Intended for healthcare professionals


Public health at 170

BMJ 2018; 362 doi: (Published 30 August 2018) Cite this as: BMJ 2018;362:k3653
  1. John Middleton, president
  1. UK Faculty of Public Health
  1. president{at}

What’s needed now is a big birthday present

The Public Health Act 1848 for England and Wales celebrates its 170th anniversary on 31 August 2018. A landmark piece of public health law, it marked the beginning of the Victorian sanitary revolution, recognising the need for the protection of all citizens from environmental and social threats, with cross party political support.1 It would take 27 more years and two more catastrophic cholera outbreaks before the 1875 Public Health Act turned the enabling provisions of the 1848 act into the powers of local authorities.2The BMJ’s readers voted sanitation and clean water the biggest medical advance since 1840.3

Health gains

Over those 170 years, life expectancy has increased greatly.4 Sanitary reform also provided the impetus for expanding local government service provision.5 Other major improvements to the public’s health included the 1875 Artisans’ and Labourers’ Dwellings Improvement Act, the driver of slum clearances and public sector housing provision5; national food rationing during two world wars, which improved the nutritional status and life expectancy of children46; the Defence of the Realm Act 1914, which restricted public alcohol …

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