Reviews: Public Health and Social Justice in the Age of Chadwick; Britain, 1800–1854

3
416 REVIEWS and Mar del Plata-style chalets. Visitors rose rapidly in number: from 28 000 in 1914 to 59 000 in 1927 and 192 000 by 1937. The old days were numbered. Not even the establishment of a new racecourse and the Jockey Club in 1907 could maintain the e ´lite’s patronage for their eyes now focused further afield; for the truly rich the world became their playground and Mar del Plata was slowly but surely abandoned to the masses. Without doubt the best chapters of this volume are those of Fernando Cacopardo, Jose ´ Mantobani and Eliza Pastoriza for they demonstrate ingenuity in their mastery of diverse source materials. They do not, like the other authors, wa e in often irrelevant asides in which the theories of Habermas, Giddens, Bartres, Foucault, and Bourdieu are paraded (alas no Duncan!). Nu ´n ˜ ez fails to relate her useful linkages between families and institutions to the urban context, and Graciela Zuppa’s extended description of the form of plazas says little of their social use or significance. Taking one city block and tracing ownership and career patterns of its Italian immigrants could have been a novel research tack but Bartolucci stops short of drawing conclusions—I fear there are none? Similarly Javier Sa ´ez’s analysis of domestic housing styles begins with verve but soon declines into symbolic gibberish where new terms (textio ´n: text and action combined) replace convincing ideas and empirical evidence. It is disappointing to have to report the very poor quality of the photos and maps throughout the book. The authors deserved better for they clearly dug deep to locate them and they would have better illustrated key points in their arguments—especially if they had been placed next to their citation in the text. Notwithstanding these defects this is an important work for it demonstrates both the availability of rich source materials for the analysis of urban form and social practices as well as multidisciplinary e orts to answer research questions that extend well beyond national borders. Mar del Plata is now on the map with Brighton, Blackpool, Acapulco and Vin ˜a del Mar. Atlantic City no longer stands alone. Syracuse University D J. R C H , Public Health and Social Justice in the Age of Chadwick; Britain, 1800–1854 (Cambridge: Cambridge University Press, 1998. Pp. vi+368. £40.00 hardback) The central theme of this book is “the politics of making a public health” (p. 11): the process by which those with power at local and national level were convinced that there was a ‘public health’ problem in the 1840s, that its causation was easily identifiable, and that the central solution to the problem lay in the sanitization of the urban environment rather than better diet, improved wages or other potential responses. This meant the creation, in other words, of an ‘acceptable’ public health; one which focused on factors exogenous to the urban socio-economic system, such as airborne disease, or which related health problems to the failings of the poor, such as filth, rather than a vision of public health which questioned social order and the operation of the labour market. In this process, Edwin Chadwick is seen as hero, villain and pawn. Chapters 1 and 2 identify and explore a “pre-Chadwickian paradigm” (p. 25) developing from the 1790s. Hamlin argues that contemporary medical opinion saw social as well as epidemiological causes of disease, and that discussion of pressing social issues such as the factory question or the population conundrum was largely conducted within a framework and language of medicine. Against this backdrop, we are invited to ask the question why, in the 1830s and 1840s, public health became a byword for sanitation reform rather than being framed in rather wider medical terms? There are some obvious explanations—a divided medical profession, for instance—but Chapter 3 develops an alternative explanatory model with two central contentions. First, the 1834 New

Transcript of Reviews: Public Health and Social Justice in the Age of Chadwick; Britain, 1800–1854

Page 1: Reviews: Public Health and Social Justice in the Age of Chadwick; Britain, 1800–1854

416 REVIEWS

and Mar del Plata-style chalets. Visitors rose rapidly in number: from 28 000 in 1914to 59 000 in 1927 and 192 000 by 1937. The old days were numbered. Not even theestablishment of a new racecourse and the Jockey Club in 1907 could maintain theelite’s patronage for their eyes now focused further afield; for the truly rich the worldbecame their playground and Mar del Plata was slowly but surely abandoned to themasses.

