Public Health Acts

8 Key excerpts on "Public Health Acts"

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  The Origins of the British Welfare State

  Society, State and Social Welfare in England and Wales, 1800-1945

  • Bernard Harris(Author)
  • 2018(Publication Date)
  • Red Globe Press

    (Publisher)

  37 However, during the 1850s and 1860s, this theory began to give way to a range of new ideas, centring on the view that many diseases were actually spread by different microscopic organisms in the air which people breathed, and in the food and water which they ate and drank. These ideas laid the founda-tions for a much more wide-ranging approach to public health policy than that envisaged by Chadwick. They meant that the government would have to intro-duce a much broader range of measures to combat different sources of infec-tion, and that sanitary engineering by itself could not be relied upon to produce all the necessary improvements in public health standards. 38 Simon’s open-mindedness, combined with the extra legitimacy conferred by the new understandings of the causes of disease, helped to bring about a number of highly significant changes in the nature and scope of public health legislation, and in the relationships between central and local government. One of the most important illustrations of this new mood was the growing willingness to intro-duce, and accept, compulsory public health legislation. The first ‘compulsory’ Act was the Sanitary Act of 1866, which not only extended the scope of public health legislation, by expanding the legal definition of ‘nuisances’ prejudicial to health, but also extended the power of central government and the obligations of local authorities by compelling local authorities to inspect their districts and exercise their basic powers. This Act was followed by the Public Health Act of 1872, which sought to simplify the pattern of sanitary administration in England and Wales by creating a single sanitary authority for each area, and obliged every sanitary authority to appoint its own Medical Officer of Health. The process of reform was continued by the Public Health Act of 1875.

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  Public Health

  Policy and Politics

  • Rob Baggott(Author)
  • 2010(Publication Date)
  • Bloomsbury Academic

    (Publisher)

  Although Parliament was a key battleground between public health reformers and their opponents in the Victorian era, local government was also an important arena. The 1848 Act was permissive in all but the most exceptional circumstances. This meant that decisions about public health were delegated to local communities, stimulating political divisions at this level. Efforts to impose a central framework for regulation were vigorously resisted. Indeed, according to some (Szreter, 1995, cited in Baum, 2002, p. 19) the 1840s were ‘a false dawn’ for the public heath movement, which failed to win over the governing classes. In the longer term, however, the impetus proved too powerful. The crucial change was the 1866 Sanitary Act, which imposed obligations on localities to cleanse their communities, although local communities continued to have considerable autonomy within this framework.

  The Public Health Act of 1875 represented the culmination of the sanitary reformers’ campaign. Although a consolidating measure, it set a clear framework for public health for the next fifty years. It also signalled the end of an era, for although legislation would still be used to improve the physical environment, attention was shifting towards other means of intervention aimed at improving social welfare generally and personal hygiene in particular.

  Victorian Public Health: Preventive Medicine

  In the latter part of the Victorian period, ‘preventive medicine’ replaced the ‘sanitary idea’ as the dominant philosophy of public health (see Armstrong, 1993; Kickbusch, 1986; Fee and Porter, 1992; Lewis, 1992). This was manifested in the ‘medicalization’ of public health; in a shift in the focus of attention from the general population towards specific subgroups and individuals, and in an increasing emphasis on access to health services. At the same time, the activities of the sanitary movement, while still contributing to public health debates, became more closely integrated with broader issues of social welfare.

  It should be noted that Chadwick had a ‘deep-seated distrust of curative medicine’ (Finer, 1952, p. 157). Indeed, the early Victorian public health programme was ‘fundamentally environmentalist’ (Sheard and Donaldson, 2006, p. 1). Medicine played a secondary role to other professions, such as engineering for example. As already mentioned, medical professional bodies were less than enthusiastic about central government intervention. Nonetheless, individual members of the medical profession were an important driving force behind the sanitary revolution. Much of the early evidence about the extent of the problem was documented by individuals with a medical background, such as Farr, Southwood Smith and Simon.

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  Healthy or Sick?

  Coevolution of Health Care and Public Health in a Comparative Perspective

  • Philipp Trein(Author)
  • 2018(Publication Date)
  • Cambridge University Press

    (Publisher)

