Public Health
England has the oldest system for collecting statistics on infectious diseases in the world. The Infectious Disease Notification Act of 1889 required both Medical Practioners and the heads of households to inform the Local Medical Officer of all cases of infectious disease with a penalty of up to 40 shillings for failure to so do. It also compelled any suffers to be sent to an isolation hospital.
It was introduced in response to a fear of infectious diseases (such as typhoid and tuberculosis) spreading rapidly in England's increasingly overcrowded towns and cities.
The notice on the right of this page was issued at the end of the summer of 1896, when in Hucknall there had been outbreaks of both typhoid and scarlet fever.
Infant mortality and its causes were of particular concern in late Victorian times. In the 1890's in England, infants deaths under the age of one began to rise against a year on year fall in the overall death rate, peaking in 1899 at 163 per 1,000 births.
Some contemporary accounts laid much of the blame on ignorance and poor parenting by working class mothers, and this theme is evident in the annual report for 1890 of Dr H.T. Jones the District Medical Officer for Hucknall, in which he:
'Strongly condemned the practice of women with children in their arms sitting in neighbours houses when infectious diseases were present and persisting in doing so inspite of the frequent warning given.'
He also commented, when referring to the number of premature births that:
'If persons intending to marry were required to undergo an examination as to their physical soundness as a necessary preliminary much suffering and misery would be prevented.'
Number of deaths by age group for Dec. 1890
12 under 1 year
6 aged 1 to 4
3 aged 5 to 14
1 aged 15 to 24
1 aged 25 to 39
4 aged 40 to 59
4 aged 60 and over
The provision of a clean water supply in the 1880's was a major step forward and by 1890 cases of enteric fever (typhoid), which was rife in earlier years, were few (the last major outbreak was in 1897).
In Hucknall in 1890 the most frequent causes of death were bronchitis, pneumonia, whooping cough, heart disease, phthsis (tuberculosis), measles and diarrhoea. The infectious diseases most prevalent were measles, scarlatina, enteric fever, whooping cough, diphtheria and croup. Many deaths of children under the age of one were caused by whooping cough.
At this time the most pressing concern was poor sanitation due to badly drained pigstyes and overflowing ashpits. In 1891 Dr Jones commented:
'Three houses in a certain part of town containing 20 inhabitants have only one closet that was in such a state that it was impossible to get within two yards of it.'
The Local Board (Local Council) agreed something must be done to ensure ashpits were emptied on a regular basis, but, with a number of property owners amongst there number, were reluctant to have this become the responsibility of landlords. They felt tenants should dispose of their own waste, but were unwilling to push the issue as it would have been a deeply unpopular move. The impasse was finally broken in the summer of 1891 when a decision was made to put the emptying of 'earth closets, privies and ashpits' out to tender.
The policies of improving health education, sanitation and housing in the late 19th century paid off and Dr Jones's annual report of 1901 was considerably more upbeat: