The Poor Law dominated the way people of lesser means, the sick, the mentally ill and the disabled were treated in England from 1601 onwards. Public health measures were implemented at a local level during the 18th century, with people being cared for in establishments based on their parish of residency and public health institutions operating through local government. From the late 18th century, industrialisation led to increased urbanisation and huge societal and economic changes. The costs of administering assistance though the Poor Law had started to increase significantly throughout the 19th century and the New Poor Law, introduced from 1834, was intended to reduce reliance on assistance and led to the rise of the workhouse. The Poor Law Amendment Act 1834 made entering the workhouse a condition of receiving assistance for able-bodied people. The workhouses were deliberately designed to be feared by the population. Unsanitary conditions prevailed, and diseases festered and multiplied. One of the architects of the 1834 Poor Law, Edwin Chadwick, later went on to be a leading campaigner for the reform of sanitary conditions. His 1842 Report on the Sanitary Condition of the Labouring Population of Great Britain would become influential in the development of public health. He argued that improving the health of the poor would help to limit the number of people seeking assistance though the Poor Law due to ill health.
In parallel, great strides were made during this period with regards to innovation in vaccination, with the introduction of vaccination programmes to stem diseases such as small pox. In 1796, Edward Jenner demonstrated that vaccinations to prevent disease were effective, and by 1841 vaccinations were available free of charge outside of Poor Law relief. The achievements of this period were not without opposition from anti-vaccination movements and those who felt that inoculations and public health measures were interferences by the state designed to oppress civil liberties.