Rise of Public Health Institutions
The growth in scientific knowledge, the discovery of measures to control diseases, and the acceptance of public health as a social responsibility led to the establishment of public health authorities under the law. These institutions were meant to control the disease through functions such as sanitation, water supply, solid and liquid waste management, immunization, health and food safety regulation, and health education. The first landmark public health law, the Public Health Act of 1848 in Great Britain, marked the beginning of government commitment to public health. The Act provided for a General Board of Public Health at the national level, empowered to create local boards of health with authority to deal with water supply, sewerage, paving of streets, regulation of offensive trade and food quality, removal of garbage, and other sanitary matters. The local board could appoint a medical officer of health and other officers to deal with public health. Capital expenses by local boards were met by central loans and subsequently financed by local taxes.
A report in 1848 by John Griscom: The Sanitary Condition of the Laboring Population of New York led to the establishment of the first city public health agency in the United States, the New York City Health Department, in 1866. By the end of the eighteenth century 40 state and several city boards of health were established in the country. Some of the new boards made pioneering efforts to prevent the spread of the cholera epidemic, including inspection, prompt reporting of cases, investigation of complaints, evacuation, disinfection of possessions and residential quarters, etc. Cities without health boards to monitor and combat disease fared worse than those having such boards in the 1866 epidemic