Britain 1750-1900 - OVERVIEW Why were there such huge changes in Peoples Health from 1750-1900?

1. Britain 1750-1900 - OVERVIEW Why were there such huge changes in Peoples Health from 1750-1900?

2. Britain 1250-1500 - OVERVIEW Did anyone really care about health in medieval England?

3. Britain 1750-1900 LIVING CONDITIONS- Public Health Crisis in Early industrial Britain Water: Water supplies were under severe pressure. In working class districts it was rare to have water piped into your houses. Water companies supplied water to pumps in streets and courts. Whole streets would have to share one pump. Landlords paid for basic provision so water might only be available for a couple of hours. Where the companies could not supply water the poorest families had to take water from streams, ponds, or rivers. Some collected water from cisterns or barrels from the rain. All water supplies were dirty. Water companies pumped their water from polluted rivers. Typhoid was common in the poorer district. Waste: The biggest health problem was the disposal of human waste. Existing sewers in towns had been built to drain the streets of rain water not sewage. As a result pools of stinking water often filled the streets. In the first half of the century people continued to use the privies that had been there for centuries. More than ten houses might have shared a single privy. Cesspits were emptied by night soil men. Land lords were cheap so they did not pay to empty cesspits and so the waste would spill over into other people’s building and land. Sometimes even contaminating the local water source. The waste became much bigger issue. It even forced parliament to move. Diseases: Tuberculosis: the largest killer in the nineteenth century. The disease was spread person to person in the droplets of water produced when coughing. It thrived in overcrowded and poorly ventilated houses. TB could be spread through unpasteurised cows’ milk. Influenza: virus transmitted though coughing and sneezing. Caused fevers, shivering and severe headaches. There were regular outbreaks. Diphtheria: spread through coughing and sneezing. Also through contact with clothing of an infected person. Typhoid: spread through contaminated food or water. The disease killed Prince Albert in 1861. Caused fever, headaches and diarrhoea. Typhus: similar to typhoid but transmitted but body lice and therefore thrived in the filthy conditions of the lodging houses. • Urbanisation Crisis: • Towns and cities grew quickly. Existing infrastructure could not cope. • The supply of housing could not keep up with demand. Houses were built quickly and the quality was not great. • Town governments were weak – many did not want to up rates to provide clean water and sewers for the poor. • There were no laws to ensure decent housing and to protect people’s health. • People did not yet know what caused germs. • Housing: All large towns had lodging housing where single people and families arrived and stayed until they could find somewhere to rent. These houses were large, overcrowded and filthy. Disease spread easily. Builders built many houses back-to-back houses to cram in as many houses as they could. These houses often had just one room downstairs and upstairs. They were hard to ventilate. The very poorest had to cram into cellars. • Food: Poor people had a very poor diet and it played a major part in the public health crisis in the early nineteenth century. It was impossible to build grow food in the slum districts. Working class families had to buy food from small shops and street-sellers. The poor families lived mainly on bread, butter, potatoes and tea. Sometimes they get cheap bacon, rabbit or offal. These people were mal-nourished, making them prone to sickness and disease. • Not only was there a lack of food but the quality of food was an issue. Food was not preserved in cans until 1860s and refrigerators were not invented until the 1880s. The government had a laissez-faire attitude meant they made little attempt to control the production and sale of food. So meat was diseased, milk was mixed with chalk and water, butter had copper to improve its colour. • So many people suffered from diarrhoea and food poisoning.

4. Britain 1750-1900 Cholera epidemic- major problem in Industrial times (contaminated water) Cholera: • Cholera was a greatly feared disease. Caused by contaminated water, it could spread with speed and with devastating consequences. Not for nothing did the disease get the nick-name “King Cholera“. Industrial Britain was hit by an outbreak of cholera in 1831-32, 1848-49, 1854 and 1867. The cause was simple – sewage was being allowed to come into contact with drinking water and contaminating it. As many people used river water as their source of drinking water, the disease spread with ease. Case Study Cholera in Leeds: Cholera reached Leeds on 28th May 1832. The disease first hit a poor family in Blue Bell Fold, a cramped dirty yard in the poorer area of the city. The houses were built next to a stinking stream which flowed into the river Aire. The disease then spread quickly, by the end of July it had killed 187 people. Most victims were in overcrowded poor areas. In Boot and Shoe Yard for example ten people shared each of the small back to back houses. There was no water within a quarter of a mile, and only three privies for the 340 people living in the yard. Dr Baker who lived in Leeds kept track of the cases and highlighted that the areas afflicted were in the area of destitution. He did investigations and concluded that dirtiest areas of the town had Cholera and still believed that bad air from overflowing cesspits and dung heaps caused the spread of cholera- still believed the miasma theory. In Leeds Boards were set up advising people to wash themselves in soap and water at least once a week. Leeds Board of Public Health also published advice on preventing the spread in newspapers and posters. Urged to whitewash the inside of houses, open windows and avoid alcohol. (but beer was much safer than the water). Church numbers increased hugely during the epidemic in Leeds as people turned to God. Victims were quarantined in Hospitals but angry citizens became convinced the epidemic was a plot by the rich and the doctors to do away with the poor- serious lack of understanding. Across Britain 32,000 were killed from Cholera. It shocked authorities but the work of Robert Baker revealed the dangers of dirty living conditions for peoples Health. Exam tip- you will need to know how to compare responses to epidemics across the eras e.g. Compare the responses to the Black Death in 1348-49 and the plague in the 16th and 17th centuries with how people responded to Cholera here in the 19th century.

