Health and the Poor Law

Lesson at a glance

To what degree did the Poor Law make an important contribution to Public Health?

This lesson asks students to examine a set of letters to discover the health concerns of a sample of poor people in the Victorian era. The activity can be done in groups or as a carousel providing the whole class with knowledge of the content of each letter.

The letters have been grouped into five main themes related to health allowing you to select the letters most appropriate to your group’s studies. You may also want to pair this activity with the use of our interactive maps on where there are over 3500 letters from the victorian poor to explore. There is a curated map on health within the ‘secondary’ student portal, or further health related filters within the ‘research’ portal. Using these maps can allow you to explore health issues in your local area or explore national trends in medical care, sanitary reform or disease outbreaks.

This lesson was created as part of the Teaching the Voices of the Victorian Poor Teacher Scholar Programme.


The main activity can be done as a carousel activity or as expert groups. Students should explore the letters looking for details which suggest how the Poor Law contributed to Public Health. The letters are paired under five topics:

  • Malnourishment
  • Smallpox
  • Vaccination
  • Typhus Fever
  • General Public Health

Students should note down details that will support their answer to the enquiry question. If studied in groups, students should feedback and discuss their thoughts with other students until their entire table is complete.

Topic Evidence of the Poor Law’s contributions to Public Health
Typhus Fever
General Public Health

Students can write a paragraph or practice essay using the enquiry question. They should use evidence from the MH12 letters in their answers.

Students can explore further letters about Health and Medicine using our interactive maps at


The Victorian era was a point of major overhaul for public health in England and Wales, with The Poor Law and the Public Health Act working to support the basic needs of the people and attempting to understand and prevent illness in a manner never seen before.

A key figure in both of these acts was Edwin Chadwick. After helping to set up the 1834 Poor Law it became clear to Chadwick that health and sanitation was a major issue for the poor, with many seeking relief for issues stemming from illness and disease. The answer for Chadwick, as he suggests in his 1842 publication ‘The Sanitary Condition of the Labouring Population for Great Britain’ was to improve sanitation and access to preventative health care in order to prevent illness and therefore stop the poor from needing to ask for relief.

In the meantime the Poor Law created new administrative systems to oversee the relief provided to those in need. Workhouses were staffed with doctors and nurses and a dietary provided a recommended meal plan – which though meagre could still be more than the poor could provide for themselves if they could not work. Out relief could also be provided by relieving officers, providing access to food, clothing or some medical treatment.

A Central Board of Health was created after the Public Health Act of 1848, following a serious outbreak of cholera that year. Yet the board was unfunded and had little power to make changes, so the Poor Law continued to be an important service for the poor seeking help with the medical needs.

Teachers' notes

  • You may want to define key words in the sources e.g. advocates or consult the glossary page provided. This is separated into the different sources, but some words may come up several times. Therefore I would ensure each group has the whole glossary page.  
  • You may want students to work in groups on a few of the sources, rather than all of them. Groups can focus on one aspect, e.g. smallpox, then share their feedback to the rest of the class.  
  • You may want to pre-teach some of the topics (e.g. smallpox and Jenner’s vaccination) to give students contextual knowledge for the source content. 
  • You may want to time this so that it fits into your chosen specifications/ schemes of learning and lesson sequencing e.g. Industrial Revolution during Medicine Through Time/ around new poor law opposition in the Poverty and Public Health course (both Edexcel). 
  • You can keep this lesson suggestion as it is or download, save and adapt it to fit your class. 
  • The plenary task could be set out in the following ways: a small group, class debate or written task.  
  • There are some difficult/ sensitive words/ terms in the texts that may not be suitable for some students. Please do check over them first at your discretion.  

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Lesson at a glance

Related resources

Voices of the Victorian Poor

Resources from the Teacher Scholar Programme

Workhouse Voices

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Coping with Cholera

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Victorian Health Reform

How did the Victorians view compulsory vaccination?