Health standards were also lowered by the vast numbers of people living together. Since land owners wished to make as much money from as little land possible, they tried to create houses on small scraps of land, houses that took up as little room as possible. The most successful way of was to create back-to-back houses. And instead of building into width, they would build in height, creating basements, terraces and extra floors, to room more people. It was not unusual that there would be 3 families living in one house, a family on each floor, and since the infant mortality rate was very high, families would consist of 5 or more children.
Since the poor houses had no integrated toilets, household sanitation was very bad. A shed with a hole was all many people had, for one two or even more families residing in one house. Living near it was very unpleasant, apart from the incredible stench that came from it, when full, this hole called the cesspit, had to be emptied by hand. If it was built close to the house, the contents would literally soak through the walls, adding to the dampness and dirtiness.
These houses were all built with the cheapest material possible. Good, sturdy houses could have been built with even these sorts of materials had they been used properly, but the builders never took much care when building houses for the poor. The main problem was that there were never cavities or damp-courses in the outside walls to keep out the cold and wet, so the walls would permanently be damp, and clammy. They were also weak, and cracked easily. The floors were made of bricks, which were also, perpetually damp, cold and difficultly cleaned, adding to the already poor conditions of these houses. If it rained, water would seep into the houses through the walls, and ooze in through the floor. The basements of these houses would be perfect breeding locations for rats and other such rodents, whose parasites would bring diseases into these already ill families.
Between 1830 and 1870 alone, there were four mayor outbreaks of Typhoid, which caused thousands of deaths and in 1849 there was a particularly severe cholera epidemic causing another thousand deaths.
Doctors in the 19th century could not cure any of these diseases, mainly because no one had any idea what caused them and because the poor were the ones who suffered the most and they could not pay for medical treatment.
Also they did not associate dirt and filth to death like we do nowadays, and it did not even come to mind for them to actually do something about the hygiene conditions; until 1848.
As a result of a growing Sanitary Reform Movement, parliament passed a series of acts in an attempt to improve sanitary conditions in urban areas. Edwin Chadwick was largely responsible for the 1834 Poor Law Amendment Act, which brought both him and the Government fierce criticism, but his thoughts were turning more and more towards sanitation.
Chadwick's character made him not only an exemplar but also a caricature of utilitarian reform. He was hard working, rigorous and determined but also tactless, humourless, impatient, dogmatic and over-confident. Chadwick was appalled at the number of people admitted to the workhouses and became convinced that if the health of the working population could be improved then there would be a drop in the numbers of people on relief. Consequently he embarked on a nation-wide investigation of public health which culminated in the historic Report . . . on an Enquiry into the Sanitary Condition of the Labouring Population of Great Britain which he published privately and at his own expense in 1842.
He felt there was a distinct link between the health of the working population and the numbers seeking poor-law relief. Like many people, Chadwick believed that disease was caused by air pollution. His ideas on cleaning up towns were a step in the right direction but his conclusions were too general and did not address the specific causes of disease. He wanted to create a new system of poor relief, where people were trained to help themselves. He believed that the existing systems encouraged laziness by simply handing out money every week.
He became a director of the Board of Health in 1848, and was responsible for the first Public Health Act: the act of 1848.
The Act of 1848 (the first of its kind) provided for a Central Board of Health with powers to supervise street cleaning, refuse collection, water supply and sewerage disposal. These Laws were passed and promoted not because of a real genuine concern for people’s health, but more out fear of what the masses might due if something was not done to protect them from epidemic disease. The board was scrapped in 1858 leaving the problem of dirt & disease untackled.
However, Chadwick’s work helped to make later reforms possible, such as the later 1868 Reform Act (Torrens Act), which entitled local councils to undertake the clearance of unsanitary dwellings and in 1871 the local government Board created the authority to oversee health policies of local councils.
Chadwick worked tirelessly for the Board of Health, but the enemies of centralised administration and intervention were determined. In 1854, he was pensioned off from public service but continued to campaign for sanitary and social reform. His wide knowledge of government departments, administration and statistics, public health engineering and building construction made him a formidable campaigner for the last years of his life.
In 1875, Britain saw the emergence of the Disraeli Public Health Act, or Artisans act.
The Public Health Act of 1875 was the first act that forced local authorities to improve on public health. The main improvements in Public Health were:
- Better diet was made possible.
- Cheap, new chemicals, and cheap cotton clothing was made available.
- Better medicines were developed and better hospitals were built.
This 1875 Act led to the change of power from central to local government, even in the urban areas, greatly improving the situation. Local authorities had to pay for all services, with taxes, such as the clearing slums and the construction and maintenance of public areas like parks, public houses and even hospitals. This mobilisation paid off in end as the deaths because in infectious diseases lowered to 10% in 1900. It also allowed for a large clearance of slums in England.