Public Health

This is a story of gradual progress of the conquest of disease and improvements in the general health of the British population. There were three elements.

In the parishes studied by Wrigley and Scholfield, the infant mortality rate declined from about 160 per thousand in the first half to about 130 in the second half of the eighteen century. In British Economic And Social History 1700-1939 the author, C P Hill, states that in the period 1731-1740 it is estimated that 44% of English children died before the age of two. By the end of the century this had almost halved due mainly to the gradual improvement in living conditions. I do not know the sources Hill used and have some doubts as to data being representative or reliable.

Little was known about many diseases. Surgery was primitive with strong alcohol being used as anaesthetic. Hospitals were rare and usually insanitary. In the eighteenth century there were no great developments in medicine or in health matters until 1798 when Edward Jenner discovered vaccination as a means of preventing smallpox.

The Agricultural Revolution (1700-1850) caused a gradual, but dramatic, change in farming. The revolution included improved farming tools, new crops, crop rotation, and the gradual replacement of open fields by enclosures. Many of the national improvements had been known locally in earlier times.

The Industrial Revolution started in the eighteenth century with the introduction of machinery run by produced power, by and the organisation of industry in factories. This led to higher production and cheaper prices for bricks, cast-iron pipes for drains, clothing and soap.

In an era of laissez-faire ("let it alone") Parliament would eventually take action when some problem reached serious proportions. There was little improvement in public health in the eighteenth century. A few cities set up local health boards around 1800. The first cholera epidemic struck Britain in 1831 and with no cure available, often killed its victims within a few hours. The worst hit were the poor living in slums. This led to more than a decade of reports on sanitary conditions. Water supply and sewerage systems were built resulting in a dramatic reduction in the death rate. Other improvements including slum clearance, which by today’s standards would have been regarded as requiring immediate action, took nearly 50 years to introduce.