established in 1834 and the boards that grew out of it. The Poor Law Commission had responsibilities as diverse as appraising poor relief campaigns, relocating thousands of workers to northern industrial areas, and uniting local perishes into unions. In passing the Poor Law Amendment Act of 1834, known as the “New Poor Law,” Parliament created medical districts covering all of the United Kingdom. The government appointed medical officers in each of these districts to oversee local services. Their records constitute a valuable, meticulous record of the reality of British society in the nineteenth century. Poor Law Union records, organized by county, constitute a significant part of this collection. Readers tracing the public health response to infectious disease including prevention and treatment should make note of the records from the Poor Law Board, which succeeded the Poor Law Commission in 1847.

The New Poor Law led not only to the Poor Law Commission, but also to a number of significant changes to the British social system based on pressure to improve the old system of providing for the poor. One of the primary influences behind the New Poor Law was the work of the social reformer Sir Edwin Chadwick, whose 1842 Report on the Sanitary Condition of the Labouring Population of Great Britain had a significant impact on the sanitation side of public health. The General Board of Health, whose records (1848–1858) are included in this collection, was established through the 1848 Public Health Act following a series of developments in sanitation organizing spurred by Chadwick's report and the Health of Towns Association's subsequent formation to encourage national sanitation reform.

In addition to forming the General Board of Health, the Public Health Act led to developments in sewage and water supply and inspired the formation in 1849 of the Metropolitan Sanitary Association to address health concerns in London, where another significant cholera outbreak killed 10,000 Londoners in three months. Research based on these public health records would lead John Snow to his seminal discoveries and the creation of the field of epidemiology. Snow's careful study and mapping of information gathered by British health officials led to his famous breakthrough linking cholera to contaminated water. His research, most significantly his 1849 paper “On the Mode of Communication of Cholera,” helped focus public attention on the role of healthy sanitation in preventing such epidemics.

The second half of the nineteenth century's public health history is dominated by education and hospitalization, as medical advances and public awareness changed the public approach to the country's health, and not only in treating the ill and the poor. Women's health also became a vital public issue, thanks to campaigners and female medical doctors such as Elizabeth Blackwell and Elizabeth Garrett Anderson.

The General Board of Health records run through 1858, when it was abolished in favor of local boards responsible for sanitation. The government further enshrined the local responsibility for public health with Parliament's 1866 Sanitary Act, mandating local municipalities to remove hindrances to public health, from unregulated public wells to dangerous housing. This localization campaign finds resonance in the current British debate over whether to localize the National Health Service.

The very end of the nineteenth century saw an increased medicalization of public health through the contributions of scientists such as Louis Pasteur, surgeons who worked to improve medical practice and patient safety, bacteriologists who explored the cause of infections, and epidemiologists who looked into the causes of infectious disease and pioneered preventative medicine, including Pasteur's vaccines. The Poor Law would not be reviewed until 1909 and the National Health Service Act would not come into law until 1948, but Britain was already on its way to a strong, nationalized public health service.

By compiling these documents online, The Rise of Public Health in England and Wales allows users to access these important historical records simultaneously and simply. The breadth of materials available in this collection makes it an attractive resource for teachers as well as researchers.

Subcollections

Collection Facts

Date Range:
1805-1900
Extent:
1,198 monographs; 356 manuscripts (95,422 items); 389 issues (9,645 articles); 421,762 pages
Source Institution:
The National Archives (Kew, United Kingdom)
Language:
English
An 1832 notice warning the London public of the symptoms of cholera, and emphasizing the importance of swift treatment.
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