City chaos, contagion, Chadwick, and social justice.

Abstract

In 1842, a civil servant, Edwin Chadwick, published at his own expense The Report from the Poor Law Commissioners on an Inquiry into the Sanitary Conditions of the Laboring Population of Great Britain, which outlined in detail the wretched social and environmental conditions within the world's first industrial society. The Chadwick Report, the first such national investigation of its kind, highlighted a number of now widely accepted phenomena concerning economic development, urbanization and health within industrial settlements. For its time, the report was a monumental step toward accepting and then dealing with the social costs of economic progress. In short, the Chadwick Report established that material progress did not equate inter alia to a universal improvement in urban health. Instead, it revealed how modern circumstances had the ability to establish a health schism between social groups. So with such a backdrop in mind, this article assesses the role of Edwin Chadwick and his 1842 sanitary report in the lead-in to the Public Health Act (1848), a legislative attempt to bestow social and health equity in Britain, and examines the wider social and medical context within which the world's first modern system of public health emerged. Demonstrating how the sanitary movement was formed and how miasmic medical notions influenced the form of the 1848 Act, this paper will appraise a variety of factors that helped shape the evolution of epidemiology within what was the world's first industrial and urban society in the 1830s and 1840s, including the realization that societal advancement did not create health benefits for all.