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

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Public wellness is the steps taken by the authorities to prevent sick wellness and disease. The government monitors wellness so that they can develop different programs and legislation to improve the wellness and well-being of the people in the state. They do this by trying to work out inequalities, so that all people, no matter what, are able to live a healthy life. There are eight policies to improve today’s public wellness.

These are: planning for wellness emergencies (this is ensuring that wellness services are prepared for emergencies such as accidents, outbreaks of disease, and terrorist attacks), assisting more people to survive cancer (by trying to reduce the cancer death rate by 5000), reducing smoking (by reducing smoking rates to 18.5% for adults, 12% for 15-year-olds, and 11% for pregnant women), giving all children a healthy start in life (by improving pregnancy care and introducing the Healthy Child Programme, which is available to all families).

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Reducing obesity and improving diet (by introducing the Change for Life program, and ensuring that food packaging has clear nutritional information), reducing harmful drinking (again by introducing the Change for Life program, and by providing £448 million to improve the lives of the 120,000 most troubled families), reducing drug abuse and addiction (by providing support and information on drugs (i.e. FRANK).

And supporting children in their first five years of their lives to prevent drug use further on in their lives), and making 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. United Kingdom. Policies).

Napoleonic Wars (1790-1815)

During the Napoleonic Wars, about eight times the number of British soldiers who were killed in action were killed by disease. This majority of deaths due to disease were caused by the Bubonic Plague and were due to the living conditions of the soldiers, as they lived in collapsible shelters 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. (https://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 ambulances 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 people with the most severe injuries would be treated first – no matter what rank they held. (https://www.historyofwar.org/articles/wars_napoleonic.html. History of War. Napoleonic Wars. Dugdale-Pointon)

Poor Law Amendment (1834)

This act was created because the authorities had spent excessively much money in the 1830s looking after the hapless. This piece of legislation stated that if the hapless wanted food, clothing, and shelter, they had to work at the workhouse. People had to cope with bad living conditions and minimal meals. Families were also split up. Edwin Chadwick played a large part in creating this legislation. (Source: http://www.bbc.co.uk/schools/gcsebitesize/history/shp/britishsociety/thepoorrev1.shtml, BBC Bitesize History)

The 1848 Public Health Act

This act was largely amended by Edwin Chadwick, who stated that if the hapless were healthier, they would be able to get better jobs, meaning that the government wouldn’t have to pay as much to workhouses and helping the hapless. One of the things changed by this law was the state of the sewers.

They improved them to ensure that there wasn’t as much waste on the streets, hence preventing disease. They also provided clean drinking water and a medical officer for each town. This was the first Public Health Act. (Source: 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)

Crimean War (1850s)

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, enteric fever, cholera, and dysentery. During this war, a lot of hospital patients had to lie on the floor because there weren’t enough beds. Also, soldiers who had infected limbs had to have them amputated with a saw, and often these limbs were given to the military dogs as food.

Two significant people during this war were Florence Nightingale and Mary Seacole. Florence Nightingale became a nurse in 1853, just a year before the Crimean War had begun. After an acknowledgment 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. (Source: 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 well known.

After Florence Nightingale rejected Mary as a nurse for the war four times because of her Jamaican descent, Mary sold her home in Jamaica so that she could afford to go to the war’s location 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 injured soldiers. (Source: Horrible Histories, Series 2, Episode 6, 8th June 2010, Lucy Clarke, Dave Cohen, Susie Donkin, Jon Holmes and Ben Ward)

John Snow (1854)

John Snow first discovered the links between the cholera outbreak and contaminated water when he plotted the main cases on a map and discovered that people who lived closest to the water system that came from sewage were more likely to suffer from cholera. He also had a huge impact on medical practices, such as hygiene and anesthesia (trichloromethane). (Source: “Brought to Life: John Snow,” Science Museum, http://www.sciencemuseum.org.uk/broughttolife/people/johnsnow.aspx)

Zulu War (1879)

This war began because Britain wanted Zulu land, causing competition between different states. Sir Bartle Frere, a British colonial decision-maker, decided that he and some soldiers would protect the trade path so that products and food could travel to and from Britain. Around 1,400 British soldiers were killed in this war. The main diseases to have affected soldiers in this war were bowel diseases and malaria, whereas in Britain, they had very little of these diseases.

The soldiers were also highly affected by dysentery and diarrhea, but very few soldiers suffered from these diseases. The soldiers were well-nourished and were fitter than we are today. (Source: “Disease and Illness Prevalent During the Anglo Zulu War of 1879,” Adrian Greaves and Dr. Alan Spicer, http://www.anglozuluwar.com/content/html3/2009/04/16/2009041611283230000100.htm)

Boer War (1898-1902)

This war was caused by the British wanting to expand their land and wishing to claim Boer, a state within the Transvaal Republic, as their own territory. In this war, around 22,000 British soldiers died, over 14,000 of them due to disease, and 86 due to drowning during a storm. These diseases included dysentery, enteric fever, and fever. (Source: “First Anglo-Boer War,” South African History Online, http://www.sahistory.org.za/south-africa-1806-1899/first-anglo-boer-war-1880-1881)

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 Serbia with a choice – either bring the assassins to justice or start a war. When Serbia disagreed with this, both countries made alliances with other states. 908,371 British soldiers died during the first world war, and only 13% of these people died due to disease or natural causes.

