Sanitation and Public Health

EDWIN CHADWICK, Inquiry into the Sanitary Conditions of the Poor (1842)

Sir Edwin Chadwick (1800–1880), a disciple of the radical philosopher Jeremy Bentham, spent his life in pursuit of social and sanitary reform. Bentham, Chadwick, and other radicals known as utilitarians shared many views with nineteenth-century liberals. Both liberals and utilitarians believed in human rationality and the concept of human progress, and both believed that poverty was chiefly the consequence of individual moral failings. The two groups parted ways sharply, however, over the role of government. Nineteenth-century liberals argued that government intervention was an impediment to social and economic progress. Utilitarians, in contrast, believed that the only measure of a policy’s worth was its utility—that is, the degree to which it improved society as a whole. If, in particular situations, such as public health, government intervention could be shown to have a positive effect, the utilitarians had no ideological objection to such intervention.

After as careful an examination of the evidence collected as I have been enabled to make, I beg leave to recapitulate the chief conclusions which that evidence appears to me to establish.

First, as to the extent and operation of the evils which are the subject of this inquiry: —

That the various forms of epidemic, endemic, and other disease1 caused, or aggravated, or propagated chiefly amongst the laboring classes by atmospheric impurities produced by decomposing animal and vegetable substances, by damp and filth, and close and overcrowded dwellings prevail amongst the population in every part of the kingdom, whether dwelling in separate houses, in rural villages, in small towns, in the larger towns—as they have been found to prevail in the lowest districts of the metropolis.

That such disease, wherever its attacks are frequent, is always found in connection with the physical circumstances above specified, and that where those circumstances are removed by drainage, proper cleansing, better ventilation, and other means of diminishing atmospheric impurity, the frequency and intensity of such disease is abated; and where the removal of the noxious agencies appears to be complete, such disease almost entirely disappears.

The high prosperity in respect to employment and wages, and various and abundant food, have afforded to the laboring classes no exemptions from attacks of epidemic disease, which have been as frequent and as fatal in periods of commercial and manufacturing prosperity as in any others.

That the formation of all habits of cleanliness is obstructed by defective supplies of water.

That the annual loss of life from filth and bad ventilation are greater than the loss from death or wounds in any wars in which the country has been engaged in modern times.

That of the 43,000 cases of widowhood, and 112,000 cases of destitute orphanage relieved from the poor’s rates in England and Wales alone, it appears that the greatest proportion of deaths of the heads of families occurred from the above specified and other removable causes; that their ages were under 45 years; that is to say, 13 years below the natural probabilities of life as shown by the experience of the whole population of Sweden. . . .

That, measuring the loss of working ability amongst large classes by the instances of gain, even from incomplete arrangements for the removal of noxious influences from places of work or from abodes, that this loss cannot be less than eight or ten years.

That the ravages of epidemics and other diseases do not diminish but tend to increase the pressure of population.

That in the districts where the mortality is greatest the births are not only sufficient to replace the numbers removed by death, but to add to the population.

That the younger population, bred up under noxious physical agencies, is inferior in physical organization and general health to a population preserved from the presence of such agencies.

That the population so exposed is less susceptible of moral influences, and the effects of education are more transient than with a healthy population.

That these adverse circumstances tend to produce an adult population short-lived, improvident, reckless, and intemperate, and with habitual avidity for sensual gratifications.

That these habits lead to the abandonment of all the conveniences and decencies of life, and especially lead to the overcrowding of their homes, which is destructive to the morality as well as the health of large classes of both sexes.

That defective town cleansing fosters habits of the most abject degradation and tends to the demoralization of large numbers of human beings, who subsist by means of what they find amidst the noxious filth accumulated in neglected streets and bye-places.

That the expenses of local public works are in general unequally and unfairly assessed, oppressively and uneconomically collected, by separate collections, wastefully expended in separate and inefficient operations by unskilled and practically irresponsible officers.

That the existing law for the protection of the public health and the constitutional machinery for reclaiming its execution, such as the Courts Leet,2 have fallen into desuetude, and are in the state indicated by the prevalence of the evils they were intended to prevent.

Secondly. As to the means by which the present sanitary condition of the laboring classes may be improved: —

The primary and most important measures, and at the same time the most practicable, and within the recognized province of public administration, are drainage, the removal of all refuse of habitations, streets, and roads, and the improvement of the supplies of water.

That the chief obstacles to the immediate removal of decomposing refuse of towns and habitations have been the expense and annoyance of the hand labor and cartage requisite for the purpose.

That this expense may be reduced to one-twentieth or to one-thirtieth, or rendered inconsiderable, by the use of water and self-acting means of removal by improved and cheaper sewers and drains. . . .

That appropriate scientific arrangements for public drainage would afford important facilities for private land-drainage, which is important for the health as well as sustenance of the laboring classes.

That the expense of public drainage, of supplies of water laid on in houses, and of means of improved cleansing would be a pecuniary [monetary] gain, by diminishing the existing charges attendant on sickness and premature mortality.

That for the protection of the laboring classes and of the ratepayers against inefficiency and waste in all new structural arrangements for the protection of the public health, and to ensure public confidence that the expenditure will be beneficial, securities should be taken that all new local public works are devised and conducted by responsible officers qualified by the possession of the science and skill of civil engineers. . . .

That for the prevention of the disease occasioned by defective ventilation and other causes of impurity in places of work and other places where large numbers are assembled, and for the general promotion of the means necessary to prevent disease, that it would be good economy to appoint a district medical officer independent of private practice, and with the securities of special qualifications and responsibilities to initiate sanitary measures and reclaim the execution of the law.

That by the combinations of all these arrangements, it is probable that the full ensurable period of life indicated by the Swedish tables; that is, an increase of 13 years at least, may be extended to the whole of the laboring classes.

That the attainment of these and the other collateral advantages of reducing existing charges and expenditure are within the power of the legislature, and are dependent mainly on the securities taken for the application of practical science, skill, and economy in the direction of local public works.

And that the removal of noxious physical circumstances, and the promotion of civic, household, and personal cleanliness, are necessary to the improvement of the moral condition of the population; for that sound morality and refinement in manners and health are not long found coexistent with filthy habits amongst any class of the community.

From Edwin Chadwick, Report . . . from the Poor Law Commissioners on an Inquiry into the Sanitary Conditions of the Labouring Population of Great Britain (London: W. Clowes and Sons, 1842), pp. 369–372.