Sanitary investment and the decline of urban mortality in England and Wales, 1817–1914

ABSTRACT

Previous authors have drawn attention to the role played by loan-financed public works in reducing mortality in England and Wales during the latter part of the nineteenth century. These arguments have often been based on an analysis of the loans sanctioned by the Government’s central health departments following the creation of the first General Board of Health in 1848, but little attempt has been made to disaggregate the loans either by function or geographical area. Moreover, as the Local Government Board itself acknowledged, it is also important to take account of the large number of loans which were approved by other means. This paper offers the first large-scale chronological account of the full range of loans which were either approved by Local Act of Parliament or sanctioned by a central department throughout the whole of the period from the end of the Napoleonic Wars to the start of the First World War. Although it largely supports the outline provided by previous research, it draws new attention to the importance of the loans which were authorised in the wake of the US Civil War in the 1860s. It also explores the relationship between these loans and the decline of mortality in areas which have previously been identified as ‘high-performing and high-contributing areas’ to Britain’s late nineteenth-century mortality decline, and makes an initial attempt to link these loans to the improvements which occurred.

KEYWORDS:

• Sanitation
• public health
• mortality
• water supply
• urbanisation

Acknowledgments

We should like to thank the following for assistance with data collection and transcription: Isabelle Barker, Amber Golding, Deborah Harris, James Hamilton, Dan Heap, Jaskiern Mann, Sara Marsden, Brian Moran, Jamal Abdul Nasir, Grace Taylor. We should also like to acknowledge the financial support of the Universities of Southampton and Strathclyde, and to thank Barry Doyle, Diego Ramiro Fariñas, Eilidh Garrett, Martin Gorsky, Jonas Helgertz, Eddy Higgs, Angelique Janssens, Julia Jennings, Alice Reid, Eric Schneider, Simon Szreter and three anonymous referees for helpful comments on earlier presentations and drafts.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. McKeown’s formulation of the problem may help to explain the comparative neglect of the role played by airborne pollution in studies of nineteenth-century mortality. This topic has been highlighted recently by Beach and Hanlon (2018) and Bailey, Hatton, and Inwood (2018).

2. For a critique of Szreter’s original paper, see Guha (1994); and for Szreter’s response, see Szreter (1994). The relationship between nutrition and mortality was also discussed by Harris (2004a) and Floud, Fogel, Harris, and Hong (2011).

3. These figures have been obtained from the Appendices to the Annual Reports of the Local Government Board for 1872/3–1888/9.

4. Shaw (1895, p. 14) reported that the total population of the urban sanitary districts of England and Wales was approximately 20.8 million, but this figure included London (see also Parliamentary Papers, 1891: viii).

5. In a previous version of the same paper, Chapman (2017, p. 1) argued that infrastructure investment explained ‘up to 60 per cent of the reduction in total urban mortality between 1861 and 1900 and 88 per cent between 1861 and 1890‘.

6. Our own analysis of the statistics which the Public Works Loan Board published in its Annual Reports suggests that loans towards the costs of schools in England, Scotland and Wales accounted for just over half (50.8%) of the total value of the loans provided by the Board between 1875/6 and 1879/80. Loans under the Public Health Acts accounted for 30.01 per cent of the total value of the Board’s loans over the same period. See Annual Reports of the Public Works Loan Board, 1876–80.

7. This excludes 26 areas whose populations have not been ascertained.

8. Within the group of authorities whose loans were recorded in 1874, commercial insurance or assurance organisations were responsible for just under half (49.97 per cent) the total value of the loans made to authorities whose populations exceeded 20,000 at the time of the 1871 census.

9. The Public Health Act was also important for the provisions it did not contain. According to Hanley (2016, p. 75), ‘the 1848 Public Health Act did not impose on local boards of health a duty to ensure that each district should, as near as may be, bear its own expenses’. This gave boards the opportunity to share the costs of drainage improvements over a wider area.

10. During the period between 1875 and 1884, the Board approved plans for Birmingham to borrow £2,693,200, This figure included three loans, each worth £500,000, under the Artisans’ and Labourers’ Dwellings Act, in 1876 and 1877. The overall figure accounted for more than 73 per cent of the total value of all the loans sanctioned for West Midlands local authorities during this period. For a brief account of Joseph Chamberlain’s role in driving Birmingham’s municipal agenda, see Chandler (2007), pp. 78–9.

11. The indexes to the individual volumes for the period 1817–75 list 9,952 Local Acts and 2,151 Personal Acts, of which 1,603 were printed.

12. The complex variety of local municipal bodies is discussed by Davis (2000), and the role played by private companies in the supply of utilities by Millward (2000, pp. 322, 326–7).

13. For example, in 1860 the Dorchester Board of Health obtained a Provisional Order which enabled it to borrow a sum equivalent to its annual rateable value plus £2,500 (23 & 24 Vic. C. 118).

14. In total, similar formulations were used to describe the borrowing powers granted to local authorities under Acts passed in 1843 (Liverpool), 1851 (St Helens), 1863 (Swansea), 1866 (Leicester, Middlesborough and Stourbridge) and 1867 (Brighton). The total value of the sums sanctioned when the powers were first approved was £143,000.

15. For details of the original Act, see 10–11 V.c.cclii. For details of the 1879 loan, see Parliamentary Papers (1880b), p. 488.

16. In 1891, the population of the urban sanitary district was 38,291. By contrast, the population of the registration district was 444,365. The urban sanitary authority itself was abolished in 1894. See Parliamentary Papers (1891), pp. 35, 49 and http://www.visionofbritain.org.uk/unit/10347555 (accessed 21 September 2018).

17. The town of Middlesborough grew extremely rapidly in the second half of the nineteenth century and the relationship between loan values per head and mortality change in this area may be particularly complex. The decennial census returns suggest that the population of the urban sanitary authority area grew from 8,067 in 1861 to 44,486 10 years later.