History of Public Health Timeline
Explainers | December 1, 2022
To celebrate the 175th anniversary of the first public health official's appointment in 1847, we have compiled a timeline of significant dates for public health.
(NOTE ADDED BY TTV: The important role played by professions alligned to medicine, and the system of local government, in the advances and improvements in public heath, is virtually ignored in this historical review, concentrating as it does on 'Medical Officers of Health' (until 1974). Whether all the social, administrative and professional changes since that date have made people's general health and well-being better or worse can be debated))
28.5.2024: THE ROLE OF SUGAR IN DISEASE: Problem is sugar (actually sucrose, glucose, fructose, galactose or maltose) is in virtually every food product as an ingredient and carbohydrates ultimately turn to sugars, as I'm sure you know, so it's not as simple as it seems. Must be very tricky trying to cut down on it. I always have an impossible job staying awake, if after a bike ride I read a book. A few pages and I'm off for an hour or so. These days I never fight it and just give in, believing that nature and its complicated biological systems, knows best. When at college I had a terrible job staying awake in afternoon lectures which was annoying as it was embarrassing. Sugar and its commerce was the great domestic innovation of the 17th and 18th Century (slavery and all that) although amazingly it had been around in the far east for thousands of years apparently. Just imagine what life was like before sweetners became common place. In recent times, some medical opinion suggests (Thomas Cleave and the 'Saccharine Diseases') is at the root of a whole range of modern diseases. It is certainly primarily responsible for the surge of cases of diabetes, though of course other factors are involved. (TTV)1842 The first idea that a medical appointee should give direction to local authorities originated in Edwin Chadwick’s report on the sanitary condition of the working population of Great Britain.
1844 Thomas Fresh became Liverpool’s first public health officer.
1846 he Liverpool Sanitary Act passed which led to the establishment of the role of ‘Medical Officer of Health’ (MOH) in Liverpool.
1847 January 01 - William Henry Duncan appointed as Britain's first MOH for Liverpool.
1848 The first Public Health Act passed which gave every town the right to appoint a MOH. The Act established a General Board of Health which was responsible for managing local boards of health as well as the overall health of the public. Dr John Simon is appointed as the first MOH for the City of London.
1854 John Snow first identifies Cholera as a water-borne disease, pinpointing the source of the outbreak and curtailing the epidemic in London.
1855 London is split into 46 Metropolitan Districts - each required to appoint a MOH. Dr John Simon is appointed as first Chief Medical Officer to her Majesty's Government and Dr Henry James Payne is appointed as the first MOH for Cardiff. Henry Letheby is appointed as MOH and analyst of food for the City of London.
1856 April 23 - Dr Pavy (MOH St Luke, Middlsex) called a meeting to propose founding a London-based society. May 13 - Inaugural meeting held with 30 MOH across London - Metropolitan Association of Medical Officers was formed. John Burdon Sanderson appointed as first MOH for Paddington, London, he took a special interest in the ventilation of work places and helped advance the acceptance of Germ Theory in Britain. Edwin Lankester appointed as first MOH for Westminster, London, his vaccination policy almost halved the incidence of smallpox in the parish.
1857 Dr John Simon published the first public health annual report which became common practice for all MOsH/DsPH.
1859 MOsH outside of London were allowed to join the Association.
1862 Sir Henry Duncan Littlejohn is appointed as the first MOH for Edinburgh.
1866 Dr M K Robinson is appointed as the first MOH for Leeds. The Sanitary Act of 1866/PH Act 1866 was passed making it compulsory for local authorities to improve sanitation - leading to the formation of drainage districts and better home drainage.
1868 John Leigh is appointed as first MOH for Manchester. He helped tackle cellar dwellings, back-to-backs and midden privies.
1869 ‘Metropolitan’ dropped from the Associations title to acknowledge the important membership from across the country and became the Association of Medical Officers of Health. Thomas Stevenson is appointed as the first MOH for St Pancras, London. He served as President of the Society of Medical Officers of Health at various times and helped to raise the status of the analytical chemist.
1872 The Public Health Acts of 1872 and 1875 made it a statutory responsibility for all districts to appoint an MOH. Dr James Burn Russell is appointed as Glasgow's first full time MOH. The American Public Health Association is founded. It is now the oldest and largest organisation of PH professionals globally.
1873 The Association became the Society of Medical Officers of Health. By this point, the Society had 115 members: 40 were metropolitan 33 were extra-metropolitan 10 were alumni 32 were Associated or Honorary
1874 The Births and Deaths Registration Act was passed. This was vital in allowing MOsH to collect information on different causes of death in their district.
