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The 20th century saw greater improvements and more rapid changes in people’s health than ever before. The years 1906 to 1914 saw huge social change. The Liberal Governments turned their back on laissez-faire ideas and decided that the state did have a role to play in improving public health.

Their decision was the result of a number of events, which highlighted the fact that in many parts of Britain ill health still remained a serious problem.

• A report in 1889 by Charles Booth showed that 35 percent of Londoners were living in abject poverty.
• Another report in 1901 by Seebohm Rowntree, found that half the population of York were living in poverty.
• During the Boer War of 1899–1902 a third of those who volunteered to fight were rejected because of poor health.

When they got into power in 1906 the Liberal Governments introduced a range of social reforms designed to wage implacable warfare against poverty and squalidness. As well as the National Insurance Act, the Liberals introduced other measures.

In the 1909 budget, David Lloyd George increased taxes on the rich (plutocrats) to help pay for the Liberal’s social reforms.

Economic problems meant that only 200,000 were completed. However, for the first time, many that were built had electricity, running water, bathrooms, indoor toilets and gardens. By 1939 over one million council houses had been built across the UK.

Following the damage and destruction of World War Two, the Labour Government had another million council houses built between 1945 and 1951. The problem of poor housing remained. Since the 1960s surveys have been conducted in Wales to assess the condition of the housing stock. In 1968, 10 per cent of our houses were unfit for human habitation. Though improvement grants and new houses have reduced this percentage, Wales still has more unfit housing than England.

There have also been other government efforts to improve public health.

In 1952, the killer smog in London killed an estimated 12,000 people. It highlighted the poor quality of air in many parts of Britain. As a result the Clean Air Acts of 1956 and 1968 aimed to reduce air pollution from coal fires.

More recently laws have been passed to reduce emissions from greenhouse gases, eg carbon dioxide and methane.

In the 1960s there was a huge slum clearance effort. The slums were often replaced with tower blocks. Some people were moved into new towns, eg Milton Keynes, which were built to get people out of old, dirty, overcrowded industrial towns. Houses had modern facilities and the towns had plenty of green spaces for public use.

The Labour Government of 1945-1951 also created the NHS in 1948. As well as running hospitals and local health centres, the NHS promotes public health through a range of activities.

• Health workers go into schools to speak to students, eg to give vaccinations or talks on sex education.
• Health visitors visit new mothers to give help and advice on childcare.
• There have been all sorts of campaigns to promote healthier lifestyles, such as giving up smoking (Smokefree), eating healthily (Change4Life and 5-a-day) and taking exercise (Walking for health).
• Other campaigns have encouraged personal hygiene, eg regular brushing of teeth, checking for nits, as a way to better health.

Reservoirs in Wales

Controversy arose from the loss or displacement of Welsh speaking farming communities between 1880 and the 1960s, when valleys were flooded to provide drinking water to Liverpool and the Midlands.

Lake Vyrnwy

The Liverpool Corporation wanted to improve their water supply so, between 1881 and 1888, the largest masonry dam in Britain was built in north Wales in the Vyrnwy Valley to supply Liverpool with fresh water.

Elan Valley reservoirs

Birmingham Corporation organised a reservoir to be built in the Elan Valley to the west of Rhayader in mid Wales to ensure clean drinking water for the Midlands.

Over a hundred Welsh occupants were moved but only landowners received compensation. It was officially opened by King Edward VII and Queen Alexandra on 21 July 1904. The scheme is still supplying Birmingham's water.

Llyn Celyn

In 1955, Liverpool Corporation chose Tryweryn to the north of Bala for a new reservoir for their water supply.

This was a Welsh speaking community of 12 farms, a school, chapel and post office. Despite major protests, on 1 August 1957 the Liverpool Corporation Act was passed, and the village was flooded to create a reservoir.

Improvements in life expectancy

During the 20th and early 21st centuries, huge strides have been made in public health and hygiene. Life expectancy has risen more rapidly than in any previous century, from just under 50 in 1900 to over 80 today. In other words, during the 20th century for each decade that passed, life expectancy rose by two and a half years.

However, these statistics hide huge divisions within the UK. A report by NHS Wales in 2011 stated that:

Despite great progress in the last hundred years, huge problems remain. As Britain has grown wealthier the diets of many people have become less healthy, with a huge increase in obesity and diseases associated with it, eg diabetes.

In spite of the many health campaigns many people still smoke, drink too much alcohol and fail to take enough exercise. Poverty and poor housing, though it is not as acute as in past centuries, also continues to have an adverse effect on public health.