The Cambridge Economic History of Modern Britain

INTRODUCTION

The years between 1870 and 2010 witnessed dramatic changes in the health of the British population and the organisation of welfare provision. At the start of this period, the average life expectancy of a newborn boy was 39.4 years and that of a newborn girl was 42.4 years, but by 2009 these figures had risen to 78.36 and 82.49 years respectively (www.mortality.org/hmd/gbrtenw/stats/E0per.txt). In 1890, public expenditure on the social services of health, education, housing and social security amounted to less than 2 % of the country's Gross Domestic Product, whereas 120 years later this figure was equivalent to more than 30 % (Harris 2009: 92; HM Treasury 2011: 62, 200). The fact that these developments have occurred in tandem raises some tantalising questions about the relationship between them.

The first section of this chapter considers these questions by examining the main changes in different health indicators since the 1870s. Section 2 examines the main proximate causes of changes in health standards and section 3 looks at some of the major developments in welfare provision. The final section explores the role which state provision in particular has played in helping to raise health standards.

HEALTH, HEIGHT AND MORTALITY

Historians have often used mortality rates to measure the health of populations, but this method suffers from two significant limitations. In the first place, it is at best an indirect method of measuring health because it does so by measuring something which is assumed to be its opposite (Oddy 1982: 121). Moreover, as the World Health Organisation (1978) has argued, health ‘is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity’. During the last three decades, economic and social historians have attempted to overcome this problem by using height, and to a lesser extent weight, to examine the extent to which the ‘human organism’ can be said to thrive in either childhood or adulthood (Steckel 2009). They have also used other types of health record, including sickness insurance statistics, to measure different aspects of positive health and non-fatal illness.