The first Public Health Act (1848) was a turning point in modern history for a variety of reasons. Edwin Chadwick successfully made the case that a modern society required a number of “basic” amenities such as housing, clean water and sewage systems. Without these, the toll on human life and thus productivity in an increasingly Industrial Age was dramatic. Looking back this does not seem a radical notion. As more people lived in that industrial society, hallmarked by more to living “cheek by jowl”, more we’re exposed to the negative effects of that change. Snow showed that many people could be contaminated by just a few “dirty” water supplies. The immediate remedy was simple, remove the pump handle, people couldn’t access the water and develop cholera. We know now that the benefits of industrialisation also have negative effects. Pollution due to burning fossil fuels for energy has caused untold health effects. Whilst the most obvious is the most visible, the post-war “smogs”, we now know that there are other, more subtle effects which are causing major health problems, akin to that seen in Chadwick’s time. Like clean water, we should be exposed to clean air to reduce the terrible toll on the health of our society but also it’s productivity. If John Snow were alive, he would point to the obvious short term solution: stop exposure. But it is not so simple and will require a major shift in our behaviour, our values, and our thinking. Perhaps the rapid shift to a post-industrial age, the technological age, will deliver this shift. But we need it now to reduce the generational impact of air pollution.

1. Air Quality – a Right
or a Choice?
Adrian Phillips
Director of Public Health
Birmingham City Council
24th October 2017

2. • Poor Air Quality affects our society
• It is a side-effect of industrialisation
• Other major societal hazards have been
successfully addressed
• Improving Air Quality has not been
meaningfully addressed by many
Governments
• Poor Air Quality is another manifestation of
economic disadvantage
• Good Air Quality is neither a “universal
right” nor a “choice for all”
Summary

10. • Maslow
➢Physiological Need (Air, Water, Food,
Shelter)
• 1st Public Health Act (To improve
productivity)
➢• improved drainage and provision of sewers
➢• the removal of all refuse from houses,
streets and roads
➢• the provision of clean drinking water
• Water quality
• “it surely the duty of a wise council to surround the
humbler classes of the population with its benevolent
and protective care”- Thos Avery
Remember some history..

11. Principles
• It was about universal “rights”
• It was not about for some or by choice
• It started from a “business” perspective first,
to maximise the opportunities of
industrialisation
• It was about doing the “simple” big things..

15. A Recap
• Air pollution is now related to burning fossil
fuels, from industrialisation
• It is the second biggest cause of preventable
death (after tobacco)
• The economic effects are £1 Billion in
Birmingham or 4% of GDP (mainly health
effects)
• Successive Governments do not see it as a
universal right

16. Choice
• Air pollution is greatest next to vehicle
movement or industrial processes (or both)
• Land next to roads, railways etc. is cheap
• People with little economic “power” have little
choice where they can live
• Poor air quality is another manifestation of
low income and not choice

18. • Poor Air Quality affects our society
• It is a side-effect of industrialisation
• Other major societal hazards have been
successfully addressed
• Improving Air Quality has not been
meaningfully addressed by many
Governments
• Poor Air Quality is another manifestation of
economic disadvantage
• Good Air Quality is neither a “universal
right” nor a “choice for all”
Summary

19. 0121 303 2360
Adrian Phillips
Public Health
adrian.x.phillips@birmingham.gov.uk