Without doubt the best chapters of this volume are those of Fernando Cacopardo,Jose Mantobani and Eliza Pastoriza for they demonstrate ingenuity in their masteryof diverse source materials. They do not, like the other authors, waffle in often irrelevantasides in which the theories of Habermas, Giddens, Bartres, Foucault, and Bourdieuare paraded (alas no Duncan!). Nunez fails to relate her useful linkages between familiesand institutions to the urban context, and Graciela Zuppa’s extended description ofthe form of plazas says little of their social use or significance. Taking one city blockand tracing ownership and career patterns of its Italian immigrants could have been anovel research tack but Bartolucci stops short of drawing conclusions—I fear there arenone? Similarly Javier Saez’s analysis of domestic housing styles begins with verve butsoon declines into symbolic gibberish where new terms (textion: text and actioncombined) replace convincing ideas and empirical evidence. It is disappointing to haveto report the very poor quality of the photos and maps throughout the book. Theauthors deserved better for they clearly dug deep to locate them and they would havebetter illustrated key points in their arguments—especially if they had been placed nextto their citation in the text. Notwithstanding these defects this is an important workfor it demonstrates both the availability of rich source materials for the analysis ofurban form and social practices as well as multidisciplinary efforts to answer researchquestions that extend well beyond national borders. Mar del Plata is now on the mapwith Brighton, Blackpool, Acapulco and Vina del Mar. Atlantic City no longer standsalone.

Syracuse University D J. R

C H, Public Health and Social Justice in the Age of Chadwick;Britain, 1800–1854 (Cambridge: Cambridge University Press, 1998. Pp. vi+368. £40.00hardback)

The central theme of this book is “the politics of making a public health” (p. 11): theprocess by which those with power at local and national level were convinced thatthere was a ‘public health’ problem in the 1840s, that its causation was easily identifiable,and that the central solution to the problem lay in the sanitization of the urbanenvironment rather than better diet, improved wages or other potential responses. Thismeant the creation, in other words, of an ‘acceptable’ public health; one which focusedon factors exogenous to the urban socio-economic system, such as airborne disease, orwhich related health problems to the failings of the poor, such as filth, rather than avision of public health which questioned social order and the operation of the labourmarket. In this process, Edwin Chadwick is seen as hero, villain and pawn. Chapters1 and 2 identify and explore a “pre-Chadwickian paradigm” (p. 25) developing fromthe 1790s. Hamlin argues that contemporary medical opinion saw social as well asepidemiological causes of disease, and that discussion of pressing social issues such asthe factory question or the population conundrum was largely conducted within aframework and language of medicine. Against this backdrop, we are invited to ask thequestion why, in the 1830s and 1840s, public health became a byword for sanitationreform rather than being framed in rather wider medical terms? There are some obviousexplanations—a divided medical profession, for instance—but Chapter 3 develops analternative explanatory model with two central contentions. First, the 1834 New

Page 2: Reviews: Public Health and Social Justice in the Age of Chadwick; Britain, 1800–1854

417REVIEWS

Poor Law offered a ‘solution’ to the poverty problem through work and individualresponsibility. Commentary that linked disease to destitution, and by implication towider flaws in the socio-economic system, would throw doubt on these ‘solutions’ andundermine a fragile commitment to the New Poor Law. Concentration on sanitationproblems as the root of disease would, by contrast, focus attention back onto individualbehaviour, and to malleable scapegoats such as the urban infrastructure. Second, tounderstand public health, we must also understand the personality and political positionof Chadwick himself. With a vested interest in deflecting attention from the poor law,an apparent interest in statistical representation of social problems, and limited optionsfor public service after being edged out of central poor law administration, Chadwick’salmost accidental involvement in the public health sphere developed into a crusade.His deep suspicion of medical men and taste for administrative solutions help to explaina focus on sanitation. Chapters 4 to 6 begin to trace the evolution of a particular formof ‘public health’ against the backdrop of a re-reading of the Public Health Report.This was not a blueprint for infrastructural reform, but “a licence to reorder society”(p. 157). The ground was not uncontested. Many of the ‘local reports’ which providedevidence on public health adopted a socio-medical rather than a socio-political view ofdisease and its treatment. However, selective presentation of the evidence and theinability of critics to conceive wide-ranging alternative solutions to social problems inthe 1840s left a central role for sanitation as a response to disease. Hence, “within adecade, public health was something quite different from what it had been in the midthirties” (p. 216). Chapters 7 to 9 elaborate a relatively familiar story of the im-plementation of this new vision of public health. The key task for Chadwick was toconvince local elites to step onto untried ground in the spheres of substantial investmentin the urban environment and reform of local government. By appealing to the needfor order, by exploiting the desire for profit/cost savings on the part of urban elites,and by playing on tensions inherent in local government, Chadwick and his alliesencouraged the key idea that localities ought to have a sense of public health. Thedifference between intention and reality in terms of physical changes in infrastructurecould be wide, but the key point is that the 1840s saw a sea change in beliefs.

