Syllabus Edition
First teaching 2024
First exams 2026
Prevention of Disease in Modern Britain (Edexcel GCSE History)
Revision Note
Written by: Zoe Wade
Reviewed by: Bridgette Barrett
Modern Approaches to the Prevention of Disease - Timeline & Summary
The governments of the 20th and 21st centuries take a more active role in preventing disease. The science explaining why people became ill was much clearer and widely available. The public could no longer accept a laissez-faire government. The government took action in many ways. The success of the smallpox vaccination led to more compulsory vaccination programmes in the 20th century. Vaccinations mean that it is rare to catch diseases like diphtheria and tetanus in Britain today. The government also passed laws to build upon the progress made by the 1875 Public Health Act. Scientific studies linked the amount of air pollution to poor health. This led to laws targeting poor air quality. The dangers of second-hand smoke prompted the government to pass anti-smoking laws in 2006. The government recognised that lifestyle could impact people's health. This encouraged the government to promote better eating and exercise habits. These healthy living campaigns like Change4Life provided people with advice about maintaining good health. Despite the progress made in the 21st century, not all diseases are preventable. The science of genetics helps scientists understand hereditary diseases. The methods to prevent these from passing to future generations are not fully developed. Some people resent the role the government takes in public health. There is a sharp rise in parents not vaccinating their children. Without herd immunity, there are more cases of childhood diseases like measles. The effectiveness of healthy living campaigns is uncertain. The increase in obesity in Britain would suggest they have limited effect. |
End of Laissez-Faire Attitudes
There are two main reasons why the government dropped their laissez-faire attitudes in the 20th century:
They understood what caused disease
There were more methods to prevent disease
Better Understanding of the Causes of Disease
The acceptance of Germ Theory over miasma in the late 19th century meant the government understood what caused diseases to occur
With this knowledge, the government knew their actions could have an impact on the health of the nation
More Methods of Prevention
Compulsory vaccination
The 20th century saw the implementation of more vaccination programmes. These included:
Whooping cough (1950)
Tetanus (1961)
Measles (1968)
Rubella (1970)
Public Health laws
The government aimed to improve air quality to reduce the number of citizens suffering from lung diseases
The addition of fluoride to some parts of the nation's water supply. This aimed to prevent tooth decay
Better communication about health risks
Healthy living campaigns ensured the public knew the risks of unhealthy habits
These encouraged people to improve their lifestyles
Charities like the British Heart Foundation supported the government in their campaigns
During pandemics like COVID-19 (2020-2022) and epidemics such as Ebola (2014-2015), the government enforced quarantine and travel restrictions to slow the spread of the diseases
The government communicated the causes of the diseases
They also publicised information about the preventative actions people should take
New Approaches to Prevention: Mass Vaccinations
Inspired by the success of the smallpox vaccination programme, the government decided to target other diseases through vaccination
They focused on diseases which caused serious illness or death in children. Vaccines tend to be more effective on children
Diphtheria (1942)
3000 children died each year from the disease
The government feared that cramped air-raid shelters in the Second World War would spread diphtheria among children
The national vaccination campaign led to the categorisation of diphtheria as a disease of the past by the mid-20th Century
Polio (1962)
In the early 1950s, there were 8000 cases in Britain each year
The last case of polio in Britain was in 1984. This shows how successful the vaccination programme was in Britain
HPV (2008)
This shows the development of vaccines against diseases which can transform into multiple illnesses
A report in 2021 stated that the HPV vaccine had resulted in an 87% reduction in cervical cancer cases
Some people choose to not vaccinate their children. This is because:
They are angry that the government is interfering in their life
They do not trust medical professionals
They believe that vaccines are unsafe
Examiner Tips and Tricks
The most famous example of people considering vaccination unsafe is the measles, mumps and rubella (MMR) vaccine. In the 1990s, a study suggested that the MMR vaccine created an increased risk of autism and bowel disease. Various studies have since disproved these findings but many parents continue to believe the vaccine is unsafe. Parents have the right not to vaccinate their children. However, scientists believe vaccination creates herd immunity which lowers the number of cases of a disease in the general population. A decrease in the percentage of children receiving the MMR vaccine since the 1990s has led to an increase in measles and mumps cases across Britain.
