Population Growth in Eighteenth Century England
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The eighteenth century saw a population explosion in England and Wales with the English populace growing from 5.05 million in 1701 to 8.7 million in 1801. The population level was reasonably inert in the first half of the century with only an increase to 5.77 million in 1751, the main population growth occurred from 1751 until the mid nineteenth century, by which point it had reached a staggering 16.8 million. There is debate by historians as to whether the growth in population over this period is due to the fall in the mortality rate or the rise in fertility rates. While it is certainly true that both did take place there are factors to be considered as to why they occurred. Immigration and emigration would also normally be considered with fertility and mortality rates in population growth but as they virtually cancelled each other out (with only a 2% increase in the population through migration) they can be disregarded in the debate as to the main cause of population growth.
Life expectancy at birth in the mid eighteenth century was only 36 or 37 while one hundred years later it had risen by 3 or 4 years to 40. This obviously meant that there were fewer deaths each year, it is in fact documented by the Cambridge Group for the history of population and social structure that the crude death rate (not including infant mortality) in England dropped from 26 deaths per 1000 of population by 4 people per 1000 to 22 per 1000 people, this equates to 143,000 fewer people dying per year by 1851.
The reasons for the fall in mortality rates and rise in life expectancy have been debated with a few ideas put forward. Advances in medical knowledge led to the first voluntary hospital opening in 1720 with a total of 33 operating by the end of the century, dispensaries offering free medicine and the humanitarian interest in physiology also increased. Unfortunately for those with infectious diseases, terminal illness or those claiming poor relief voluntary hospitals running on charity refused to admit them, leading to a very limited patient intake, most likely close to a third of the population were refused admission solely because they accepted poor relief. Even those who were admitted to a voluntary hospital had only a slim chance of being cured or even leaving the hospital alive. Doctors had no antiseptic or anaesthetic, making surgery highly painful and often extremely dangerous for any class of person, in addition there was very little known about disease, nothing was known about the germ theory of disease, and there were no known cures for many epidemics of the time such as measles and cholera. The only exception to the problem of curing disease was smallpox, which could be inoculated against thanks to the realisation of Edward Jenner in the 1750s that those who had contracted cowpox earlier in life were immune to smallpox. This major accomplishment reduced deaths from smallpox from 16% in the 1750s to only 1% of deaths a century later when the vaccine had become more widely available. Unfortunately the medicine of the time was hugely unreliable and, other than the smallpox vaccine, is unlikely to have been a much of a factor in the fall in mortality.
It has been suggested that improvements in personal and public hygiene could have been a factor in the fall in mortality rates but with the majority of people living in overcrowded accommodation with their houses almost on top of each other and being subjected to soot and smoke from industrial works daily it can hardly be said that they lived in an atmosphere conducive to healthy living. Unfortunately for these same people there was no public health act until 1848, and this, when it came about, mainly dealt with the seriously inadequate sewer and drainage systems that most areas had at this time. Personal cleanliness has never historically been a huge consideration for the common people and while soap and lighter clothing that was easier to wash became widely available it was often costly and out of the economic means of the lower classes to whom a rise in living standards would do the most good. Soap consumption did rise in the eighteenth century but most of it was sold to industry and there never be any way of knowing how often people washed either themselves or their clothing. So whilst personal hygiene may have been a factor in a healthier lifestyle and a fall in mortality rates there is no conclusive proof of this fact.
At this time a greater variety of food became available and while better nutrition would improve the health and immunity of the population there is again no conclusive proof that the poorer classes were able to afford such goods, had access to them or that they thought it expedient to spend their hard earned income on them, in fact although there were greater supplies of milk this would not automatically lead to greater nutrition for mothers or the babies that they fed as pasteurisation did