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Sanitation is an essential public health service, so where is the outrage at the pollution of England’s waterways, ask these authors
Recently the dire state of the UK’s rivers was highlighted once again when rowers in the annual Oxford vs Cambridge boat race were taken unwell. They criticised the levels of sewage and high rates of e-coli in the river Thames.1 The organisers of the boat race declared “bathing is prohibited” and warned against throwing the cox into the water as is tradition.2
It had echoes of a visit that Queen Victoria made to Cambridge University back in 1843. Gwen Reverat, a local historian recounts:
“ There is a tale of Queen Victoria being shown over Trinity by the Master, Dr Whewell, and saying, as she looked down over the bridge: What are all those pieces of paper floating down the river? To which, with great presence of mind, he replied: Those, ma am, are notices that bathing is forbidden.’” 3
But maybe we need to cast our minds back to the t
The Public Health Act 1848 was a major landmark in the history of health in England and Wales.1 It is 175 years old on 31 August 2023. Testament to the vision of the act, life expectancy in England and Wales has nearly doubled between 1841 to 2011.2 The largest increases have been through improved drinking water and sanitation, better housing, and better nutrition.3 Life expectancy continued to improve through the first 65 years of the NHS and the welfare state. But austerity policies since 2010 have seen life expectancy stall and inequalities widen. The life expectancy of women in England and Wales has declined since 2010.45 Life expectancy worsened through the covid-19 pandemic, with inequalities in death rates widening, particularly for people from ethnic minorities and for men.6
Five years ago, The BMJ marked public health’s 170th birthday and asked for a big birthday present to go alongside the NHS’s 70th birthday investment.7 Since then we have had the covid-19 pandemic, Bre