  Demand for public health policies was high during this time, due to the limited possibilities to cure contagious sicknesses. 85 86 Healthy or Sick? 5.1.1 Unification of Both Sectors in National Public Health Legislation The United Kingdom already had encompassing health legislation dur- ing the nineteenth century. During this period, the country experienced a comprehensive sanitary reform. Specifically, a series of Public Health Acts was passed, most of which entailed public health regulations for England and Wales. These acts governed, for instance, waste removal and disease prevention, sewers, housing management, vaccination, and established general boards of public health (Porter, 1999, 127). Based on these laws, the national government pursued a restrictive and interventionist policy with compulsory vaccinations, such as against smallpox and other transmittable diseases. Noncompliance was subject to fines. The interventions were based on the arguments of advocates for state medicine. The basic idea behind these laws was that the individual’s right to die and to be sick needs to be suspended in favor of the community. Nevertheless, these laws helped to prevent but could not cure infectious diseases; for instance, a number of syphilis cases were transmitted during an epidemic in 1871 (Porter, 1999, 128–129). Doctoral organizations and popular movements, for example, the National Anti-Vaccination League, protested against this legislation and demanded to repeal restrictive public health legislation, such as the Contagious Disease Act. The opponents succeeded in the repletion of compulsory legislation on vaccination of infants as well as the legislation permitting the arrest and detention of prostitutes (Porter, 1999, 130). Yet, many of the interventionist public health policies in the United Kingdom went unopposed, because the government intro- duced most of these policies at the end of the nineteenth century based on the findings of bacteriological research.

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  Managing the Environment, Managing Ourselves

  A History of American Environmental Policy, Second Edition

  • Richard N. L. Andrews(Author)
  • 2008(Publication Date)
  • Yale University Press

    (Publisher)

  The existence of preventable health hazards provided a powerful justification for using stronger and more professional municipal governance to improve citizens’ living conditions. The New York Metropolitan Health Act marked a turning point in the history of U.S. public health, by creating the first clearly professional agency for local public health ad-ministration. Prior to 1866 public health had been advocated by loose coalitions of physi-cians and civic reformers, but local government agencies had limited health authority and were sta√ed by patronage rather than competence. Under the new law, health administra-tion was delegated to a board of health consisting mainly of physicians and police commis-sioners, which was given broad discretionary authority to investigate, regulate, promote, and implement sanitation measures (Rosen 1958, 243–48). State boards of health also proliferated, beginning in Massachusetts in 1869. The professionalization of public health paralleled a similar di√erentiation of sanitary engineering as a distinct expertise, specializing in the particular problems of urban water supply and wastewater and solid waste removal. Sanitary engineers were both environ-mental generalists and technical specialists: they were technical specialists in the way they 122 Public Health and Urban Sanitation approached the design and construction of complex water supply and sewer systems, but they were also the most knowledgeable experts about the general urban physical environ-ment and its material and energy flows. Because of their commitment to urban service systems, their career opportunities lay in municipal government, and by the early twen-tieth century they had emerged as key policymakers for urban environmental services, even superseding public health o≈cials as the latter shifted their attention to other health priorities (Melosi 1981, 79–104).

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  Public Health in Asia and the Pacific

  Historical and Comparative Perspectives

  • Milton J. Lewis, Kerrie L. MacPherson, Milton J. Lewis, Kerrie L. MacPherson(Authors)
  • 2007(Publication Date)
  • Routledge

    (Publisher)

  4 History of public health in modern India

  1857–2005

  Radhika Ramasubban

  Introduction

  Public health interventions and reforms, by their very nature as expensive and large-scale undertakings, have historically been the domain of governments. Their success depends upon a state’s capacity to demonstrate a strong political will, based on enlightened understanding that financial resources and administrative competence invested in public health measures can produce long-term and self-multiplying economic and social gains.

  The nineteenth and early twentieth centuries were a period when the developed countries of today successfully achieved control over preventable infectious diseases causing high and premature mortality. This they did through public health reform: state-led improvements in water supply, sewerage, drainage, air quality, housing and town planning backed by legislation, and accompanied by health education, often in response to public pressures. By the time the era of revolutionary clinical medicine based on antibiotics set in, these countries had virtually won the battle against killer communicable diseases. This transformation took place in, by and large, culturally homogeneous societies, in tandem with economic growth (urbanization, industrialization, a skilled and educated workforce, and rising incomes that facilitated improved nutrition) and considerable national wealth generated by an extensive engagement with overseas colonies.

  It was during the peak of this phase in Britain’s history that India became its flagship colony. It was inevitable that the rising tide of the new metropolitan sanitary science would have an impact on Britain’s engagement with India. The challenge for the European constitution of coping with the Indian climate and its perceived propensity for generating disease had understandably been a preoccupation since the earliest days of the East India Company. This intensified during the nineteenth century when the Company’s armies claimed new parts of the country. The colonizing project matured after the Sepoy Mutiny of 1857 – better known in India as the First Indian War of Independence – and the takeover of the country’s administration by the Crown. The decision that Britain would relocate a third of all its armed forces in India, and not develop India as a Crown settlement colony but only exploit its natural resources for repatriation and international trade, set off economic, social and political currents that shaped the mix of public health solutions that evolved for the enclave community and the general population. For India – many times the size of Britain, geographically more heterogeneous, predominantly rural, socially highly stratified and culturally complex – the colonial encounter marked a unique moment in its public health history.

