Dirt and disease were common in Victorian Britain. For most of the nineteenth century, a combination of population growth and migration, inadequate housing and insufficient sanitation and health care meant that conditions were poor and life expectancy was low. Industrialisation did bring wealth to factory owners and business men. However, as people moved to the city to work in new factories, living space became overcrowded and existing water supplies and sewers could not cope with demand. Refuse lay uncollected in the street, food and drink became contaminated and people were forced to share their living space with three or four other families.
The growing urban population lived in squalor and poverty but everyone suffered from the lack of adequate health provision. Even the Royal family could smell the stench of raw sewage in their home on the banks of the river Thames and Prince Albert, Queen Victoria's husband, died from Typhoid in 1861.
An already precarious health situation was made worse by the cholera epidemics that hit Britain between 1831 and 1860 and killed 140,000 people. We know today that these epidemics were caused by contaminated water supplies. However, while diseases such as cholera were fatally common, there was little in the way of public health provision. For the most part, people were ignorant of the ways in which disease was spread and medicine was not sophisticated enough to save more than a few lives.
Who took part in the campaign?
During the 1830s, it became obvious that something needed to be done, though a coherent and united effort for reform was never established. Instead, prominent members of society, as well as scientists, physicians and journalists, raised the profile of the issue by writing to newspapers, contributing funds and undertaking independent research. These individuals included Edwin Chadwick, who published his Report on the Sanitary Condition of the Labouring Population of Great Britain at his own expense in 1842 and, as commissioner of the Board of Health, saw the introduction of the Public Health Act of 1848; John Snow, who was convinced that cholera was a water-borne disease and was eventually proved correct in 1853; Charles Dickens, who used his position as editor of the journal Household Words to publish articles on sanitary reform and Thomas Southwood Smith, who ran a propaganda campaign, known as the Health of Towns Association, raising public awareness of the cause.
What did they campaign for?
Campaigners sought to overhaul the existing public health provision which was considered woefully inadequate. Until 1866, public health legislation was not even enforced by law and local authorities had the option to ignore it. Further, there were many individuals and organisations – water companies for example - who made money from the existing situation and therefore did not want it to change.
Campaigners also wanted research to be conducted not only into the living conditions of Britain’s population but also into how diseases were spread in order to prove the necessity of proper legislation. As a priority, they needed to discredit the common belief that disease was spread by miasma or ‘bad air’ as this prevented real progress from being made in public health reform.
Why were they campaigning?
The campaign for public health legislation was probably prompted by the first British cholera epidemic of 1831-2 which killed 30,000 people. However, while the scale of this epidemic shocked authorities and members of the public alike into action, deaths from contagious diseases were all too common even without epidemics on a large scale.
Life expectancy in mid-Victorian Britain was low - around forty. Three in twenty babies did not live beyond their first year. As well as inadequate sanitation, dangerous working conditions and poor diet meant that the population was generally unhealthy. Statistics gathered by Edwin Chadwick in 1840 for his Report on the Sanitary Conditions of the Labouring Population of Great Britain indicate the frequent causes of death in a small district of Leeds. Among the young, measles and scarlet fever were common while asthma and rheumatism were frequent killers of adults. In 1840 alone, 167 children died before the age of five, accounting for over half of the total deaths in the district that year.
A number of factors contributed to this low life expectancy. Much of the population lived in terrible, overcrowded conditions. Houses were poorly constructed and offered little protection against cold weather, and open sewers and overflowing cesspits meant that drinking water was often contaminated. It was felt by campaigners that many of these conditions could be removed if adequate public health legislation was enforced.
How did they campaign?
A number of individuals, including Edwin Chadwick and Dr. Robert Baker, investigated the living conditions in poorer communities and neighbourhoods. The evidence they collected was usually collated into reports made to the local Boards of Health. Chadwick published a study of the labouring population of Great Britain and later used his research to influence the passing of the Public Health Act in 1848.
The Board of Health and other governmental institutions were frequently lobbied by organisations such as the Health of Towns Association and the Metropolitan Sanitary Association whose members were often wealthy and influential.
Other individuals sought to raise awareness among the general population. Charles Dickens frequently published articles in his journal Household Words and also used his novels to vividly describe the terrible living conditions of many of London's inhabitants. Henry Mayhew, a journalist, wrote several letters to the Morning Chronicle newspaper and also used his position as a journalist to publish an article on sanitary reform almost every day from September 1849 and throughout 1850.
When did this happen?
While the living and working conditions of Britain's population had been inadequate for some time, the cholera epidemic of 1831-2 prompted action on the part of both the government and public health campaigners. However, the first legislation concerning public health was not introduced until the mid 1840s. Even then, various smaller Acts were introduced rather than a national Public Health Act. This Act was finally established in 1848 though it had many weaknesses. For example, it did not apply to London or to Scotland and only had to be implemented in districts where the death rate was 23 in every 1000. Until the Sanitary Act of 1866, the responsibility for public health was in the hands of local authorities. From 1866, the state was directly involved in directing public health reform and improvements were gradually made from then on.
Virtual Tour of the recreated 1840s street at the Thackray Medical Museum.