The Medicine in Britain exam goes from c1250 to the present. As a result, you can use this example in an answer.
New Approaches to Prevention: Government Legislation
Governments of the 20th and 21st centuries have used their legal powers to improve the health of the nation
The Clean Air Acts of 1956 and 1968
London experienced bad periods of smog in 1952
Smog is a mixture of fog and smoke created by air pollution
Large cities like London relied upon coal for heating and running factories
The smoke from burning coal produced excessive pollution in the air
The poor quality of air triggered an increase in respiratory diseases
Bronchitis killed between 800,000 and 1.4 million people from 1840-1900
The Clean Air Acts of 1956 and 1968 aimed to improve air quality
The law allowed local authorities to create 'smokeless zones'
Payments to households who swapped using coal for gas or electricity (which did not create smoke when burnt) helped them convert their houses
Whilst air quality improved, there are still issues with pollution today
The government continue to limit car emissions
In 2003, a congestion charge was introduced for central London
In 2019, London Mayor Sadiq Khan introduced ULEZ (Ultra Low Emission Zone) which increased the charges for older, higher polluting vehicles
In 2020, a nine-year-old girl called Ella Adoo-Kissi-Debrah was the first person to have air pollution listed as her cause of death. Ella was exposed to "excessive" levels of pollution living in Lewisham, South-East London
Anti-Smoking Laws
The Health Act of 2006 established new restrictions on smoking. People were no longer allowed to smoke in:
All enclosed workspaces
On public and work transport
In pubs, clubs, cafes and restaurants
In shopping centres and hotels
A study found that between 1996 and 2007, children's exposure to second-hand smoke declined by almost 70%
Worked Example
Explain one way in which the government's role in the prevention of illness in the years c1250-c1500 was different to the government's role in the prevention of illness in the years 1900-2023
4 marks
Answers:
One way in which the government's role in the prevention of illness was different from the Medieval period to the 20th and 21st centuries was the use of their legal powers (1). In the Medieval period, the government did not introduce any laws to improve public health (1). They did not attempt to prevent the spread of the Black Death in 1348 (1). However, by the 20th century, the government took responsibility for preventing diseases. In 1956 and 1968, they released the Clean Air Acts which aimed to reduce respiratory diseases in large cities (1).
Examiner Tips and Tricks
In this style of question, you must either identify a similarity or a difference between the two time periods. To answer this question well, make sure that you:
Identify a clear similarity or difference
Give a clear example from both time periods
Use words like 'similarly' or 'whereas' to compare the two time periods
New Approaches to Prevention: Government Lifestyle Campaigns
There was a larger emphasis in the 21st century on the public attempting to prevent some diseases themselves
The science that linked lifestyle to illness was much more detailed in the 21st century
The demand for the NHS increased to unmanageable levels
There was a need to reduce the amount of people suffering from preventable diseases
The government introduced healthy living campaigns. These campaigns aimed to educate the public about the health implications of certain habits. Examples of these are:
Adverts warning about the dangers of smoking, binge drinking and unprotected sex
National events, such as Stoptober, which encourage people to give up smoking
Campaigns which promoted healthy eating and regular exercise. The government introduced Change4Life in 2015
Developments in technology helped these campaigns spread across the nation
Most households have TV and radio
The government used these modes of communication to show their healthy living adverts to the nation
A government website dedicated to public health
Initially, this was Public Health England
It is now the Office for Health Improvement and Disparities and the UK Health Security Agency
Change4Life has a SugarSmart app which helps busy families determine the amount of sugar in everyday items
Worked Example
Describe one feature of the government's healthy living campaigns of the 21st century
2 marks
Answers:
The healthy living campaigns use modern technology to help spread the word (1). For example, Change4Life has its own SugarSmart app which helps busy families determine how much sugar is in everyday items (1).
Examiner Tips and Tricks
This question previously asked students to describe two features of a given event. This question was out of four marks. However, as of 2025, Edexcel will split this question into two subsections, asking you to describe a feature of two different events. Each subsection is worth two marks.
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