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Medicine and the Industrial Revolution - AQACholera epidemics

Urban populations increased rapidly in the 19th century. Diseases such as cholera, typhus and typhoid spread due to poor public health conditions. The work of Edwin Chadwick, John Snow and Charles Booth led to significant improvements.

Part of HistoryBritain: health and the people, c.1000 to the present day

Cholera epidemics

Cholera was a disease that spread through towns and cities in 19th-century England. It was caused by contaminated water or food.

Watch to find out about the pioneering work Edwin Chadwick and John Snow undertook to improve public health.

Edwin Chadwick

Edwin Chadwick was a lawyer who wanted to reform the conditions poor people lived in. He carried out research into the living conditions in different parts of the country. This work was put together in his Report on the Sanitary Conditions of the Labouring Population of Great Britain in 1842. The report highlighted the impact of public health conditions and wealth on life expectancy.

Chadwick found that labourers who lived in northern towns and cities, such as Bolton, Liverpool and Manchester, had a life expectancy of just 15-19 years. In contrast, people living in rural northern areas, such as Rutland, and who worked in a professional trade had a life expectancy of 52 years.

A graph showing the average age of deaths for different types of people (gentry and professional, tradesmen and farmers, labourers) in two different locations: Manchester (urban) and Rutland (rural).
Figure caption,
The average age of workers' deaths within different job roles, in both Manchester and Rutland.

Chadwick wanted the government to take action. He said the government should ensure a clean water supply for everyone and invest in proper sanitation systems.

The idea that the government should be involved in public health was rare in the 19th century. Many people accepted this attitude and did not want the government interfering in their lives. This view is reflected in a letter sent to The Times newspaper in 1852. It helps to explain why there was a reluctance from the government to make public health reforms compulsory:

鈥淲e prefer to take our chance with cholera than be bullied into health. There is nothing a man hates so much as being cleansed against his will or having his floor swept, his hall whitewashed, his dung heaps cleared away and his thatch forced to give way to slate.鈥
Extract from The Times in 1852

1848 Public Health Act

In 1848, the government responded to Chadwick鈥檚 report and passed a Public Health Act. The act set up a Central Board of Health to oversee the improvement of public health. This meant that:

  • Local authorities could set up a local board of health to oversee public health. If an area had a higher than 23 per 1,000 people, the local authority had to set up a board.
  • The local board of health could then raise taxes to pay for clean water supplies and new sewerage systems.

The act was limited in that there was little funding and the local boards of health were usually not compulsory. However, it was an important first step in the government taking action to improve public health.