Recently, this blog has had a lot of posts about health conditions that are unequally distributed among the population, causing increased health problems among people affected by poverty. Notably, last week’s Guinea Worm post and my recent <a href="https://theartofahealthyheart.wordpress.com/2018/02/15/serving-the-medically-underserved/"Serving the Medically Underserved post. As a result, I wanted to talk about someone who has worked to lessen health disparities by being an advocate for the poor. I felt that the best way to start this conversation is to recognize that this issue is not a new problem. It’s something we have been struggling with for literally centuries. In my search for an individual fitting to this role, I found one name kept popping up on my search, Sir Edwin Chadwick. He is widely thought to be one of the most influential public health figures of the 1800s. So, without further ado, this month’s Famous Name in Public Health is, of course, Sir Edwin Chadwick!
Sir Edwin Chadwick was born in England in 1800. During his studies to become a lawyer, Sir Chadwick became interested in social and political reform while studying law in London. During this time, Sir Chadwick developed the concept of the “sanitary idea” based on science and integrated with the miasma theory. This concept proposes that diseases are caused by poisonous vapors in the air. Thus areas of the community that smell foul (mostly impoverished areas in this time period) are the causes of illness and disease among the population that lives there. Although we now know that this theory is not correct, the concept persisted for a long time because of the (yet unknown) association between bacteria and their production of malodorous scents. Around the time that Sir Chadwick’s concept of the “sanitary idea” began to grow and fuel his investigation of sick wards he took the position assistant commissioner on the poor-law commission. The following year he was appointed as the secretary of the royal commission. His work helped contribute to the future passing of the Ten Hours Act which limited “the work of women and young persons (aged 13–18) in textile mills to ten hours a day for five days in the week and eight hours on Saturday.”
Next, he worked on the Poor Laws of England. The Poor Laws were established in 1601 during the English period of depression to combat unemployment and famine. In essence, the laws classified groups of people within a each parish based on their ability to work and provide for themselves and their family. Additionally, these laws gave the local government the means to tax those able to pay and to provide relief to those in need of assistance. However, by the 1800s, these laws were in need of updating and reform. This led to the creation of the Poor Law Amendment Act. This amendment set up the Poor Law Commission to supervise local parishes, and it removed the assistance given to able bodies workers as a means to stimulate the workforce.
In 1848, he successfully campaigned for the passage of the The Public Health Act. This act is considered one of the greatest achievements in the public health history of England. This act allowed states to become the “guarantor of standards of health and environmental quality and provided resources to local units of government to make the necessary changes to achieve those standards.” This allowed things like water supply and sewage and waste management to be managed by the local government using governmental funds as a means to manage the health problems of the population (notably caused by things like the industrial revolution and urbanization). This act was incredibly controversial at the time because there was still no known link between the environment, germs and health. As a result, the act only lasted 5 years before it failed to be renewed by the government. However, this was not a loss for Sir Chadwick, as his legacy became enduring through the crating of the Public Health Act of 1875, which consolidated a lot of the legislation surrounding public health and created a uniformed administrative body to carry out the policies.
The works of Sir Chadwick extends broadly. His involvement in a variety of public health matters contributed to the eventual passing of many acts and reforms by the government. For example, beyond his investigation into child labor laws, he contributed to the Employers’ Liability Act concerning on the job injuries of adult workers. He also contributed to drainage work and matters of military sanitation to relieve troop suffering. He campaigned for the maintenance of railway systems as a public health issue. Sir Chadwick’s interests and perspectives were revolutionary and controversial at the time, but many of his arguments proved valuable and true in the future. His work helped contribute to the overall improvement in sanitation and maintenance of sanitation and living conditions for the entire population of England.
Overall, Sir Edwin Chadwick became one of the greatest social reformers in England of his time. He received knighthood in 1889 before passing away one year later on July 6, 1890.