1875 Several provincial associations of MOsH were formed: North Western Association Yorkshire Association Birmingham and Midland Association Northern Counties Association The University of Dublin (Trinity College) was the first to recognise the increasingly important work of MOsH and created a post-graduate Diploma in Public Health (DPH).
1884 Koch’s postulates – 4 criteria designed to establish a causal relationship between a microbe and disease. It is considered to be the one of the founders of bacteriology.
1888 Arthur Newsholme is appointed as full time MOH in Brighton and wrote a textbook on vital statistics ‘The Elements of Vital Statistics’ (1889) which became a standard textbook for MOsH. An amalgamation of the society with the three surviving provincial associations became ‘branches’ (North-Western, Yorkshire, and the Birmingham/Midlands). By 1888, there were 1,490 MOsH outside of London, of which only 90 were full time. They set the standards, determined the course of public health activity and were responsible for over half of the population.
1888 Arthur Newsholme appointed as full time MOH in Brighton and wrote a textbook on vital statistics ‘The Elements of Vital Statistics’ (1889) which became a standard textbook for MOsH.
1890 William Johnston MOH for Leicester developed a method to prevent the transmission of Smallpox. The diffusion of the disease was drastically reduced and any major outbreak was prevented until 1982.
1891 The Society became the Incorporated Society of Medical Officers of Health (ISMOH) and membership was between 500-600. The Metropolitan and Northern Branches were formed.
1893 Formation of the West of England and South Wales Branch. The British Institute of Public Health was established.
1894 Dr Edward William Hope appointed as MOH for Liverpool and served as the longest MOH in the UK until his retirement in 1924. James Niven appointed as MOH for Manchester and served a 28 year term. Niven's most notable work was in restricting the impact of the Spanish Influenza in Manchester. Formation of the Home Counties and Southern Branches
1896 The Society of Medical Officers of Health of Scotland (formed in 1891) joined the Society as the Scottish Branch.
1899 Boer War - The Committee on Physical Deterioration was set up in 1903 after the war’s culmination in 1902. It made the following recommendations: compulsory medical inspections of children in schools, free school meals for the very poor, training in mothering skills for working class women.
1902 The Association of County Medical Officers of Health of England and Wales (ACMOH) broke from the ISMOH.
1904 Formation of the Eastern Branch of the ISMOH.
1905 The Society moved into its first office: 1 Upper Montague Street, Russell Square. The North Western Branch accepted its first female member.
1906 The welfare state is launched with a series of welfare reforms to provide provisions for free school meals and medical treatment for children, old age pensions, compulsory health insurance for low-paid workers, and unemployment insurance for those out of work. This legislation is greatly expanded over the next 40 years.
1908 Arthur Newsholme was made CMO until 1919. He oversaw the initiation of national health insurance and the national programmes introduced to combat TB, venereal disease and infant mortality.
1911 All cases of TB were required to be reported to the local MOH so that patients could be kept under observation. Each reported case was visited, their living conditions noted, and advice issued. Most MOH saw the improvement of general housing as the central fight against TB.
1914 Jessie Gellatly is appointed as assistant MOH for Cambridgeshire.
28/07/1914The outbreak of WW1 – also called The Great War, there were around 40 million casualties and 20 million deaths.
1916 The Local Government Board issued the Public Health Venereal Diseases Regulations based on recommendations by the Royal Commission on Venereal Diseases. These regulations led to the development of a nationwide network of clinics based in hospitals in heavily populated areas offering free confidential diagnosis and treatment for syphilis, gonorrhoea and chancroid.
1918 Spanish flu pandemic infected an estimated 500 million people. LA's played an important role in running hospitals, keeping essential services open and ensuring care for vulnerable people. Dr James Niven (MOH Manchester) was the first to introduce preventative measures that slowed the spread of the diseases.
1918 Maternity and Child Welfare Act was passed which gave LA’s the power to provide services supporting the health of pregnant and nursing mothers, and children under 5, under the supervision of the MOH. Joseph Priestley (MOH Lambeth) initiated a number of practical measures to prevent epidemic diarrhoea in infants (Lambeth Maternity and Child Welfare Scheme).
11/11/1918WW1 ends. Motorised ambulances, the development of new antiseptics and advancements in anesthetic medicine are all credited to WW1.
1919 Housing Act made housing a national responsibility and saw the beginning of mass council house building. Veitch Clark (MOH Croydon) introduced the Scheme of the Croydon Town Council for the provision of New Houses, which converted empty houses into flats for the working class. The Welsh Branch is formed. July 3: The society approved a new constitution which consolidated its position as the ‘central representative body of the Public Health Service’.
1920 Formation of the County District Medical Officers of Health Group. William Wilson Jameson appointed as MOH for Finchley. He went on to become the first Professor Public Health at the London School of Hygiene and Tropical Medicine.
1921 Marie Stopes opens the first sexual health clinic in Britain, the Mothers' Clinic for Constructive Birth Control. It was the first time qualified clinical staff gave contraceptive advice and it marked the beginning of Sexual Health Services (SHS) being a medical speciality rather than a social or commercial activity.
1922 By 1922, 7 specialised groups of MOH had been formed, including the Tuberculosis Group; County District Medical Officers Group; Maternity and Child Welfare Group. MOHs could no longer be dismissed from their post without the active consent of the Minister.
1923 John Parlane Kinlock appointed as MOH for Aberdeen. He pioneered the removal of public hospitals from the Poor Law which held that only the voluntary sector should provide acute care.
1924 Doctor George M’Gonigle appointed as MOH for Stockton-on-Tees. He opened the Ragworth Open Air School in Norton which took in sick children, nursed them back to health with lessons held outside, regular meals and daily provisions of milk and fruit.
1924 Housing Act gave substantial grants to local authorities in response to acute housing shortages.
1930 The responsibilities of MOsH were extended in parallel with the Local Government Act of 1929, to include school health services, food control and hygiene, and housing. The East Midlands branch is formed.
1930 Housing Act forced local councils to clear all remaining slum housing and provide further subsidies to re-house inhabitants. This single Act led to the clearance of more slums than at any time previously, and the building of 700,000 new homes.
1930 The National Birth Control Council (NBCC) was formed from 20 SH clinics so ‘married people may space or limit their families and thus mitigate the evils of ill-health and poverty’. Unmarried and working-class women were offered little support to seek advice.
1936 Catherine Crane appointed as assistant MOH for York and Chief Medical Officer for maternity and welfare in the city.
1939 NBCC member societies merged into The Family Planning Association (FPA).
01/09/1939 Outbreak of WW2.
02/09/1945 WW2 ends. The Emergency Health Service was established and gave central government the right to control the voluntary and municipal hospitals. The EMS showed the British government that working on a large scale meant that major challenges such as the Blitz or the aftermath of Dunkirk could be dealt with effectively as a collective and gave an insight into the potential successes of a national, joined-up health service.
1946 Catherine Crane appointed as the UK's first female MOH for York.
1948 Creation of the NHS. This removed hospitals from the remit of MOsH, leaving them with residual public health and social care functions. Membership eligibility of the Society was extended to Professors and Lecturers in social medicine. The Northern Ireland branch is formed.
07/04/1948 The WHO is established.
1950 Sir Richard Doll conducts a study to demonstarte that smoking was a cause of cancer.
1951 The British Doctors Study commences, based on Doll's preliminary evidence from the investigation the previous year. The study lasted 50 years and proved beyond reasonable doubt the relationship between smoking and the risk of death from lung cancer.
1952 Catherine Crane's pioneering work bought together the local authority and mental hospital medical staff to form the York Mental Health Service, she was later responsible for establishing one of York's first cervical screening services.
1952 Dec 1952: London's Great Smog. John Brown (MOH Greenwich) reported the smog killed approximately 4000 people "indicating a catastrophe of the first magnitude".
1952 FPA clinics begin to offer pre-marital advice to women.
1956 Robert Wolfinden is appointed as MOH in Bristol. He enhanced Bristol's reputation as a model for health services a decade before they became popular.
1956 The Clean Air Act 1956 granted local authorities the power to control emissions of smoke, grit, dust and fumes from industrial premises and furnaces.
1961 The first oral contraceptive is introduced.
1965 Cigarettes were banned by the Government from being advertised on television and taxation on cigarettes slowly began to increase.
1965 Dr J Adrian Gillet is appointed as MOH for the newly created London Borough of Barking and Dagenham. Only one other DPH Matthew Cole has been responsible for this borough since then. This is unique in London.
1967 The Abortion Act legalises abortion in certain circumstances. The Family Planning Act enabled local authorities to give contraceptive advice and supplies under the NHS.
1967 Plans to build new town Milton Keynes were approved. John Reid MOH Buckinghamshire was closely involved in town planning and the establishment of the health services.
