SOURCE: Hamlin, Christopher. “A Political Medicine.” In Public Health and Social Justice in the Age of Chadwick: Britain, 1800-1854, pp. 52-83. Cambridge: Cambridge University Press, 1998.

In the following essay, Hamlin provides the context for both Chadwick's Sanitary Report and for the issue of public health reform in general. Hamlin details the slow recognition of social factors that could lead to disease and the assumptions about class that had permitted unsanitary conditions to continue and flourish. At the point when Chadwick introduced his Report, Hamlin observes a tension between public health advocates who critique the fundamental systems of industrial society and those who felt that class differences, even at the level of health and happiness, were part of an unchangeable Providential plan.

The great social issues of the first half of the nineteenth century—hunger, public order, population, and conditions of work—were stated as issues of health. It...