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Public Health enquiries

Background to the Sanitary Report of 1842

The public health movement was the child of the 1834 Poor Law Amendment Act.

Early Investigations

• James Phillips Kay (1804-77) later Sir James Kay-Shuttleworth, an Edinburgh doctor who practised in the poorer parts of Manchester. (see his Moral and Physical Conditions of the Working Classes of Manchester published in 1832.  Be warned: it is a long and detailed document!).

• Neil Arnott (1788-1874) was a friend of Bentham and Chadwick's family doctor. He contributed to reports behind the 1834 P.L.A.A. and in 1838 submitted a report on poverty in London. He supplied information to Chadwick.
• Dr. Southwood-Smith (1788-1861) was another Edinburgh doctor, working in London after 1820. He was also a friend of Bentham and Chadwick. He contributed to the 1834 Poor Law Amendment Act and was a member of the Mines Commission (reported in 1842) - it was his idea to illustrate the Mines Report.

• Edwin Chadwick

Statistical surveys were made to analyse the problem and to justify legislation. This began in the 1830s.

1834: Statistical Society of London was set up
1837: Office of the Registrar-General was set up

Evangelicals, philanthropists and humanitarians - surprisingly - were not prominent in the Public Health movement. Public support was necessary, but not forthcoming. As Flinn points out, "To the ladies of polite society, there was nothing appealing about sewers and privies"

In 1838, Dr. Southwood-Smith produced a health report on London in which he showed the direst connection between diseases and bad water supply and in 1842, Chadwick's personal sanitary report to the government was published. This was probably the most outstanding contribution to public health in the early 19th century. His Report on the Sanitary Condition of the Labouring Population of Great Britain was the product of a massive personal investigation between 1839 and 1842. It stressed the need for massive improvements in public cleanliness, controlled by the government from the centre. The Report stimulated Peel's government into action.

In 1844 and 1845 two government reports on health in towns proved the points made by Chadwick. For example, these reports showed bad sanitation causing bad health so that the death rate in some towns (e.g. Macclesfield) was 43 per 1,000, and that the average age of death was 24. In 1847 there was another serious outbreak of cholera. This, together with the evidence from the various reports, drove the Whig government under Lord John Russell to pass the1848 Public Health Act. A Central Board of Health was created and Dr. Smith, Chadwick and Shaftesbury were put in charge of it. They had power to create local Boards, but their main function was advisory. It was only a partial answer to a vast problem and virtually all initiative was left at the local level, but at least a step had been made in the right direction. Government was accepting responsibilities beyond its normal scope of action. It set a useful precedent for the future. Henceforward more positive action came.