1967 The Road Safety Act 1967 made it an offence to operate a vehicle with a blood alcohol concentration of over 80mg of alcohol per 100ml of blood.
1967 The WHO announced the Intensified Smallpox Eradication Programme which aimed to eradicate smallpox in more than 30 countries through surveillance and vaccination.
1970 The Local Authority Social Services Act was passed. This seperated social services from LA PH departments, leaving MOsH with largely environmental responsibilities.
1972 Establishment of the Faculty of Community Medicine by the Royal Colleges of Physicians of the United Kingdom. The formation of new associations and decrease of the Society's representation on the British Medical Associations Public Health Committee contributed to its decline in size and activity.
(Tim Veater qualified as a Public Heath Inspector! (Bristol Polytechnic/Bristol City Council/PHIEB/MPHIA)) Ha. Ha.
1973 The ISMOH was renamed to the Society of Community Medicine.
1974 The post of MOH was abolished and replaced with Community Physician. The newly renamed Society replaced its branches with 17 new 'regions' congruent to the NHS. The ACMOH became the Association of Area of Medical Officers. Dr Spence Galbraith is appointed MOH for Newham. He had long argued for a centrally financed/ co-ordinated national epidemiological service and in 1977, the Communicable Disease Surveillance Centre (CDSC) was set up under Galbraith.
1975 The Association of District Community Physicians was formed.
1980 33rd World Health Assembly declares the world free of smallpox.
1982 The Association of District Medical Officers (ADMO) was formed from the merger of the Association of Area Medical Officers and the Association of District Community Physicians.
1986 BSE (bovine spongiform encephalopathy), commonly called Mad Cow Disease, infects the UK food chain, and causes a PH crisis.
1988 The Worldwide Polio Eradication Initiative is launched led by the WHO, Rotary International, CDC and Unicef.
1989 The ADMO became the Association of Directors of Public Health (ADPH) and The Society of Community Medicine became the Society of Public Health. The newly named Society set up the Faculty of Community Health to support the community health doctors and promote academic excellence in the field of preventative medicine.
1980/90 HIV/AIDs crisis erupts globally. According to the WHO, as of 2021, HIV/AIDS has killed approximately 40.1 million people.
1992 The ADPH logo was drawn up and added to the medal.
1996 A combination of antiretroviral drugs, known as triple combination threat therapy (HAART), became standard treatment for HIV infection.
1996 The Education Act 1996 stipulates that maintained schools must provide free school meals to disadvantaged pupils aged between five and 16 years of age.
1997 The Society formally merged with the Royal Institute of Public Health and Hygiene.
1990/2000 H5N1 influenza starts spreading and global outbreaks begin to become a common occurrence.
2000 The CDC establishes the Global Health Programme.
2002 The Rough Sleepers Unit is set up. It aims to reduce the number of rough sleepers by recognising its causes. Numbers have falled by 56% since 2003.
2002 The National Chlamydia Screening Programme was established to ‘prevent and control chlamydia through early detection and treatment of asymptomatic infection; reduce onward transmission to sexual partners; and prevent the consequences of untreated infection’.
2003 The congestion charge is introduced in London. It enforced a mandatory fee for vehicles entering specific zones. Congestion has been reduced by 30% within these zones as well as reducing CO and NO pollution.
2003 The Licensing Act 2003 replaces earlier controls of alcohol and introduces a more permissive, flexible regime, moving responsibility and licensing from local magistrates to local councils.
2005 Scotland is the first country in the UK to enforce rules which banned smoking in public, passing the Smoking, Health and Social Care (Scotland) Act 2005.
2005 "Scores on the doors" food hygiene ratings are introduced and information is collected by local authorities. The scheme is standardised by the Food Standards Agency and in 2012 is rolled out as the Food Hygiene Rating Scheme. The UK becomes a Party to the WHO Framework Convention on Tobacco Control
2006 The Health Act 2006 is passed, affecting the sale of tobacco products. The Act places a ban on smoking in enclosed public places and increased the age of purchase for tobacco products. Bowel Screening Programmes began in England (2007 Scotland, 2008 Wales and 2010 in NI). Over 25,000 cases of bowel cancer have been detected as a result of the scheme.
