Lesson video

Hello, I'm Mr. Marchant, and thank you for joining me for today's history lesson.

My top priority today is to help guide you through all of our resources and make sure that you can meet today's learning objective.

Welcome to today's lesson, which is part of our Edexcel unit on medicine in Britain and our AQA unit on health and the people.

By the end of today's lesson, you'll be able to evaluate how and why the government's approach to public health changed during the 19th century.

There are three key words which will help us navigate our way through today's lesson.

Those are public health, adulterated, and laissez-faire.

Public health refers to the actions and systems intended to prevent disease and maintain good health within communities.

Adulterated refers to foods which have been made weaker or worse in quality, especially by having something added to them.

And laissez-faire is the belief that governments should not interfere in people's daily lives.

Today's lesson will be split into three parts and will begin by focusing on public health challenges in the 19th century.

In the early 19th century, Britain was experiencing the Industrial Revolution.

The Industrial Revolution had many consequences, including significant public health challenges.

These challenges included overcrowding, poor waste disposal, and poor access to safe food and water.

From 1801 to 1851, the population of London doubled, Birmingham's population tripled, and the population of Glasgow, Manchester, and Liverpool more than quadrupled.

This population growth challenged public health as it led to overcrowding, and many industrial workers were forced to live in slums. New houses were constructed, but these were often built so close together that they became known as back-to-backs.

Back-to-backs were notorious for their poor ventilation, lighting, and lack of space, all of which was made worse as many people crowded together inside them.

In industrial cities, five or more people often shared one room.

And in 1847, officials found one room in Liverpool shared by 40 people.

Overcrowding like this contributed to high death rates as it was easy for infectious diseases like tuberculosis to spread from person to person.

So, let's check our understanding of everything we've just heard.

What name was given to many of the new homes built for industrial workers? Pause the video here and press play when you're ready to see the right answer.

Okay, well done to everybody who said the correct answer was back-to-banks.

Let's try another question.

How many people often shared a single room in industrial cities? Was it one, three, or five or more? Pause the video here and press play when you're ready to see the correct answer.

Okay, well done to everybody who said the correct answer was C.

In many industrial cities during the 19th century, it was common for five or more people to share a single room.

Poor waste disposal and poor access to safe water and food were also major public health challenges.

Many areas where industrial workers lived lacked rubbish collection, sewers, toilets, and running water.

For example, it was common for many families to share a single toilet, especially in back-to-back houses.

Consequently, waste and sewage was often able to build up close to where industrial workers lived, making it easy for diseases to spread.

Indeed, urban water sources, whether they were wells, rivers, or ponds, frequently became contaminated by sewage in the early 19th century.

These contamination issues led to the spread of deadly diseases such as cholera and typhoid, which killed thousands.

Poor food standards were also a serious issue for public health in the 19th century.

In particular, food was sometimes adulterated by those who sold it to help them make more money.

In Liverpool, it was reported that some merchants mixed the sugar they sold with waste chemicals from a local soap factory.

And elsewhere, it was reported that bakers mixed flour with chalk to make their bread more white.

These practises could be deadly in some cases and put the health of many people, rich and poor alike, at risk in Britain.

So, thinking about what we've just heard, we have a statement on the screen that reads, the standard of food eaten by industrial workers was often poor in the early 19th century.

But is that statement true or false? Pause the video here and press play when you're ready to see the right answer.

Okay, well done to everybody who said that that statement was true, but we need to be able to justify our response.

So, why is it that that original statement was correct? Pause the video here and press play when you're ready to check your answer.

Okay, well done to everybody who said lack of money forced industrial workers to buy some poor quality food and similar products they bought were adulterated by those who sold them.

And let's another question.

Why were deaths from cholera so common in industrial cities? Was it because food was often adulterated, because houses were usually overcrowded, or because water was often contaminated? Pause the video here and press play when you're ready to see the right answer.