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  Public Health and Society

  • John Costello, Monica Haggart, John Costello, Monica Haggart(Authors)
  • 2017(Publication Date)
  • Red Globe Press

    (Publisher)

  Part I Public Health and Nursing: Origins and Development 3 1 Holding Public Health Up for Inspection JOEL RICHMAN The key points discussed in this chapter include: ● public health definitions: the political and social significance of public health in contemporary society ● key historical public health changes that have influenced the develop-ment of public health in the UK ● the link between industrialisation and the development of the ‘new public health’ in the twentieth century. Introduction The purpose of this chapter is to consider some of the key definitions of public health, highlighting its importance in terms of its analytical and moral status. In doing this the chapter will develop an historical and cross-cultural perspective on public health, noting the diffusion of public health with colonisation (an ‘early stage’ of globalisation). Public health is a mul-tiplex concept consisting of a wide range of interpretations, social, politi-cal and economic, with many lay and professional practices, values and ideas embedded within it. From a sociological point of view, consideration is made of the various debates about the ‘new’ public health and espe-cially whether it constitutes a new social movement with a modern health agenda. This necessitates the provision of an outline of some of the dis-cussions about public health within current health delivery. The chapter concludes with a consideration of lay beliefs and their importance in defining ideas about health, as well as a look forward to some of the underpinning issues associated with public health which will hopefully sensitise the reader to their more substantial unfolding in later chapters. Differing Perspectives on Public Health Public health has been variously described as ‘old’ and ‘new’.

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  The Development of Modern Medicine

  An Interpretation of the Social and Scientific Factors Involved

  • Richard Harrison Shryock(Author)
  • 2017(Publication Date)
  • University of Pennsylvania Press Anniversary Collection

    (Publisher)

  254. 28 Quoted in B. L. Hutchins, The Public Health Agitation, 1833-1848 (Lon., 1909), pp. 109, 110. 218 DEVELOPMENT OF MODERN MEDICINE gram of health reform. Not even the Poor Law or the Factory Question, declares a modern English historian, go so deep into the national life. 29 The first stage in the public health movement was one of investigation on a grand scale. Governmental authorities must learn the worst about living conditions and disease among the masses, in order to inaugurate improvements. While the rank and file of physicians were rarely much con-cerned with public hygiene, the lead in investigations was taken by individual medical men who combined humane sen-timents with a scientific interest in disease prevention. Vir-chow's report on Silesia was paralleled by more sweeping inquiries made in Great Britain and in the United States between 1835 and 1850. In the former nation, Drs. Arnot, Kay, and Southwood Smith submitted striking reports on the causes of fevers in London. These were followed in 1842 by a comprehensive survey of national health as a whole. This took the form of a report to the Poor Law Board from all the poor law physicians in England, on the disease conditions in their respective unions. 30 In the United States the National Institute at Washington tried for several years to secure a similar national survey. Failing in this, the Institute persuaded the newly formed American Medical Association to examine conditions in the larger American cities. The resulting reports indicated clearly that just such poverty and disease as obtained in London, Manchester, and Glasgow also disgraced Boston, New York, and Philadelphia, and that the death rates were even higher in the American cities. 81 In some cases medical investigators cooperated effectively 2» Hutchins, op. cit., p. 58. The Poor Law Act of 18)4, of course, had itself possessed public health significance. See Sir Allen Powell, The Relation of Public Assistance to Public Health, Amer.

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  Public Health

  Local and Global Perspectives

  • Pranee Liamputtong(Author)
  • 2022(Publication Date)
  • Cambridge University Press

    (Publisher)

  This tension between individual and collective responsibility for health is a common thread in the history of public health. As you read this chapter, ask yourself: how has this tension developed over time, and why does it persist? Introduction This chapter explores the assumptions and struggles that have occurred over the long history of public health. It provides an opportunity to question what public health is and where it is going, based on where it has been. A comprehensive history is outside the scope of a single chapter; instead, the chapter takes a critical overview. Following the social philosopher Michel Foucault (1926–84), the public health knowledge presented is considered a product of its time, culture and context, rather than the result of ‘progress’: a linear path of discovery (Foucault, [1969] 2002). Accordingly, the chapter examines contemporary public health principles and practices that have resulted from the actions of historic heroes and innovators as much as from chance or folly. With a critical examination of its history, this chapter shows that public health is more than a health discipline. It is a scientific profession, a social science and a political endeavour to empower individuals and improve health through organised collective intervention (see also chapters 1, 5, 10 and 14). This chapter introduces readers to the different lenses through which public health has been viewed and practised, from individualist, behaviourist and biomedical perspectives through to cultural and socio-environmental; from ancient Greece to 19th-century Prussia. Australia’s and Aotearoa New Zealand’s histories are also explored, to show how different approaches to public health have (de)emphasised the importance of collective action. The chapter concludes with an examination of this tension in contemporary public health through the example of tobacco control.

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