The Origins Of Public Health

Public health has been a recognised specialist field of practice in the UK since the middle of the 19th century when the foundations of the public health movement were laid.

In 1848 Parliament passed the first Public Health Act as a direct result of Sir Edwin Chadwick’s ‘General Report on the Sanitary conditions of the Labouring Population of Great Britain’.

Chadwick was convinced that socio-economic class was linked to health and he demonstrated that the average age at death in Liverpool at that time was 35 years for gentry and professionals, but only 15 years for labourers, mechanics and servants.

Chadwick managed to persuade Parliament that widespread disease amongst the lower social classes resulted in an enormous cost to society, and as a result of the Act, employers were required to implement measures that would reduce the incidence of disease and ill health at work.

The Act also led to the creation of Local Boards of Health to improve the sanitary condition of populated places in England and Wales by placing the supply of water, sewerage, drainage, cleansing and paving under a single local body.

Public health today

It may be over a century and a half since the first Public Health Act was passed but many of the issues identified by Chadwick are still relevant today, particularly the impact of health inequalities.

In addition, the primary cause of illness in the UK is moving away from communicable (mainly infectious) diseases and accidents at work, towards illnesses caused by non-communicable diseases such as diabetes, coronary heart disease and stroke, which are mainly the result of lifestyles.

A modern day public health approach accepts the importance of collective responsibility for improvements in population health and prevention of disease.  There is much greater practice of, and evidence available on, public health now than in Chadwick’s day, but the responsibility remains with the State to lead health improvement and set out priorities for action. 

Today, however, health professionals, industry, public service organisations and increasingly, individuals themselves, have a key role to play in the promotion of good health and the prevention of disease.