Okay, well done to everybody who said the correct answer was C.

Deaths from cholera were very common in many industrial cities because water was often contaminated, allowing the bacteria responsible for cholera to be spread.

So, we're now in a good position to put all of our knowledge about public health challenges in the 19th century into practise.

I want you to study the source.

It's an extract from a letter written in 1837 about living conditions for industrial workers in Manchester.

It says, "Generally speaking, throughout these areas the streets are unpaved, with a dunghill in the middle; the houses built back to back, without ventilation or drainage; and whole families occupy a corner of a cellar or attic room." So, I want you to identify two public health challenges referred to in the extract.

You should include quotes from the source as part of your answer.

So, pause the video here and press play when you're ready to reflect on your response.

Okay, well done for all of your hard work on that task.

So, I asked you to identify two public health challenges referred to in the extract, and your answer may have included one public health challenge referred to in the extract is overcrowding in industrial cities.

For example, the extract states that "whole families occupy a corner of a cellar or attic room" in many houses in Manchester.

Another public health challenge referred to in the extract is poor waste disposal.

For instance, the author of the extract observed that "throughout these areas the streets are unpaved, with a dunghill in the middle." So, really well done if your own responses look something like those models which we've just seen.

And so, now we're ready to move on to the second part of our lesson for today, where we're going to think about the 1848 and 1875 Public Health Acts.

In 1848 and 1875, the government responded to poor public health conditions in Britain by passing new laws.

These laws were the 1848 and 1875 Public Health Acts.

These laws represented a step away from laissez-faire attitudes towards public health in Britain.

During the early 19th century, laissez-faire attitudes were common in government.

This meant that when came to public health, most authorities believed individuals rather than the government were responsible for managing their own wellbeing.

However, deadly cholera epidemics during the 1830s did prompt the government to investigate the living conditions of the poor.

This investigation was led by Edwin Chadwick, who published his findings in 1842.

Chadwick's report highlighted that the average life expectancy for poor workers in many industrial cities was below 20, and he blamed poor sanitary conditions for this.

Chadwick concluded that if these problems were to be solved, the government needed to act, especially by improving water supplies and sewage systems. So, thinking about what we've just heard, what did Edwin Chadwick's 1842 report reveal about life expectancy? Was it that it was below 10 for many industrial workers, that it was below 20 for many industrial workers, or that it was below 30 for many industrial workers? Pause the video here and press play when you're ready to see the correct answer.

Okay, well done to everybody who said the correct answer was B.

Edmond Chadwick's 1842 report revealed that for many industrial workers, their life expectancy was below 20 years.

And let's try another question.

This time, we have a statement which reads, laissez-faire attitudes meant that many authorities believe the government shouldn't make public health reforms. But is that statement true or false? Pause the video here and press play when you're ready to see the right answer.

Okay, well done to everybody who said that that statement was true, but we need to be able to justify our response.

So, why is it that that original statement was correct? Pause the video here and press play when you're ready to check your answer.

Okay, well done to everybody who said laissez-faire attitudes meant that many authorities believed it was individuals' own responsibility to manage their wellbeing, rather than the responsibility of governments.

The government did not respond to Chadwick's recommendations immediately, but did it eventually pass the 1848 Public Health Act.

This new law followed some of Chadwick's recommendations by encouraging local authorities to set up their own boards of health, which would be responsible for improving both water supplies and sewage systems. However, the actual impact of the 1848 Public Health Act was relatively limited.

This was mainly because the law was permissive rather than compulsory.

Local authorities could choose to make sanitary reforms, but because they did not have to, many did not.

In 1875, a new Public Health Act was passed, which went much further than the law of 1848.

This new law did not just encourage local authorities to make reforms, but required them to do so.

Indeed, amongst other responsibilities, local authorities were required to provide clean water, build sewers to dispose of waste, improve housing standards, check food quality, and appoint medical officers to ensure that public health standards were being met in their area.