2007 Ofcom bans advertisement of foods high in fat, sugar and salt during television aimed at children under 16.
2008 The HPV vaccine is introduced for girls aged 12-13. Boys of the same age are now also eligible for the vaccine.
2009 Swine flu pandemic began. The virus is first identified and causes a global flu outbreak.
2010 The Marmot review is published, a government-commissioned report looking at the landscape of health inequalities in England, and what could be done about them. The review made a strongly evidenced case that health inequalities have social determinants, and that health and wellbeing were just as important measures for society as economic growth.
2012 The Alcohol Minimum Pricing Scotland Act 2012 passes introducing a minimum unit pricing (MUP) and setting a baseline price at which a unit of alcohol can be sold. The Health and Social Care Act 2012 is passed, extensively reorganising the structure of the NHS in England. Responsibility for the operation of the public health system moved from the NHS to local authorities.
2013 The childhood flu vaccine is introduced. The success of the programme led to the roll out in 2019-20 of flu vaccines for all primary school aged children in the UK every year. Traffic light labelling on packaged food is rolled out. It encourages the nutritional content of food to be colour coded on packaging. Public Health England (PHE) is established. Responsibility for commissioning PH services was moved from the NHS to local authorities. Drug safety testing at UK festivals is first piloted, allowing anonymous substance testing. In 2016, two UK festivals saw nearly 1 in 5 users dispose of their drugs once aware of the content.
2018 Soft Drinks Industry Levy taxes manufacturers based on the sugar content of their product. It forces product reformulation and recognises the role of the food and drink industry in the public making healthier choices. The UK government reduces the maximum stake on fixed odds betting terminals from £100 to £2.
2019 Abortion is decriminalised in Northern Ireland. Junk food advertisement is banned across the entire Transport for London network.
11/03/2020 Covid-19 is declared a pandemic by the WHO.
2021 The UK Health Security Agency (UKHSA) is formed, an agency under the Department for Health and Social Care. It transferred health improvement functions from Public Health England (PHE) to the DHSC.
2022 The Khan Review is published. The report considers what is needed to achieve the Government's 2030 Smokefree target, making 15 recommendations, including the promotion of vapes as an effective ‘swap to stop’ tool to help people quit smoking.
2022 ADPH celebrates 175 years since the first DPH was appointed. Monkeypox outbreaks occur in non-endemic countries, including the UK, with cases mainly concentrated in London.
2023 ADPH celebrates 175 years since the first Public Health Act was passed in 1848.
Chartered Institute of Environmental Health
"The voice of Environmental Health since 1883"
Key Milestones - https://www.cieh.org/about-us/history-of-cieh/timeline/
12.10,2023:
8h
Shared with Public
To John Creech: Well I never! Yes I can see the likeness John. Well done you and that really is a blast from the past. My first proper job straight from school was a junior in the health department. Of course I was in awe of your dad and of Wolfinden, the MoH. It was your dad I have to thank for my career in public health, as he approved my sponsorship as a student public health inspector at the second attempt in 1968. I also appeared with him at the Public Health Committee to present my paper on Lead Pollution, but very wisely I remember he didn't let me open my mouth to put my foot in it! He was I think followed in that post by Don Barnett. Not sure if the latter is still going. I always remember a little incident when your dad arrived at Canyning Hall. The Public Analyst looked out of the window and said, "Here comes the boss!" I was impressed. Your dad was I believe St John's 'royalty'. I would be very interested to hear any information relating to either him or yourself. In the meantime, best wishes. I was never able to thank him myself.
Fool's Gold by Tim Veater
The poet's task is very hard,
yea and lovers also.
Like ancient alchemists of old
dull poisonous malleable lead -
into butter yellow everlasting gold,
so too we try by all means hot and cold
to find dull words to represent
the feelings that lie buried,
deep within our souls.
For words and rhyme are inadequate
to represent that stab of pain,
that thumping chest, that knotted gut;
when like a dewy mist a voice is heard
or familiar face appears,
like clotted cream out of white milk;
or better still, when just by chance
in busy thoroughfare, where all is hurry,
you bump into each other
and time stands still just for a second.
The gulp of breath, the windows on the soul,
when with an iron rod the eyes connect,
searching and probing deep
the silence, when no one can speak
and prayers would be profane.
Again, again, I try to replicate
that magic moment, moments gone,
when out of darkness came forth light,
when out of rock a jewel tumbled.
When words gave way to bliss
and all the angels swooped to see and tell,
curious at what the gods had brought to pass
for levity and sport in some remote location.
We heat and cool, we mix and stir,
then leave for weeks to coalesce,
then with what anticipation peep
into that caldron love
to see if speck of yellow dust
might yet appear upon the breast.
Breathe deep those fumes of musk.
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