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The origins of public health in the UK from the 19th Century to the present day Essay

Public health is the measures taken by the government to prevent ill health and disease. The government monitor health so that they can develop different programmes and legislation to improve the health and well being of the people in the country. They do this by attempting to solve inequalities, so that all people not matter what are able to live a healthy life. There are eight policies to improve today’s public health, these are; planning for health emergencies (this is making sure that health services are prepared for emergencies such as accidents, outbreaks of disease and terrorist attacks), helping more people to survive cancer (by attempting to reduce the cancer death rate by 5000), reducing smoking (by reducing smoking rates – 18.5% for adults, 12% for 15 year olds, and 11% for pregnant women), giving all children a healthy start in life (by improving maternity care and introducing the Healthy Child Programme, which is available to all families), reducing obesity and improving diet (by introducing the Change for Life programme, and ensuring that food packaging has clear nutritional information), reducing harmful drinking (again by introducing the Change for Life programme, and by providing £448 million to improve the lives of the 120,000 most troubled families), reducing drugs misuse and dependence (by providing support and information on drugs (I.e. FRANK), and supporting children in there first five years of their lives, to prevent drug use further on in their lives), and Creating a lasting legacy from the 2012 Olympic and Paralympic Games (by promoting sports and healthy living). (https://www.gov.uk/government/policies?topics%5B%5D=public-health, Gov.uk, Policies).

(1) Napoleonic Wars (1790 – 1815)
During the Napoleonic Wars, almost eight times the amount of British soldiers that were killed in action were killed by disease. This majority of deaths due to disease were caused by the Bubonic Plague, and was due to the living conditions of the soldiers – as they lived in tents and in fields which were often overrun by rats, which carried the disease. It was also found recently that many soldiers suffered from lice borne versions of the disease typhus, and also the infection trench fever. (http://news.bbc.co.uk/1/hi/health/4534540.stm BBC News, Health, Lice ‘undermined Napoleon’s army’) An important thing that these wars brought was the use of field hospitals, and nurses and ambulances on the battlefield. These ambulance were carts pulled by horses. Another thing that was brought by these wars was the Principle of Triage. This was devised by Dominique Jean Larrey, who was Napoleon’s chief surgeon, and meant that the people with the most severe would be treated first – no matter what rank they are. (http://www.historyofwar.org/articles/wars_napoleonic.html, History of War, Napoleonic Wars, Dugdale-Pointon)

(2) Poor Law Amendment (1834)
This act was created because the government had spent too much money in the 1830’s looking after the poor. This piece of legislation stated that if the poor wanted food, clothes and shelter, they had to work at the workhouse. People had to cope with bad living conditions and minimum meals. Families were also split up. Edwin Chadwick played a big part in creating this legislation. (http://www.bbc.co.uk/schools/gcsebitesize/history/shp/britishsociety/thepoorrev1.shtml, BBC BITESIZE, History)

(3) The 1848 Public Health Act
This act was amended mostly by Edwin Chadwick, as he stated that if the poor were healthier, they would be able to get better jobs – therefore meaning that the government wont have to pay as much to workhouses and helping the poor. One of the things changed by this law was the state of the sewers. They improve them to ensure there weren’t as much waste on the streets – therefore preventing disease. They also provided clean drinking water and a medical officer for each town. This was the first Public Health Act. (http://www.parliament.uk/about/living-heritage/transformingsociety/towncountry/towns/tyne-and-wear-case-study/about-the-group/public-administration/the-1848-public-health-act/, Parliament.co.uk, The 1848 Public Health Act

(4) Crimean War (1850’s)
During this war, around 21,000 British soldiers died – however, only 2,755 were killed in action, and 2,000 because of battlefield injuries. Over 16,000 British soldiers died due to diseases such as typhus, typhoid, cholera, and dysentery. During this war a lot of hospital patients had to lie on the floor – as there weren’t enough beds. Also, soldiers who had infected limbs had to have them amputated with a saw – and a lot of the time these limbs were given to the military dogs as food. Two significant people to this war were Florence Nightingale and Mary Seacole. Florence Nightingale became a nurse in 1853 – only a year before the Crimean war had begun. After a statement that there weren’t enough medical facilities for the war, the war minister of the time – Sidney Herbert – asked Florence to help improve the medical work in the military hospitals. (http://www.bbc.co.uk/history/historic_figures/nightingale_florence.shtml BBC, History, Florence Nightingale)

She was the first person to focus on cleanliness and hygiene in hospitals, and also invented the pie chart. After the war, she was able to continue her work as a nurse due to her wealth. Mary Seacole, however, was unable to do this. This is why she wasn’t known about much. After Florence Nightingale rejected Mary as a nurse for the war four times because of her Jamaican decent, Mary sold her home in Jamaica so that she could afford to travel to the destination of the war, and built her own military hospital out of her own money so that she could help the British soldiers. During this time, she worked with the treatment of cholera and also with tropical medicines, and actually went onto the battlefield to treat wounded soldiers. (Horrible Histories, Series 2, Episode 6, 8th June 2010, Lucy Clarke, Dave Cohen, Susie Donkin, Jon Holmes and Ben Ward)