This represented a shift away from laissez-faire attitudes and a more serious government approach towards improving public health.

There were no major cholera epidemics in Britain after 1875, and death rates from other infectious diseases fell over the next three decades.

Nevertheless, progress could be slow.

For instance, one in eight deaths in Britain during the 1890s was still caused by tuberculosis and average life expectancy remained below 50 by 1900.

So, thinking about what we've just heard, I want you to change one word to correct the following sentence, which reads, as it was not compulsory, the 1875 Public Health Act was simply ignored by many local authorities and public health reforms were only carried out in few places.

So, consider which word appears to be incorrect in that sentence, and what should it be changed to? Pause the video here and press play when you're ready to check your answer.

Okay, well done to everybody who changed 1875 to 1848.

As it was not compulsory, the 1848 Public Health Act was simply ignored by many local authorities and public health reforms were only carried out in few places.

And let's try another question.

Which example suggests the 1875 Public Health Act was effective? Is it that life expectancy was below 50 in Britain by 1900, that there were no cholera epidemics in the 1880s and 1890s, or that tuberculosis counted for one in eight deaths in the 1890s? Pause the video here and press play when you're ready to see the right answer.

Okay, well done to everybody who said the correct answer was B.

One way we can tell that the 1875 Public Health Act was effective is that there were no cholera epidemics in the 1880s or 1890s.

So, we're now in a good position to put all of our knowledge into practise.

I want you firstly to describe one difference between the 1848 Public Health Act and the 1875 Public Health Act.

Then, I want you to describe one similarity between the 1848 Public Health Act and the 1875 Public Health Act.

So, pause the video here and press play when you're ready to reflect on your responses.

Okay, well done for all of your effort on that task.

So firstly, I asked you to describe one difference between the 1848 Public Health Act and the 1875 Public Health Act.

And your answer may have included, one way in which the 1875 Public Health Act differed from the 1848 Public Health Act was in its use of compulsory measures.

The 1848 Act had encouraged local authorities to improve water supplies and build new sewers, but this law had been permissive so many councils ignored it.

By contrast, the 1875 Act included many similar measures, but these were compulsory so local authorities had to make improvements.

And for the second part of Task B, I asked you to describe one similarity between the 1848 Public Health Act and the 1875 Public Health Act.

And your answer may have included, one similarity between the 1848 and 1875 Public Health Acts was that they emphasised the importance of improved sanitation for public health.

For example, the 1848 Act encouraged the construction of new sewage systems to dispose of waste safely.

When the 1875 Act was introduced, it also required local authorities to build or improve sewer systems to ensure waste was safely removed from areas where people lived.

So, really well done if your own responses looked something similar to the model answers we've just seen.

And so, now, we're ready to move on to the third and final part of our lesson for today, where we're going to focus on explaining public health reforms. Increased government action was very important for improving public health in Britain in the 19th century.

Historians have often highlighted three factors which helped encourage greater government action.

These included the role of individuals, scientific knowledge, and politics.

Individuals such as Edwin Chadwick and John Snow, a doctor who proved that cholera was spread through contaminated water, appealed to the government to introduce public health reforms. However, in Snow's case, his recommendations were simply ignored.

Even in Chadwick's case, whilst his recommendations influenced the 1848 Public Health Act, this was after a delay of several years, and the new law was only permissive.

Improvements in scientific knowledge were also helpful for encouraging government action.

In 1861, Louis Pasteur published his germ theory, which explained that microbes caused some diseases.

As this theory gained acceptance, it became easier to justify the expense of public health reforms to protect people from harmful microbes.

However, germ theory was not accepted immediately, and incorrect explanations of medical ideas like miasma remained popular with many authorities until late in the 19th century.

Finally, political concerns also helped encourage more government action, especially as the number of people who could vote in British elections increased.

In 1832, 1867, and 1884, new laws were passed, which allowed more and more men to vote in Britain.

