* 1901: Living at the Time of the Census Living in 1901
Health care in 1901Hygiene and DiseaseOld Age and the Workhouse  

Hygiene and Disease

Infant health
Whilst death rates overall continued to fall in England and Wales in the late-Victorian period, deaths of infants under the age of one began to show an increase after 1896, peaking at 163 per 1,000 births in 1899. Some contemporary commentators blamed working-class mothers for neglect, lack of hygiene and inappropriate feeding. Poverty, however, and the number of premature babies provide a more likely explanation of the high infant mortality rate. Maud Pember Reeves's Round About A Pound A Week rebutted such accusations of neglect:

…that the diet of the poorer London children is insufficient, unscientific, and utterly unsatisfactory is horribly true. But that the real cause of this state of things is the ignorance and indifference of their mothers is untrue. What person or body of people, however educated and expert, could maintain a working man in physical efficiency and rear healthy children on the amount of money which is all these same mothers have to deal with?

After 1901, infant death rates fell, to 138 per 1,000 births for the period 1901 to 1905, starting a trend that would continue through the century. In 1981, the number of infant deaths per 1,000 births was 16.

Preventing infant deaths - link to an enlarged version

'National efficiency'
Concerns about the poor quality of army recruits for the South African War led to a public outcry: working-class men were perceived (by middle-class commentators) to be in a state of moral and physical 'deterioration', possibly due to poor living conditions in urban slums. Earl Grey wrote to The Times in November 1901, arguing that a

population reared in the sunless slums of our smoke-enveloped cities, unless reinforced by marriage with men and women born and reared in God's fresh air, deteriorate quickly to such an extent that the third generation is either sterile, or at best capable of giving birth to an infirm and rickety posterity.

An inter-departmental committee on physical deterioration, set up by the government partly in response to such concerns, reported in 1904 and its findings on urban poverty helped to pave the way for the introduction of free school meals and other benefits for poor children and their families.

Infectious disease
Many 19th century public health reforms were fuelled by the fear of infectious disease spreading rapidly within overcrowded towns and cities. The Infectious Diseases (Notification) Act of 1889 had made it compulsory to notify local medical officers of health of any cases of specified infectious diseases (such as typhus, smallpox and scarlet fever) and to compel sufferers to be sent to an isolation hospital. The state saw itself as being responsible - as a public good - for containing the spread of infectious disease, but individual health care was still seen largely as a matter for the individual concerned.

The Local Government Board sought to promote better sanitation, water supplies and vaccination as part of the government's policy - clean local water supplies had been essential for the eradication of typhoid and cholera. The annual report of its Medical Officer for 1901 describes a smallpox epidemic in London in the autumn of 1901 (spreading to over 6,000 cases by the end of March 1902) as well as outbreaks of bubonic plague in Cardiff and Liverpool, both linked to the plague pandemic at this time. No cases of cholera, however, had been confirmed since 1896.

Bubonic plague - link to an enlarged version