Living conditions in Middle Ages: For peasants in the countryside: Peasants (majority) heavily

1. Living conditions in • Middle Ages: • For peasants in the countryside: • Peasants (majority) heavily • dependent on harvest – Great • Famine 1315 – 1316 (10% pop died) • Ergotism (Rye); polluted stream • water (animals); fulling used urine; • small beer and cider; pottage • No chimneys, so smoke in huts • Middens in gardens; a few houses • had cess-pits – holes otherwise! • For townsfolk: • Open markets and open shops • Conduits (fountains) in market squares • Public latrines in many town squares • Waste from food in streets and dung from • animals • Butchers; masons; dyers; masons created • environmental problems • Smell; cramped living conditions; water bought • from water carriers; a few had pipes or wells • Latrines; gongfermers • Responses to the Black Death: • When? 1348/49; 50% pop died • Causes: • Rats and fleas for bubonic plague • but also septicemic and pneumonic • No cure – so some unusual • responses, e.g. Camomile; opening • Veins; live toads and chickens • Lots of supernatural responses • that reflected the power of the Church • e.g. flagellants; priests urged people • to confess their sins; • Some used astrology; unbalanced • humours or miasma to explain plague • Huge impact! Everyone affected by • death toll, but hit towns especially • hard • Although King Edward III wrote a • letter to the Lord Mayor of London • requesting the streets to be cleaned, • the government did little to intervene. • Plague revisited in 1361 - 62

2. Public health in the Middle Ages: • Church authorities: • Monasteries had high standards of hygiene • (Fountains Abbey). It had an infirmary for the sick • and latrines • Cathedrals laid pipes to bring in fresh water • Why? They had the wealth (tithe) • For town authorities: • Some towns did try to deal with problems of • public health, e.g. Bristol passed laws in 14th C • for dungheaps to be moved outside; York 1301 • King Edward I ordered the authorities to clear filth • from the streets; 1329 Winchester’s butcher’s • guild appointed 2 people to check the quality of • meat. • In London there was piped spring water from • the 1230s. Further measures were taken in the • 15th Century, e.g. 1415: Mayor of London ordered • The rebuilding of a latrine; 1417; as plague struck, • London closed public baths • However, government involvement in public • health was minimal! • Responses to the Great Plague: • When? 1540s; 1550s; especially 1665 • Same symptoms as Black Death • Mostly struck in summer months • Poor in towns hit the most • STILL nobody understood it! • BUT never returned after 1667 • 1518Henry VIII proclaimed that houses that were infected by plague should be identified with bundles of straw. • 1578Elizabeth I ordered the printing of Plague Orders- prayers should be said in church, no cats or dogs should be allowed on the streets, clothing of plague victims should be burned, and infected house should be shut for six weeks • 1604Parliament passed the Plague Act.; ordered towns to collect money to help the sick. Plague victims found out of their house could be hanged. Healthy people leaving and infected house could be whipped.

3. Write a clear and well organisedsummary that analyses people’s living conditions in the Middle Ages. Support your summary with examples. How will you analyse?

4. When did the most important changes in public health take place – 20th Century or 19th century? • Problems - first half of 19thcentury? • M _______ • I ___________ R ___________ • U ____________n • K ______ C _________ 18 __ • B ____ to B ______ T _________s • W ______ Com _______ • W ______ P _______s • C ____ P ___ s • R ______ T _________ (London) • Problems – early 20th century • P______y & P ____ L ______ C _________s • (Charles B _____ & Seebohm R _______) • Poor d ____t • Poor could not afford a D _______ • People had to w ____ into O___ A ___. • 1918: S ________ F ___ • Solutions? • Canned foods (H _____ B _____ 1905) • No B ____ to B _____ housing to be built (1905) • The Liberal Part set up the W _______ S _____ • This included O ____ A ___ P _______ (1908): • N __________ I ________ (1911) • H _______ A ___ (1919) (Homes fit for h _____s) • High building standards! • Solutions? • E_____ C_______’s report (1842) • The 1stP______ H _____ Act (1848) • (Not ___________) • In 1854 J_____ S_____ discovered? • The Summer of the G_____ S_____ (1858) • led J______ B_________ to? • The 2nd P_____ H______ Act (1875) • (Was __________) • Increase in C ____ P ______

5. When did the post important changes in public health take place – 20th Century or 19th century? • 20th Century BUTs! • Housing: • Following 2nd World War, new H ____ R _____ • F ___s built. These broke-up C ___________. • Food: • Rationing GOOD! After war, people’s eating habits • change with increased incomes. BUT …! • Scares like B _ _. • Air:: • C____ + bad; S ___gs • 1956: C _____ A ____ A ____ • BUT! Pollution from D ______ C ____s • Cars & computers: • Inactivity leads to people being O ___________ • (especially the P _____) • Epidemics • A ____s –growing complacency caused by mis- • understanding about A ____ R _______virals • NHS/Welfare State (1948 • Healthcare for all at the “P ______ of D ________” • BUT in the late 20th Century …?

