The Great Stink and Public Health Reforms

In the summer of 1858, London experienced an unusually warm and dry season, which led to a significant drop in the water levels of the River Thames. The river, which had long been used as a dumping ground for sewage and waste, could no longer effectively wash away the filth being poured into it. As a result, the accumulated waste began to putrefy, creating a terrible stench that became unbearable for the city's residents. The situation was so dire that it became known as The Great Stink, and it even led to the temporary closure of the Houses of Parliament, which were directly affected by the overpowering smell.

At the time, the prevailing belief about disease transmission was still grounded in the miasma theory, which held that foul smells or "bad air" were responsible for the spread of disease. To combat the smell, people resorted to cleaning their homes with chloride of lime, hoping that it would help neutralise the stench. The unbearable conditions brought about by the Great Stink prompted urgent action and helped to push the issue of public health to the forefront of political attention.

Joseph Bazalgette and the Sewerage System

The Great Stink proved to be a catalyst for change in public health policy. As a result of the crisis, the government decided to invest in the construction of a comprehensive sewerage system for London. The project was overseen by Joseph Bazalgette, a civil engineer who had been appointed to design a solution to the city’s chronic sanitation problems. The new sewerage system, which was conceived in 1858, aimed to prevent the waste from contaminating the river and improve the overall hygiene of the city.

Bazalgette’s system was an ambitious project, involving the creation of a network of large underground sewers that would carry waste away from residential areas and into the Thames, where it would be less likely to affect drinking water sources. The construction of the system began immediately after the Great Stink and took several years to complete, being finished in 1875. This new sewerage system had a profound impact on public health in London. It not only mitigated the foul smell that had previously plagued the city, but it also helped to end the recurring cholera outbreaks that had caused widespread death in the mid-19th century.

In fact, the building of Bazalgette’s sewer system is often seen as one of the key factors in dramatically improving the health of London’s population and reducing the transmission of waterborne diseases such as cholera.

The 1875 Public Health Act and Other Reforms

The lessons learned from the Great Stink and the success of Bazalgette's sewerage system, coupled with the increasing scientific understanding of disease transmission, led to significant changes in public health policy. By the 1870s, there was clear evidence that improved sanitation, and better urban planning could prevent disease and save lives. This marked a decisive shift away from the prevailing laissez-faire attitude of minimal government intervention, and there was a growing recognition of the need for state action to address public health issues.

In 1875, the government, under Prime Minister Benjamin Disraeli, passed a second Public Health Act, which went much further than the previous 1848 Act. The new law required local authorities to provide clean water supplies, build sewerage systems, and appoint a medical officer to oversee public health in their areas. This was a major step towards ensuring that the health of the population was safeguarded through proactive public health measures.

The reforms of 1875 did not stop with the Public Health Act. In the same year, Disraeli's government introduced several additional pieces of legislation aimed at improving living conditions:

• The 1875 Artisans’ and Labourers’ Dwellings Improvement Act established new standards for housing, particularly in the overcrowded and unsanitary areas where many of the working class lived.
• The 1875 Sale of Food and Drugs Act introduced stricter laws surrounding food safety, including the regulation of food labelling, to ensure that people were not consuming harmful or contaminated products.
• The 1876 Rivers Pollution Prevention Act aimed to tackle pollution in rivers and improve the quality of water supplies, further reducing the risk of waterborne diseases.

These reforms were a direct response to the growing awareness that poor living conditions and inadequate sanitation were major contributors to ill-health, particularly among the working classes.

Charles Booth and the Discovery of Poverty in London

Despite the significant strides made in public health reform, much work remained to be done, especially in addressing poverty and its impact on health. In 1889, social reformer Charles Booth set out to investigate the extent of poverty in London. Booth produced a pioneering social survey, mapping the levels of poverty across the city. His colour-coded map divided London into different areas according to income and living conditions, providing a stark visual representation of the disparity between the wealthy and the impoverished.

Booth’s findings were shocking he discovered that approximately 35% of the population in London lived in extreme poverty, despite many of them being in full-time employment. This figure was far higher than anyone had previously imagined, highlighting that the improvements in public health and housing had not yet reached the poorest sections of society.

While public health reforms had begun to make an impact on sanitation and living conditions, Booth’s work emphasised the need for further changes. His research drew attention to the link between poverty, poor health, and overcrowded living conditions, and underscored the need for ongoing efforts to tackle inequality and improve the quality of life for the working classes.

Public Health Milestones of the Industrial Revolution

The public health reforms of the mid-19th century were pivotal in the development of modern healthcare and urban planning. The changes sparked by the Great Stink, Joseph Bazalgette’s sewerage system, and the introduction of key pieces of legislation helped to shape a new understanding of the role of the state in protecting public health. These reforms not only reduced the incidence of infectious diseases such as cholera, but they also paved the way for broader social reforms aimed at improving the living conditions of the working classes.

The ongoing challenges of poverty, overcrowded housing, and social inequality, however, demonstrated that public health improvements were a work in progress, and much more would be needed to ensure that all citizens could benefit from the advances of the Industrial Revolution.