President’s bulletin: 150 Years of the Public Health Act 1875

This year we celebrate 150 years of the Public Health Act 1875 – a landmark piece of legislation that formalised the state’s responsibility for the health of its citizens.

The Public Health Act 1875 marked a decisive shift from piecemeal interventions to a comprehensive framework, covering the whole field of environmental public health, sanitation and nuisance prevention.

In my latest bulletin, I explore the historical context of the Act and why it remains foundational to the environmental health profession today.

Life leading up to the Public Health Act 1875

The 1800s were marked by a series of public health crises: the 1854 Broad Street cholera outbreak, the Great Stink of London in 1858, and uncontrolled urbanisation culminating in civil unrest, including the Merthyr Rising of 1831.

Towns across the UK were rapidly increasing in size while lacking safe, adequate water supplies and drainage systems. Within 30 years the population of Merthyr Tydfil in South Wales increased from around 7,000 to 46,000. The iron workers of Merthyr replenished lost fluids by drinking seven or eight pints of mild ale in the unlicensed public houses as the water was unfit to drink.

The Act and the emergence of environmental health

The Public Health Act 1875 required local authorities to appoint Medical Officers of Health and Sanitary Inspectors. It consolidated previous legislation and gave these new professionals powers to enforce improvements in water supply, drainage, refuse, and housing conditions.

This was a critical juncture for improving sanitary conditions in the UK. It was the moment the environmental health profession formally emerged. The title of Sanitary Inspector remained until 1955, when it was legally redefined as Public Health Inspector, recognising the evolving scope of responsibilities.

Key figures who championed reform

The Act was not passed without resistance. There were vested interests against its enactment, not least the costs of such major infrastructure projects and the laissez-faire approach of both central and local government.

When Prime Minister Benjamin Disraeli was mocked by his opponents in parliament, he retorted with the now iconic phrase "sanitas sanitatum, omnia sanitas" – “health above everything”.

The UK Parliament passed the Act in 1875, a few years after the death of Mary Anne, Disraeli’s wife. During her previous marriage to Wyndham Lewis, a Conservative MP and landowner in South Wales, Mary Anne often visited Merthyr Tydfil where Lewis had a financial interest in the Dowlais ironworks. She was appalled at the conditions she saw and became a passionate advocate for improvements for the working classes.

The decades leading up to the Act were also shaped by reformers such as Sir Edwin Chadwick the CIEH’s first President, Dr William Henry Duncan and Sir John Simon who championed improvements in sanitation and working conditions.

A new era of public health challenges

150 years later the very problems the Act sought to solve are returning in new forms. Climate change, water scarcity, unfit housing, pollution of water courses, and poor air quality – all echoing the urgency of the past. If there was ever a time for reinvigoration of public health reforms then it must be now.

Our profession continues to stand at the forefront of environmental public health, health equity, and environmental justice. Let us carry on the work of the Public Health Act 1875 by renewing our commitment to its founding purpose to ensure “health above everything”.

CIEH members interested in delving deeper into the rich history of the Act and its relevance today – look out for President Mark’s full article in your September issue of EHN magazine.