G650 A nineteenth century medical officer of health and child welfare

Abstract

In 1873 a Medical Officer of Health (MOH) was first appointed in a rapidly enlarging industrial northern city. This was 3 years after the 1870 Education Act which introduced 5 years primary education for all children, usually between the ages of 5 and 10 years. Once children were gathered together in the classroom, the condition of the poor, their clothes and hygiene, and above all, their health was realised. The impact of the MOH on local children’s health was studied using local sources including Council and Health Committee minutes, MOH annual reports, school records and newspaper articles. The MOH had a wide ranging remit from sewage disposal to the health of all children. He was guided by laws such as the Vaccination Acts and the 1889 Children Act, by a national network of MOHs and in addition he introduced his own local procedures. He oversaw general measures to set up the infrastructure of a modern city, such as a clean water supply, a sewerage system, and monitored air pollution and adulteration of food and took legal action to enforce compliance with guidelines. All this improved the welfare of the population, including children. Illnesses and deaths of children and infants received particular attention when MOH undertook a huge audit by introducing a local notification system for illness. This was limited in quality as diagnoses were not always accurate. Nevertheless, they were sufficient to focus treatment and preventative measures for common infectious diseases such as measles, scarlet fever, diphtheria and tuberculosis. This resulted in amngst other things, contact tracing and vaccinations for smallpox, disinfection centres for household goods and advice to school staff. The MOH also monitored and influenced services for specific groups of children, such as the deaf, blind and migratory children in canal boat families. This paper will illustrate the work of the MOH in detail, including the raw data, interpretation and measures put in place to improve the health and welfare of children in this industrial city.