6. Britain 1750-1900 Progress in the fight against filth • John Snow: • In 1854 there was a large outbreak of Cholera in the Broad Street area. Dr John Snow decided to track the cases in order to identify what caused the disease. He did not believe it was caused by miasma. • In order to confirm his ideas he marked on the map every case. He saw that very few people died from the work house and no body died from the brewery. Both of which had their own well. His anomaly that was far from Broad Street found that the lady that died collected water from the Broad Street pump as she liked the taste. He identified through interviews that the source of the Cholera outbreak was the Broad Street pump. Cholera was a waterborne disease, but he could not prove it scientifically. The local residents were convinced and the pump was removed. However, the local preacher believed it was a punishment from God and the medical board still believed it was miasma. • Edwin Chadwick and the 1848 Public Health Act • SIGNIFICANT EVENT: 1861 Louis Pasteur can scientifically link germs to disease. He first of all proved that alcohol is spoilt by bacteria. He then linked germs to disease in animals (silk worms). The Robert Koch took the next big leap by linking germs to disease in humans. The two of them, in competition, then used their research to create vaccines to protect people from diseases such as Cholera and Tuberculosis. • National Government: Edwin Chadwick was a civil servant who wanted to save the government money by finding out why the poor were so sick constantly. He believed in miasma and he found that poor areas reeked, therefore miasma might be the problem. Edwin's interest in public health stemmed from his work with the poor law commission and became convinced the main cause of poverty was ill health as a result of peoples filthy living conditions • In the late 1830s he led a big investigation ‘On the sanitary condition of the labouring population of England’ based on detailed evidence from doctors and officials that sold more copies than any other government report previously. • He provided a clear solution to ill health- set up a national public health authority to provide clean water and new sewage systems • Public Health Act 1848: said that sewers should be built, clean water supplies, local boards of health etc and it was all to be paid for by local rate payers. The big problem was that it was optional and many people did not want to pay. • 1867: the working class got the vote and to ensure a win at the elections the Conservative party promised a big clean up so the 1875 Public Health Act made actions from the 1848 Act and other acts compulsory. There was a massive increase improvement in public health but it still had a long way to go. Lots of other acts were introduced in the late 1800s to ensure better food quality and conditions in terms of waste collection and disposal.

7. Britain 1750-1900 INDUSTRIAL IMPROVEMENTS Sewer systems at last. Spurred on by ‘The Great Stink’- but were they 100% safe? Joseph Bazalgette: unwittingly saved the lives of thousands of Londoners. Although he was on the Metropolitan Board of Works they did not start anything immediately. It was not until the Great Stink of 1858 that Parliament decided to do something to clear up London. As it effected Parliament huge amounts of money was pumped into the Board of Works. Bazalgette designed a massive and entirely new sewage system for London. He wanted to construct 82 miles of sewers running from west to east across the city. Three main sewers to the north of the river, and two to the south. The angle of the sewers would dump the waste into the Thames downstream. He also created pumping station (the likes that had never been seen before) to pump sewage into huge covered reservoirs. The sewers took seven years to build but the result was spectacular. Cholera and typhoid more or less vanished as the system prevented the spread of waterborne diseases. It was a huge revolution.

8. Massive development- Edwin Chadwick and the 1848 Public Health Act The 1848 Public Health Act was the first step on the road to improved public health.  One of the individuals who played an important role in its creation was Edwin Chadwick. Chadwick’s argument was economic, as he was convinced that if the health of the poor were improved, it would result in less people seeking poor relief; much poor relief was given to the families of men who had died from infectious diseases.  Money spent on improving public health was therefore cost effective, as it would save money in the long term. He considered that the most important steps to improve the health of the public were:• improved drainage and provision of sewers• the removal of all refuse from houses, streets and roads• the provision of clean drinking water• the appointment of a medical officer for each town After much campaigning by the Health of Towns Association, and another severe outbreak of cholera in 1848, the government was forced to act, and the Public Health Act of 1848 was passed.  The Act as it was passed was not perfect but was an important step forward.  The main limitation of the Act was that it was not compulsory and towns could choose to follow it or not. It was not until the 1875 Public Health Act that it became compulsory and towns HAD to follow the guidelines.

