Public Health

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Public Health
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What is Public Health?http//www.bbc.co.uk/scotl
and/learning/bitesize/standard/history/1830_1930/p
ublic_health_rev1.shtml
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• The filthy overcrowded conditions in which so
  many people lived made sure that Cholera spread
  quickly.
• Contact with human excrement and flies which had
  been in contact with human excrement was
  inevitable. The worst source of Cholera was dirty
  water.
• Cholera attacked with terrible suddeness and
  victims could die within a few hours, or after a
  few days of violent pain and diarrhoea.
• Where it was waterborne whole streets and areas
  were affected, entire households could die.
• There was no effective treatment and one in two
  of those infected died. It was terrifying because
  they did not understand that it was waterborne,
  - it just seemed to move and jump from one area
  to another at random.

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• Cholera was not the only danger - Typhus was
  almost as bad.
• The huge increase in population meant cesspools
  were constantly overflowing, often because
  emptying them was very expensive. some were even
  completely open.
• In Whitechapel, London, that there were no sewers
  so was, 'the filthiest place you can imagine'. In
  Manchester, it was normal to empty raw sewage
  into the rivers.
• While the overcrowded poor were in the most
  danger the middle classes were also in danger,
  from Cholera and Typhus because it was caught
  through dirty water.

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Housing Problems
Housing Problems Diseases caused
Poor sanitation drainage cesspools, no running water Cholera
Shared toilets
Dirty stairs, and so on Typhus, diphtheria
Open sewers and middens Typhus
Rats vermin Typhus typhoid
Poor diet TB
Overcrowding TB typhus
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Improvements to housing
Year Changes
1833 Scottish Municipal Reform this allowed rate payers to vote for local councillors and, as a result, some corrupt councils were replaced by those willing to improve towns.
1835 The Municipal Corporation Act this allows councils in England to improve lighting, sanitation street paving it still did nothing for slums
1855 Removal of Nuisances Act this allowed compulsory council purchase of slums
1875 Public Health Act meant many houses had water and sewers
1875 Artisans Dwelling Act councils were given the power to pull down slums and build new houses, but cost was a problem
1909 Housing and Town Planning Act local authorities could prepare town planning schemes
1919 Addisons Act was passed to make Homes for Heroes but funding ran out in 1921
1924 Wheatley Housing Act council houses were built with electricity, gardens and indoor toilets
1930 Green Woods Housing Act further large-scale clearance in slums
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Housing and health

• Cholera epidemicsYear Deaths1831 32,0001
  848 62,0001854 20,0001866 14,000
• 1842 Edwin Chadwick- Report on the Sanitary
  Conditions of the Labouring Population of Great
  Britain
• Argued that government could improve peoples
  lives by bringing about reform
• Recommended The most important things needed
  are drains, removing rubbish from streets, and
  purer water. There should be improved sewers and
  drains, and a medical officer of health should be
  put in charge of each district

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Public Health Act 1848

• A board to set up local health boards was
  established
• A central board was set up to make
  recommendations to the local boards
• Act not successful
• boards had no real power
• Too few boards set up
• 1858 abolished

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Dr John Snow, 1854

• Investigated cholera outbreak in London
• Linked cholera with contaminated water

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Cholera in Scotland

• Dundee, (page 60)
• Glasgow (page 61 62)

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Public measures

• The first public health measures were based upon
  the idea that miasmas (bad smells) caused
  disease. Although the idea was wrong, the
  measures against the miasmas involved a greater
  focus on cleanliness, and this improved public
  health.
• Further measures included
• In 1848 the first Public Health Act caused the
  setting up of a Board of Health, and gave towns
  the right to appoint a Medical Officer of Health.
  
• In 1853 vaccination against smallpox was made
  compulsory.
• In 1854 improvements in hospital hygiene were
  introduced (thanks in large part to Florence
  Nightingale).
• In 1875 a Public Health Act enforced laws about
  slum clearance, provision of sewers and clean
  water, and the removal of nuisances.
• The benefits of these measures soon became clear,
  and by the late 19th century local councils were
  competing with each other to provide the best
  public health.

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Public Health Act 1875

• Local authorities had to appoint a Medical
  Officer
• Authorities had to
• Cover maintain sewers properly
• Provide clean water
• Pave and clean the streets
• Local officers were appointed to check up on
  slaughterhouses and take responsibility to make
  sure that contaminated food was properly
  destroyed.

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Other factors which improved health

• Better diet due to better transport, fresh food
  reached the cities
• Cheap new materials soap and disinfectant
  reduced infections
• Cheap cotton clothes these were easy to clean
  and launder.
• Better medicines and hospitals

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Developments in medical knowledge helped
Year Discovery
1847 James Young Simpson discovered chloroform and its uses
1864 Louis Pasteur discovered germs
1867 Joseph Lister used antiseptics in surgery
1882 Robert Koch discovered the germs that caused TB cholera
1895 X-rays were invented by William Roentgen
1906 Calmette and Guerlin worked on a cure for TB
1928 Alexander Fleming discovered penicillin
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Individual measures

• When the Boer War revealed that half the
  population were unfit for military service, the
  government accepted that it had to pass laws to
  improve the situation of the individual poor
• In 1906 local councils were told to provide free
  school meals for poor children.
• In 1907 school medical examinations were ordered
  for all children (among these examinations were
  those of the 'nitty nurse').
• In 1908 Old-age pensions were introduced.
• In 1911 National Insurance (free medical
  treatment for workers who fell ill) was
  introduced.