For instance, the number of voters in Britain doubled in 1867, giving many industrial workers the right to vote for the first time.

Politicians believed it was necessary to pass laws which would appeal to these new groups of voters by addressing issues such as poor standards of public health, which affected their lives.

So, let's make sure we have a secure understanding of everything we just heard.

Firstly, I want you to write the missing word from the following sentence that reads, Chadwick's recommendations were included in the 1848 Public Health Act, but this law was not blank.

So, what's the missing word? Pause video here and press play when you're ready to check your answer.

Okay, well done to everybody who said that the missing word was compulsory.

Chadwick's recommendations were included in the 1848 Public Health Act, but this law was not compulsory.

And let's try another question.

What happened to the number of voters in Britain in 1867? Was it halved, taking the vote away from many industrial workers, that it doubled, giving the vote to many industrial workers, or that it quadrupled, giving the vote to many industrial workers? Pause the video here and press play when you're ready to see the right answer.

Okay, well done to everybody who said the correct answer was B.

In 1867, the number of voters in Britain doubled after a new law was passed, meaning that many industrial workers gained the right to vote.

And let's try another question.

This time we have a statement which reads, those who gained the vote in 1867 were likely to support public health reforms. Is that statement true or false? Pause the video here and press play when you're ready to see the right answer.

Okay, well done to everybody who said that that statement was true, but we need to be able to justify our response.

So, why is it that that original statement was correct? Pause the video here and press play when you're ready to see the right answer.

Okay, well done to everybody who said many industrial workers gained the vote in 1867, and these people often lived in poor conditions, so public health reforms would improve their lives.

And so, now we're in a good position to put all of our knowledge from today's lesson into practise.

We have a statement which reads, without the work of Edwin Chadwick, governments would not have supported public health reforms in the 19th century.

How far do you agree? I want you to write two paragraphs to explain your answer.

Pause the video here and press play when you're ready to reflect on your response.

Okay, well done for all of your hard work on that task.

So, we had the statement, without the work of Edwin Chadwick, governments would not have supported public health reforms in the 19th century, and I asked how far you agreed.

Your answer may have included, Edwin Chadwick's work did help to encourage the government to make public health reforms. In the early 19th century, laissez-faire beliefs meant that authorities refused to make public health improvements.

However, in 1842, Chadwick published a report which demonstrated that industrial workers were badly affected by poor standards of public health and told the government it should take responsibility for improving this.

In 1848, government passed the Public Health Act.

Chadwick's influence can clearly be seen as the new law included some of his recommendations, including encouraging local authorities to improve water supplies and suit systems. Nevertheless, other motives, such as political change, also encouraged reforms. A more effective Public Health Act was passed in 1875.

This law not only encouraged reforms, but made it compulsory for local authorities to carry them out.

The 1875 Act came less than 10 years after the number of people who could vote in Britain was increased to include many industrial workers.

This is important as it suggests that in 1875, the government was targeting support from new voters by addressing an issue that affected their lives.

Therefore, it's likely that even without Chadwick's work, political changes would have encouraged the government to increase its efforts to reform public health.

So, really well done if your own response looks something like that model which we've just seen.

And so, now we've reached the end of today's lesson, which puts us in a good position to summarise our learning about improvements in public health in the 19th century.

We've seen that overcrowding, poor waste disposal, and poor access to both food and water were all major public health challenges in the 19th century.

Laissez-faire attitudes discouraged government public health reforms. Edwin Chadwick's investigation into living conditions for the poor helped encourage government action.

Public Health Acts were introduced in 1848 and 1875 with a particular focus on improving water supplies and sewage systems. And knowledge of germ theory and the extension of the vote to industrial workers also encouraged the government to make reforms. So, really well done for all of your effort during today's lesson.

It's been a pleasure to help guide you through our resources today, and I look forward to seeing you again in future as we continue to think about medicine in Britain and health in the people.