Due to living in trenches, the soldiers often got a disease called “trench foot,” which is caused by the wet conditions in the trenches. If left untreated for a large amount of time, it could lead to necrosis, which could progress to requiring amputation. Other diseases known to the soldiers of World War 1 were influenza, enteric fever, and trench fever. (Source: “Diseases in World War 1,” http://diseasesww1.blogspot.co.uk/2009/03/diseases-in-ww1.html)

Beveridge Report (1942)

The authorities tackle societal inequalities by making societal policies. Our state is a public assistance province; this means that the authorities takes responsibility for and looks after the citizens of our state by making policies to assist in improving our economy. The public assistance province was first created in 1942 by Sir William Beveridge. It was founded because the authorities were unsure of why so many people were in poverty and suffering from illness, so they sent Beveridge to conduct a study.

During this study, Beveridge discovered what he called the “five giants of evil” and stated that these were the main reasons for poverty. These giants are Want (low income due to households that are unemployed, ill or widowed), Ignorance (lack of education for deprived areas, which increases the number of people suffering from unemployment), Squalor (due to poor living conditions and lack of housing), Disease (the state was overwhelmed with illness due to poverty), and Idleness (unemployment, as soldiers returning to Britain were not reabsorbed).

The authorities attempted to address these situations by creating certain policies. For poverty, the authorities introduced National Insurance and used the money gained from this to provide benefit support for the more disadvantaged people. For ignorance, the authorities created a policy that states that you have to stay in full-time education until the age of 15.

For squalor, the authorities 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 authorities created the NHS (National Health Service) to provide free healthcare so that people in poverty can still get the treatment they need. For idleness, the authorities took control of some companies and created more jobs in these companies. (https://www.slideshare.net/nola/the-welfare-state. Slideshare. The Welfare State)

World War 2 (1939-1945)

This war began because even after Adolf Hitler agreed not to occupy any more states, Germany invaded some states – one of these states being Poland. Britain signed a pledge with Poland stating that they will help to protect them if they are ever invaded – which 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 diarrhea, dengue fever (this is infectious, and similar to measles), malaria (this is carried by 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 still kills around 500,000 people a year), itch, and typhus. (https://www.world-war-2.info/statistics/ World War 2 statistics)

NHS (1948)

The NHS was founded by Aneurin Bevan due to the authorities’ desire to guarantee that anyone – even those of small wealth – was given medical intervention. At first, the NHS offered wholly free medical attention – including dental work, lens makers, GPs, infirmaries, and druggists – but after the authorities’ disbursement much more money on the intervention than what was expected, they began to bear down people for the usage of dental medicine, lens makers, and some pharmaceutical medical specialties. (https://www.england.nhs.uk/nhs-history/nhs-anniversaries/)

Deoxyribonucleic acid Was Discovered (1953)

In 1953, two scientists – James Watson and Francis Crick – discovered the structure of DNA. They had been working together at King’s College and used X-ray diffraction to detect the double spiral. This caused tons of advancements in biology and still helps us to discover new treatments. (https://www.bbc.co.uk/history/historic_figures/crick_and_watson.shtml)

Smoke and Cancer Links Established (1954)

After researching whether coal fire exhausts were related to lung cancer, Sir Richard Doll (scientist) discovers that smokers are more likely to suffer from the disease than non-smokers. (https://www.nhs.uk/nhs-england/thenhs/nhs-history/Pages/nhs-history-1948.aspx)

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 traumatized. This led to children being able to see their parents in hospital daily, and vice versa. (https://www.nhs.uk/nhs-england/thenhs/nhs-history/Pages/nhs-history-1948.aspx)

Poliomyelitis and Diphtheria Vaccinations

The NHS made it so that anyone under the age of 15 was able to get both Polio and Diphtheria inoculations – preventing epidemics of these diseases. (https://www.nhs.uk/nhs-england/thenhs/nhs-history/Pages/nhs-history-1948.aspx)

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 fetus. (https://news.bbc.co.uk/1/hi/health/222649.stm)

Our Healthier State (1999)

Our Healthier State was created so that we could improve the health of our nation. It focuses on the problems of today that create sick health. These things are cancer (which the NHS spends £1 billion a year on), accidents (which take more than 10,000 lives a year), coronary heart disease/stroke (which kills 5x more unskilled workers than professionals), and mental health issues. (https://www.nhshistory.net/savinglives.html)

Comparison of historical and current features of public health:

Public health has evolved greatly over time, with a focus on improving the health and well-being of the population. In the past, public health efforts were often directed towards infectious diseases, such as polio and diphtheria, and towards providing free medical attention to all, regardless of wealth. Nowadays, public

Due to discoveries and creative activities throughout history, there are some diseases that we no longer have to worry about as much as we used to. Nevertheless, some diseases have become more prominent due to certain findings. In the 1900s, 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 who have suffered from cholera had caught it abroad. Something that has had a huge impact on the public health of England has been pollution. Even though they used coal in the 1900s, the usage wasn’t as inordinate as it is now.

Pollution can cause health problems such as asthma (this is because some pollutants aggravate your lungs) (https://www.asthma.org.uk/knowledge-bank-pollutants, Asthma UK, Air Pollutants), emphysema (by pollutants causing the air passages to swell) (https://copd.about.com/od/whatisemphysema/a/emphysema.htm, About.com, Emphysema), and even cancer (https://scienceblog.cancerresearchuk.org/2013/10/18/the-link-between-air-pollution-and-cancer/, Cancer Research, Science Blog).

Additionally, due to research in 1957, we found out that smoking cigarettes is a huge contributor to cancer. Because of this, the smoking percentages have dropped by 29% in men and 22% in women since 1974 to 2012 (https://ash.org.uk/files/documents/ASH_106.pdf, ASH Fact Sheet). A comparison between England in the 1900s and England now is that even though the UK is the 7th 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 1900s, 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 the government is 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) (https://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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