Health, Economy, State and Society in Modern Britain: The Long-Run Perspective

ritain was the first society in the world to industrialise, a process now considered to have taken the entire eighteenth century to achieve but also to have had longer-term, deeper tap roots in the country’s history and its agrarian economy. In evaluating the relationship between health and social change in British history the protracted process of industrialisation is clearly an event of the greatest importance. However, it was in the following century, 1815–1914, that social change became even more comprehensive, as the full consequences of the new economy’s mechanised and urbanised modes of production exerted their full effects. This chapter will offer a long-term perspective on the relationship between social change and health, considering key features of the period from the sixteenth to the twentieth centuries. In particular, the influence of certain institutional aspects of the relationship between state and society within this long time period will be explored. This survey departs from the premise, which has been argued at length elsewhere, that the processes of economic growth, especially the rapid and transformative phase which we term ‘industrialisation’, always entails profoundly divisive and disruptive forms of social and political change. Although economic advance creates the potential for enhanced wealth and health for all, the growth process itself offers no guarantee of this whatsoever. Indeed, economic growth is so disruptive of