9. GOVERNMENT AND PUBLIC HEALTH- WHAT DID THEY DO IN THE INDUSTRIAL ERA? In an attempt to control the living and working environment of the people, the government aimed to improve public health by passing a number of new laws. To help you remember these Acts you can classify them in various ways: • hygiene • housing • working conditions • medical care Here are the Acts and the key points they were aiming to enforce: • 1848 Public Health Act The Central Board of Health was created and although it was abolished 10 years later, the Act also encouraged local Boards of Health to be set up to appoint a Medical Officer, provide sewers, inspect lodging houses and check food which was offered for sale. • 1853 Vaccinations were made compulsory although no one was given the power to enforce them. • 1855 Nuisance Removal Act This Act made overcrowded housing illegal. • 1864 Factory Act This made unhealthy conditions in factories illegal. • 1866 Sanitary Act This made local authorities responsible for sewers, water and street cleaning. • 1868 This Act encouraged the improvement of slum housing or its demolition. • 1871 Vaccinations Act This made sure that the previous Vaccinations Act was obeyed. • 1875 Artisans Dwelling Act This made the house owners responsible for keeping their properties in good order and gave local authorities the right to buy and demolish slums if they were not improved. • 1875 Public Health Act This brought together a range of Acts covering sewerage and drains, water supply, housing and disease. Local authorities had to appoint Medical Officers in charge of public health. Local sanitary inspectors were appointed to look after slaughterhouses and prevent contaminated food being sold. Local authorities were ordered to cover sewers, keep them in good condition, supply fresh water to their citizens, collect rubbish and provide street lighting.

10. IMPROVEMENTS- DIRT DEFATED? The ‘Great Stink’ 1858: Plans were already being made for a new sewer system in London in 1858. However, the extremely hot weather meant that the level of the River Thames was low and the smell of the exposed sewage along its banks was so great that parliament could not meet, even though sheets soaked in disinfectant were hung at the windows to cover up the smell. This ‘Great Stink’ combined with outbreaks of cholera and the work of people such as Chadwick and Snow to convince the authorities that more public health reform was needed. Joseph Bazalgette: The Metropolitan Board of Works agreed to the expensive ideas being put forward by Joseph Bazalgette for a new sewer system in London. Bazalgette was an engineer who had worked in the railway industry before working on large-scale sewage and drainage projects. He designed a complex sewerage system for London that took into consideration future population growth as well as the needs of the time. It included 1,300 miles of sewers, plus pumping stations and embankments besides the River Thames to house the stations. It took Bazalgette and his huge team of engineers and construction workers over seven years to complete. Fascinating fact Queen Victoria was so excited about the new large sewer tunnels that she ordered a small railway line to be installed to transport people through the sewer. Gas lights and walkways were installed, with booths selling souvenirs. Women's cooperative Guild: campaigned for an improvement in women's political and legal rights. Fought for matters such as better maternity care, free school meals for poor children, better housing and clean water- supported public health improvements. New housing and clean water by 1900: Town councils began spending huge sums of money across Britain on building schemes such as theatres, art galleries, town halls and on engineering projects to bring clean water in to towns and cities. Constructed dams and aqueducts to bring it in from lakes and provide people with a constant supply of clean water to their homes. New homes were build- local authority housing/council houses. FIRST time councils invested in homes for citizens that provided clean save living spaces. Aim: decent homes for all. Demolished some of the worst slums in cities. Wasn't done in all places and many landlords still rented filthy homes. Also see the rise of high rise council flats from this. Back to back houses not illegal yet. BY 1900 NEARLY EVERYONE IN BRITAIN HAD CLEAN WATER BUT NOT DECENT HOUSING, GOOD FOOD OR CLEAN AIR

11. Britain 1750-1900 Overview: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Living Conditions: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Epidemics: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Improvements: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

12. Britain 1750-1900 Why were there such huge changes in Peoples Health 1750-1900? Beliefs, attitudes and values: ____________________________________________________________________________________________________________________________________________________________ Urbanisation: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Wealth and Poverty: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Science and Technology: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Local and National Government: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

13. Britain 1750-1900 Did anyone really care about health in medieval England? Imagine that someone tells you that the government did nothing to improve conditions or to help people in England from 1750-1900. Write a clear, organised and well-supported reply that agrees and disagrees. Include as much evidence as possible. ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

14. Why was the impact of Edwin Chadwick's 1848 Public Health Act? Explain your answer. [10] ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

15. Britain 1750-1900: remember you need 3 PEEELS to agree AND disagree and then an overall conclusion that links to the Q- how far you agree. “The work of Edwin Chadwick was the most important factor in improving the health of towns in the 19th Century”. How far do you agree with this statement. Explain your answer.[18] ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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17. PUT IN AN EXAMPLE ANSWER HERE