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I can identify
five essential ingredients of the processes that brought about the
public health reforms we call the Sanitary Revolution of the late 19th and
early 20th century. Indeed these five features are essential for the control
of all public health problems.
1. Awareness that the problem exists. John Graunt began this
process with the Natural and Political Observations. Others
consolidated his conceptual breakthrough, and it was applied to great effect
after the establishment of formal national vital statistics in England and
Wales under the inspired leadership of William Farr. By Farr’s time,
widespread literacy, the proliferation of daily newspapers and word of mouth
helped to enhance awareness among thoughtful people everywhere that there
were massive public health problems of society at that time.
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