BMJ 1998;317:587-591 ( 29 August )

Education and debate

Revolutions in public health: 1848, and 1998?

Editorials by Alderslade, Palmer Recent advances p   584 Education and debate pp   592 , 596

Christopher Hamlin, professor and head, ^a Sally Sheard, lecturer in history of public health. ^b

^a Department of History, University of Notre Dame, 219 O'Shaughnessy Hall, Notre Dame, IN 46556-0368, USA, ^b Department of Public Health, University of Liverpool, Liverpool L69 3BX

Correspondence to: Professor Hamlin Christopher.S.Hamlin.1@nd.edu

The first 150 words of the full text of this article appear below.

This autumn marks the 150th anniversary of the Public Health Act for England and Wales, the beginning of a commitment to proactive, rather than a reactive, public health. The act began a series of legislative measures extending through the Victorian era and into this century in which the state became guarantor of standards of health and environmental quality and provided means for local units of government to make the structural changes to meet those standards.

That public action can substantially improve the health of the general population now seems obvious, and it also seems obvious that public authorities owe their citizens that improvement. Both were controversial in the 1830s and 1840s. For centuries European governments had reacted to epidemics with decrees. With medical boards to advise them, they set their military forces to protecting borders and ports, whitewashed towns, fumigated dwellings, and burnt bedding. The threat of unusual disease prompted . . . [Full text of this article]

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