Contagion, Policy, Class, Gender, and Mid-Twentieth-Century Lancashire Working-Class Health Culture

rom earliest times, governments have been concerned about the threat posed by epidemics and have embraced policies and regulations intended to prevent or limit the impact of diseases identified as contagious. However, the public health initiatives of nineteenthand early twentieth-century England were more ambitious, inclusive, and sustained than any previous public attempts to control disease. The sanitation reforms and preventive health services implemented from the 1840s onward had an enormous impact on the quality and duration of life experienced by English people. Indeed, in his challenge to the McKeown thesis, Simon Szreter argues, ‘The public health movement working through local government, rather than nutritional improvements through rising living standards, should be seen as the true moving force behind the decline of mortality in this period.’