(5) John Snow (1854)
John Snow first discovered the links between the cholera outbreak and dirty water when he plotted the main cases on a map, and discovered that the people who lived closest to the water system that came from sewage were more likely to suffer from cholera. He also had a huge input on medical practices such as hygiene and anaesthetics (chloroform). (http://www.sciencemuseum.org.uk/broughttolife/people /johnsnow.aspx, Brought to Life, John Snow) (6) Zulu War (1879)

This war began due to the Britain wanting Zulu’s land. This caused rivalry between different countries, and Sir Bartle Frere – British colonial administrator – decided that he and some troops would protect the trade route – so that products and food could go to and from Britain. Around 1,400 British soldiers were killed in this war. (http://forums.canadiancontent.net/history/84817-remains-british-soldier-who-died.html, Canadian Content, British soldier who died in Anglo-Zulu War identified after 130 years) The main diseases to have affected soldiers in this ware were bowel diseases and malaria. Whereas in Britain, they had very little of these diseases. The soldiers were also highly affected by dysentery and diarrhoea. However, very few soldiers suffered with these diseases. The soldiers were very nourished, and were fitter than we are today. (http://www.anglozuluwar.com/content/html3/2009/04/16/2009041611283230000100.htm, Disease and Illness Prevalent During the Anglo Zulu War of 1879, Adrian Greaves and Dr. Alan Spicer)

(7) Beor War (1898 – 1902)
This war was caused by the British wanting to expand their land, and they wished to claim Boer (a country within the Transvaal Republic) as their own territory. In this war, around 22,000 British soldiers died – over 14,000 of these due to disease, and 86 due to lightening during a storm. These were diseases such as dysentery, typhoid and fever. (http://www.sahistory.org.za/south-africa-1806-1899/first-anglo-boer-war-1880-1881, South African History Online, First Anglo – Boer War)

(8) World War 1 (1914 – 1918)
World War 1 first started when the Archduke of Austria – Franz Ferdinand – was murdered by Serbian assassins. After this, Austria provided with a choice for the Serbians – either bring the assassins to justice, or they would start a war. When Serbia disagreed with this, both countries made alliances with other countries. (http://www.firstworldwar.com/origins/causes.htm, First World War, Origins, Causes) 908,371 British soldiers died during the first world war, and only 13% of these people died by either disease or natural causes. Due to living in trenches, the soldiers often got a disease called ‘trench foot’. This is because of the wet conditions in the trenches, and if it was left untreated for a large amount of time, it lead to gangrene – which could progress onto needing amputation. Other diseases known to the soldiers of world war 1 were influenza, typhoid, trench fever. (http://diseasesww1.blogspot.co.uk/2009/03/diseases-in-ww1.html, Diseases in World War 1) (9) Bevridge Report (1942)

The government tackle social inequalities by creating social policies. Our country is a welfare state; this means that the government take responsibility for and look after the citizens of our country by creating policies to help improve our economy. The welfare state was first created in 1942 by Sir William Beveridge. This was founded as the government was unsure of why so many people were in poverty and suffering from illness, so they sent Beveridge to do a report. During this report, Beveridge discovered what he said were the ‘5 giants of evil’, and stated these were the main reasons of poverty. These are Want (this is low income due to families that are unemployed, sick or widowed), Ignorance (lack of education for deprived areas, which increases the amount of people that suffer from unemployment), Squalor (this was due to poor living conditions and not enough housing), Disease (the country was over run with illness due to poverty) and Idleness (this is unemployment, as soldiers returning to Britain were not materialised).

The government attempted to tackle these situations by creating certain policies. For want, the government introduced National Insurance, and used the money gained from this to provide benefit funding for the more deprived people. For ignorance, the government created a policy which states that you have to stay in full time education until the age of 15. For squalor, the government helped by creating the New Towns act, which is when they built more housing in the countryside, and they also introduced council housing. For disease the government created the NHS (National Health Service) to allow free health care so that the people in poverty can still get the treatment they need. For idleness, the government took control of some companies, and created more jobs in these companies. (http://www.slideshare.net/nola/the-welfare-state, Slideshare, The Welfare State)

(10) World War 2 (1939 – 1945)
This war begun because even after Adolf Hitler agreed not to invade any more countries. However, soon after Germany invaded some countries – one of these countries being Poland. Britain signed a pledge with Poland stating that they will help to protect them if they’re ever invaded – which therefore resulted in Britain protecting Poland. During world war 2, around 400,000 British soldiers died, and around 90,000 civilians died – caused by the bombs dropped onto Britain. The diseases that were very common during the second world war were diarrhoea, dengue (this is infectious, and similar to measles), malaria (this is carried my mosquitoes and still kills around 655,000 people per year), filariasis (this is also carried by mosquitoes and similar insects), sand fly fever (this is also known as black fever, and is still kills around 500,000 people a year), scabies and typhus. (http://www.world-war-2.info/statistics/ World War 2 statistics)

