Public health expenditures and mortality in England and Wales, 1870-1914

The secular decline of mortality is a subject which has attracted considerable scholarly attention yet important aspects of the disaggregation and measurement of its causes remain incomplete or unattempted. This article addresses one of the most notable omissions by making local taxation returns the basis of an account of the contribution of local authority sanitary reform programmes to the pattern and progress of mortality decline in Britain in the nineteenth century and afterwards. It is shown that the main growth in sanitary expenditure occurred right at the end of the nineteenth century. The sanitary infrastructure thereby established was a key element in the rapid decline in mortality, including infant mortality, in the early 1900s.