Hamlin presents us with an attractive re-reading of the issue of public health innineteenth-century Britain. Of course, he cannot avoid overlap with other commentatorson Chadwick and on public health provision, but the real strength of this book lies inthe presentation and elaboration of alternative public health worlds. This is new andimportant, and the analysis is bolstered by an excellent listing of contemporary publichealth pamphlets which should be a compulsory reference point. Yet, there are alsoweaknesses. The ‘people’ are absent from this analysis, much as they were absent fromthe perceptions of Chadwick himself. The book would have been more balanced hadan analysis of contested public health policy fed seamlessly into a challenging depictionof alternative worlds of public health experience on the ground, however slight.Moreover, Hamlin’s explanatory model for the particular version of public health thatEngland adopted depends in part on the question of whether Chadwick himself, andother contemporary welfare commentators, really did believe that the principles of 1834were enforced and enforceable. Chadwick certainly did, and Hamlin accepts withoutquestion a version of poor law historiography which sees considerable change in welfarestructures after 1834. However, for those contemporaries and subsequent historianswho have seen the New Poor Law as a flawed compromise and an irrelevance, continuityrather than change was the order of the day. There were alternative visions of welfareas well as alternative visions of public health, and Hamlin’s argument would have beenstronger for a review and rebuttal of these alternatives. Finally, there are some placeswhere the evidence is stretched rather thin. We hear much about the motivations ofChadwick on the slimmest of evidence, and one example—“while we do not haverecords of deliberations on particular issues, it is pretty clear that Chadwick couldusually count on strong support” (p. 223)—illustrates a wider problem of the subtle

Page 3: Reviews: Public Health and Social Justice in the Age of Chadwick; Britain, 1800–1854

418 REVIEWS

merging of empirical reality and speculation. These issues notwithstanding, Hamlin’sattempt to show us a contested ‘public health’ is a useful corrective to long standinggeneralisations in areas such as historical demography and urban history. Read carefully(and it must be), this volume could suggest new ways of thinking about a whole rangeof historical problems and should be compulsory reading.

Oxford Brookes University S K

G H. J (Ed.), The Welsh Language Before the Industrial Revolution (Cardiff:University of Wales Press, 1997. Pp. xiv+455. £15.95 paperback)

Why is a new book on the social history of the Welsh language in pre-industrial timesof major interest to the international readership of the Journal of Historical Geography?For some this volume will be of intrinsic personal interest. Its 12 substantial chapterschart important themes in the history of their nation. In the present context it issignificant for us to remember that the Welsh words ‘yr iaith’, meaning today ‘thelanguage’, in the past also meant ‘the nation’. The two were, and some might arguetoday are still, intertwined, inextricably. But for the great majority of readers theparticular significance of this volume will be the innovative ways in which a large rangeof diverse sources have been marshalled, painstakingly and masterfully, to provide uswith a series of detailed studies in the social history of a particular speech communityin pre-industrial times—long before official population censuses had begun to collectinformation on the language or languages spoken by the ordinary people (first collectedin Ireland in 1851, in Scotland in 1881, and in Wales not until 1891). So, The WelshLanguage Before the Industrial Revolution provides us with a series of excellent casestudies and examples of data recognition and exploitation; plus, of course, the essentialscholarly analysis and context for understanding the changing social life of a smallnation and the ways in which its distinctive cultural identity has been maintained. The12 chapters deal with a series of major themes which span the period from the Acts ofUnion with England (1536–43) to the early decades of the Industrial Revolution (looselydefined but clearly assumed by the contributing authors to be some time between thelate 1780s and the early 1800s). Estimates give Wales a residential population of 225 826in 1545/63 (soon after the Acts of Union), rising to 341 674 by 1670. In 1801, whenthe first population census was taken, the country’s population had reached 601 767.

The 12 substantial chapters have been contributed by a team of 10 establishedscholars—social historians and litterateurs—following an interdisciplinary framework,drawing, often, on approaches that are relatively new. In addition to published workin historical geography, new interpretative strands, drawing on findings in sociolinguisticsand geolinguistics, are much in evidence. Thus, after charting the territorial relationshipsbetween Welsh and English, and regional changes, the specific ‘domains’ of social andcultural life in which one or other of the two languages was dominant are explored.Amongst many other important considerations, the significance of England as a cultureexperience for Welsh people receives cogent attention. For the 2000 or more studentsfrom Wales at Oxford between 1540 and 1640, and the 700 or so at London’s Inns ofCourt, the experience of living in England engendered an important common sense ofWelshness which was effective in breaking down “the very real regional barriers”, andregional particularisms, in ways that these students, working away from home in asecond language, might, at that time, never have experienced back in their homeland(p. 311). New interpretations elsewhere in this volume provide further fresh insights.In a chapter enriched by a lifetime of practical scholarship, Glanmor Williams commentson the significance of the translation of the Bible into Welsh. This, he explains,“. . . had given Wales a standard language of distinction, which like the poetic languageit replaced, was common to the whole country and intelligible to most of its people”