🛀 Sewers
Councils built sewer networks to carry waste away from houses, so cesspits could be emptied and closed. Towns also paid for rubbish collection and for paving and cleaning streets.
Accelerating Change, 1875-1905: Ehrlich, Koch and Chemistry » Cleaner Towns: The Impact of the 1875 Public Health Act
What you'll learn this session
Study time: 30 minutes
Edexcel spec: Paper 2 Section B, Breadth study B2, Key topic 3
- What the Public Health Act of 1875 changed in towns: sewers, clean water and medical officers
- How far death rates fell in the decades after the Act
- Why poverty and ill health still remained by about 1900
- How to answer a 6-mark "Explain TWO ways ... similar" question
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Unlock This CourseFrom law to clean streets
The Public Health Act of 1875 made town councils responsible for the health of their towns. A law on paper is not the same as a clean street, so the real question is what happened next. In the decades after 1875, towns across England and Wales changed a great deal. This lesson looks at the impact of the Act: what it achieved, and what it did not.
Key terms:
- Infant mortality: the number of babies who die before their first birthday, for every 1,000 born.
- Poverty: not having enough money for basic needs such as food, rent and heating.
- Impact: the effect something has, in the short term and the long term.
Sewers and clean water
Before 1875 many poor streets had cesspits, open drains and shared pumps. Councils now had a legal duty to deal with this, and over the following years they spent ratepayers' money on big projects.
💧 Clean water
Water companies often charged high prices and supplied poor streets badly. In the mid-1870s Birmingham's council, led by its mayor Joseph Chamberlain, bought up the town's water and gas supplies and cleared some of the worst slums in the centre.
This mattered because dirty water carried disease. Safe water and working drains cut off one of the main routes by which diseases such as cholera and typhoid reached people, and deaths from typhoid fell.
Medical officers and inspectors
Medical officers of health and sanitary inspectors did the day-to-day work that a law cannot do by itself.
- Medical officers wrote yearly reports on the town's death rate and its main diseases. This showed councils which streets and illnesses needed attention.
- Inspectors checked houses, drains, slaughterhouses and food, and could order owners to put problems right.
- Medical officers also pushed for infectious patients to be kept apart from others, to stop diseases spreading.
Having a trained person whose whole job was public health was new, and it gave towns a steady push to keep improving.
Did death rates fall?
Yes. The death rate (deaths each year for every 1,000 people) in England and Wales was about 22 in the early 1870s. By 1900 it was about 18. Deaths from diseases linked to dirty water, such as typhoid, fell. The Act was not the only cause, because better food supplies and rising wages helped, and doctors were learning more about germs. But many historians think cleaner water, sewers and inspections helped to cause a big part of the fall.
What had not changed by 1900
The Act did not solve everything.
- Uneven action: councils had to act, but how quickly and well they did so varied. Some ratepayers did not want to pay for improvements, and some towns moved slowly.
- Poverty: the Act could not make people richer. Charles Booth's survey of London found about 30 per cent of the people there living in poverty. Seebohm Rowntree's survey of York in 1899 found about 28 per cent.
- Ill health: in 1900 about 150 in every 1,000 babies in England and Wales still died before their first birthday, and tuberculosis (TB) still killed many people. Poor, crowded housing and poor food made them more likely to fall ill.
What changed and what stayed the same
Changed: towns had sewers, cleaner water and officials in charge of health, and death rates fell. Stayed the same: poor families still lived in crowded housing, the poor still suffered most from ill health, and the government still left much to local councils. The next big step came when national governments began to help poor families directly, after 1900.
Common mistakes
- Saying the Act "ended" disease. It cut some diseases, but TB and high baby deaths remained.
- Giving the Act all the credit for falling death rates. Write "helped to cause" and name another factor.
- Re-telling why the Act was passed. In an impact question, write about what happened afterwards.
Exam-style question
Explain TWO ways in which public health in towns in about 1900 was similar to public health in towns in 1848. [6 marks]
Remember: in 1848, many workers in Manchester lived in back-to-back houses and cellars, and labourers died at an average age of about 17, compared with about 38 for professional people.
Model answer
One way is that poor people still lived in poor, crowded housing. In 1848 labourers in Manchester lived in back-to-back houses and cellars, and in about 1900 Charles Booth found about 30 per cent of Londoners living in poverty, and poor, crowded housing was still part of that poverty. So in both periods the poorest families lived in the worst housing.
Another way is that infectious disease still killed large numbers of people. In 1848 labourers died at an average age of about 17 and cholera swept through towns. In 1900 about 150 in every 1,000 babies still died before their first birthday and TB still killed many, so in both periods ill health cut many lives short.
What lifts it to the top level: each way names a fact about both 1848 and about 1900, and the paragraphs make the comparison clear with "in both periods".
Exam tip
For "similar" questions, put one precise fact from each period in every paragraph. A paragraph about only one period cannot score the top marks.