6. New technology: the most important factor in the development of public health in Britain? ARGUMENTS FOR? ARGUMENTS AGAINST? • Yes! • 19th Century: J _______ B ________ • London S ______s (pumping stations); • O ____ shaped pipes; • Increased use of flushing T _______s • especially early 20th C (T _____ C ______!) • BUT! • Not all new technology was good! • Steam (I ________ R _________) caused • atmospheric P ________ • The M ______ C ____ • People leading a S __________ lifestyle • as a result of new technology • Was new technology the ONLY FACTOR in • developing public health? • What about the role played by other factors? • E.G. • Individuals like: • L _____ P _______ and G ____ T _______ • or J ____ S ____ and B _____ S _____ • P ____ • The role of Government • The V _____ (1862 and 1918) • 1st and 2nd P ______ H _______ A ___s • L________ Government and O ___ A ___ • P ______/N ________ I ________ (early • 20th Century) • L _______ Party and NHS • Impact of WAR, e.g. R _________; • B _________ R ________ 1942

7. When did the post important changes in public health take place – 20th Century or 19th century? • Problems - first half of 19thcentury? • Miasma • Industrial Revolution • Urbanisation • King Cholera 1931 (Sunderland) • Back to Back Terraces • Water Companies • Water Pumps • Cess Pits • River Thames(London) • Problems – early 20th century • Poverty & Poor Living Conditions • (Charles Booth & SeebohmRowntree) • Poor diet • Poor could not afford a Doctor • People had to work into Old Age. • 1918: Spanish Flu • Solutions? • Canned foods (Heinz Beans 1905) • No Back to Back housing to be built (1905) • The Liberal Part set up the Welfare State • This included Old Age Pensions (1908): • National Insurance(1911) • Housing Act (1919) (Homes fit for heroes) • High building standards! • Solutions? • Edwin Chadwick’s report (1842) • The 1stPublic Health Act (1848) • (Not compulsory) • In 1854 John Snow discovered? • The Summer of the Great Stink (1858) • led Joseph Bazalgette to? • The 2nd Public Health Act (1875) • (Was compulsory) • Increase in Civic Pride

8. When did the post important changes in public health take place – 20th Century or 19th century? • 20th Century BUTs! • Housing: • Following 2nd World War, new High Rise • Flats built. These break-up Communities. • Food: • Rationing GOOD! After war, people’s eating habits • change with increased incomes. BUT …! • Scares like BSE. • Air:: • Coal + bad; Smogs • 1956: Clean Air Act • BUT! Pollution from Diesel Cars • Cars & computers: • Inactivity leads to people being Overweight • (especially the Poor) • Epidemics: • A IDSs –growing complacency caused by mis- • understanding about Anti Retrovirals • NHS/Welfare State (1948): • Healthcare for all at the “Point of Delivery” • BUT in the late 20th Century …?

9. New technology: the most important factor in the development of public health in Britain? ARGUMENTS FOR? ARGUMENTS AGAINST? • Yes! • 19th Century: JospehBazalgette • London Sewers (pumping stations); • Oval shaped pipes; • Increased use of flushing Toilets • especially early 20th C (Thomas Crapper!) • BUT! • Not all new technology was good! • Steam (Industrial Revolution) caused • atmospheric Pollution • The Motor Car • People leading a Sedentary lifestyle • as a result of new technology • Was new technology the ONLY FACTOR in • developing public health? • What about the role played by other factors? • E.G. • Individuals like: • Louis Pasteur and Germ Theory • or John Snow and Broad Street • Pump • The role of Government: • The Vote/franchise(1862 and 1918) • 1st and 2nd Public Health Acts • Liberal Government and Old Age • Pensions/National Insurance (early • 20th Century) • Labour Party and NHS • Impact of WAR, e.g. Rationing; • Beveridge Report 1942