The GRO and the Public Health movement in Britain, 1837-1914.

Abstract

From its earliest years the General-Register Office (GRO) developed a twin-pronged publication strategy to maximize both its political and scientific impact in promoting the environmentalist policies of the public health movement. Through its weekly and quarterly bulletins of comparative death-rates the GRO fought a relentless campaign to heighten local awareness of the extent of preventable death. The government's chief medical officer also used this information to investigate negligent local authorities. A parallel series of annual and decennial reports offered a more rigorous and scientific analysis of the incidence of the nation's fatal diseases. A relative decline in the GRO's leading position in the public health movement after the retirement of William Farr in 1880 has been misinterpreted as the end of its commitment. But this was only a temporary lull, primarily due to developments beyond its control: the rise of germ theory and also the increasing powers and professional organization of the Medical Officers of Health. The GRO had to adapt to a less glamorous supporting role supplying the country's MOHs with the epidemiological information they required. In the Edwardian period, however, the GRO was to be found once more in the center of the most significant scientific and political conflict, successfully defending an environmentalist and increasingly state-sponsored public health and welfare policy against the attacks of hereditarian eugenicists. The GRO's Powers of Influence How did the GRO perform an effective role promoting public health in the nineteenth century? First among its contributions in this respect was the attempt to provide authoritative factual information on districts’ overall death-rates. It is easy to overlook the importance of this simple and obvious service. But this was, after all, the essential basis for informed local action. There was nothing more likely to prevent a local authority from taking a decision to implement what was always perceived by their voting ratepayers to be grievously expensive preventive health measures than a debilitating uncertainty as to the basic facts of their situation. Provision of regular bulletins on the changing state of health in many localities was an entirely self-appointed role.