Book Review

Abstract

Davey Smith , G., Dorling , D. and Shaw , M. (eds) Poverty, Inequality and Health in Britain 1800–2000: a Reader . Bristol : The Policy Press , 2001 , £15.99 and £50.00 , lxxxvii + 373pp . ISBN 186134211X (pbk), 1861343280 (hbk) . This publication draws together extracts from some of the most important writing in the history of poverty, inequality and health in Britain in the last 200 years. A number of the texts in this collection should prove familiar, including Booth's survey of poverty in London (in the late 1880s), Rowntree's York study (1899), the Beveridge Report (1942) and the Acheson Report (1998). Others may be less well known including Clarkston's essays on the African slave trade, written in the late 18th century, and a chapter from McGonigle and Kirby's Poverty and Public Health (1936). Given the breadth of the pieces, the editors should be congratulated for their skilful selection and editing of the 29 extracts that constitute this collection. However, some of the history in the introductory chapter and the ‘timeline’ that follows could have been better handled. There are minor irritations, such as the description of the paintings of Clarkson and Malthus as ‘photographs’. More seriously the complexity of historical change seems to be understated, and longstanding debates in the historiography neglected. Amongst the omissions, for example, are the victories and defeats of popular movements that inspired the revolutionaries, reformists and reactionaries whose work appears in this volume. The significance of the French Revolution is recognized, but Chartism in Britain in the 1830s and 1840s, considered by some as the first working-class struggle for direct democracy, and the revolutions that swept through the rest of Europe in 1848, are largely ignored. Yet it was in this world of upheaval that Farr, Chadwick, Marx, Engels and Mayhew produced their analyses of poverty that are included in this collection. The 1840s allowed for new ways of understanding society to emerge and included insights into how inequality and health were interconnected. This was ‘no accidental discovery of this or that ingenious brain’, as Engels would later point out. Chadwick's Report on the Sanitary Condition of the Working Class further illustrates the importance of understanding the relevance of the historical contexts in which ideas succeed or fail. National public health reform took another six years after Chadwick's masterpiece was published in 1842. The delay in implementation has been ascribed to ‘sinister interests’ combined with administrative difficulties and public inertia. The forces for change included the middle class Health of Towns Association (founded in 1839) and a growing public fear of cholera, along with the efforts of the civil servant Chadwick. There is also little recognition of the ways in which poverty has been addressed differently across Britain. By the 19th century many of those in poverty who could be supported under the Poor Law in England could not be assisted in Scotland. Indeed fewer Scots in need were receiving assistance in 1890 than had been the case in 1830. By the 1920s the parish welfare system in Scotland was collapsing amid protest and riot. And within Scotland the Parish Councils responded differently to the crisis. At points, the introduction falls into too simple a duality. The argument is portrayed as having progressives offering socioeconomic explanations on one side and conservatives explaining poverty as a result of individual ignorance, drunkenness and immorality on the other side. Of course the circumstance/lifestyle debate can be identified as a common theme in a great deal of the literature, but there are other historical threads. The rise of working class respectability (including hygiene) in the 19th century might have been considered a corrective in this context. By the beginning of the 20th century there were socialists and communists who were campaigning for the collective storming of the commanding heights of the economy while asserting the values of sobriety and physical exercise. Amongst the debates missed are the long-term consequences of the Second World War that continue to be hotly contested by historians, including those who believe that postwar ‘reforms’ limited social change and sustained inequalities. One leading historian of the period has convincingly argued that the conflict simply pushed society in Britain at a slightly faster pace in the same direction in which it had been heading before 1939. Despite these reservations, the extracts in this volume will provide an excellent resource for researchers and teachers of health inequalities. Historians working in this area will especially welcome the collection.