(11) NHS (1948)
The NHS was founded by Aneurin Bevan, due to the government wanting to ensure that anyone – even those of little wealth – was given medical treatment. At first, the NHS offered completely free medical care – including dental work, opticians, GP’S, hospitals and pharmacists – but after the government spending much more money on the treatment then what was expected, they began to charge people for the use of dentistry, opticians and some pharmaceutical medicines. (http://www.nhs.uk/ NHSEngland/thenhs/nhshistory/Pages/NHShistory1948.aspx, NHS, The History of NHS England)

(12) DNA Was Discovered (1953)
In 1953, two scientists – James Watson and Francis Crick – discovered the structure of DNA. They had been working together at Kings College, and used X-ray diffraction to discover the double helix. This caused lots of advances in biology, and still helps us to discover new treatments. (http://www.bbc.co.uk/history/historic_figures/crick_and_watson.shtml , BBC History, Crick and Watson) (13) Smoking and Cancer links established (1954)

After researching whether coal fire fumes were related to lung cancer, Sir Richard Doll (scientist) discovers that smokers are more likely to suffer from the disease than non smokers. (http://www.nhs.uk/NHSEngland/thenhs/nhshistory/Pages/NHShistory 1948.aspx, NHS, The History of NHS England) (14) Daily Hospital Visits for Children

Sir James Spence – a paediatrician – and Alan Moncriff explained that by children being separated from their parents for so long, they could become traumatised. This lead to children being able to visit their parents in hospital daily, and visa versa. (http://www.nhs.uk/NHSEngland/thenhs/nhshistory/Pages/NHShistory 1948.aspx, NHS, The History of NHS England) (15) Polio and Diphtheria Vaccinations

The NHS made it so that anyone under the age of 15 were able to get both Polio and Diphtheria vaccinations – preventing epidemics of these diseases. (http://www.nhs.uk/NHSEngland/thenhs/nhshistory/Pages/NHShistory 1948.aspx, NHS, The History of NHS England) (16) Acheson Report (1998)

In 1998, a report by Sir Donald Acheson was published, as he was doing an inquiry on social inequalities. The main point of this report was that the government needed to increase the amount of benefits given – especially to childbearing women and people with young children. This is because Acheson discovered that certain inequalities start from before birth – such as the weight of the mother having an effect on the foetus. (http://news.bbc.co.uk/1/hi/health/222649.stm, BBC, Health, The Acheson report up close)

(17) Our Healthier Nation (1999)
Our healthier nation was created so that we could improve the health of our country. It focus’ on the problems of today that create ill health. These things are cancer, (which the NHS spend £1 Billion a year on) accidents (which takes more than 10,000 lives a year), coronary heart disease/stroke (which kills 5x more unskilled workers than professional) and mental ill health. (http://www.nhshistory.net/savinglives.html, NHS History, Geoffrey Rivett) Compare historical and current features of public health

Due to discoveries and creations throughout history, there are some diseases that we no longer have to worry about as much as we used to, however some diseases have become more prominent due to certain discoveries. In the 1900’s, John Snow discovered how Cholera spread which helped to prevent the disease. The last place to have caught cholera in the UK was in 1893, all other people in the UK that have suffered from cholera had caught it abroad. Something that has a huge impact on the public health of England has been pollution. Even though in the 1900’s they used coal, the use wasnt as excessive as it is now. Pollution can cause health problems such as asthma (this is because some pollutents aggrivate your lungs) (http://www.asthma.org.uk/knowledge-bank-pollutants, Asthma UK, Air Pollutants), emphysema (by pollutents causing the airways to swell) (http://copd.about.com/od /whatisemphysema/a/emphysema.htm, About.com, Emphysema), and even cancer. (http://scienceblog.cancerresearchuk.org/2013/10/18/the-link-between-air-pollution-and-cancer/, Cancer Research, Science Blog)

Also, due to research in 1957, we found out that smoking cigarettes is a huge contributor to cancer. Because of this, the smoking percentages since 1974 to 2012 has dropped by 29% in men and 22% in women. (http://ash.org.uk/files/documents/ASH_106.pdf, ASH Fact Sheet) A comparison between England in the 1900’s and England now is that even though the UK is the seventh richest country in the world, in 2012 it was measured that 1 in 6 (5.6 million, 17%) adults in the UK are living in poverty. During the 1900’s, 25% of the UK population was living in poverty. Even though the percentage has decreased, there are still too many people living in poverty. This could be because of the government spending money on things that aren’t necessary rather than the health of their own people. (http://www.localhistories.org/povhist.html, A Brief History Of Poverty in Britain) (http://www.bbc.co.uk/news/education-22887005, BBC News, Education and Family)

In this assignment I have described the origins of public health in the UK from the 19th century to the present day. I have also compared historical and current features of public health.

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