ABSTRACT
The basis of ‘collectivism’ and the programmes of social welfarism which it gave rise to in the twentieth century is to be found in the condemnation of the social effects of rapid industrialisation and urbanisation which signalled the evolution of early industrial capitalism in the nineteenth century. The devastating effects on the health and welfare of the urban masses on which the new economic system depended are graphically illustrated here by an extract (Reading 1) from Engels’ critique of the factory system in England. Engels’ materialist analysis argues that the poor health and premature deaths of the English working class are caused by their conditions of life, conditions over which they have no control but which are determined by the demands of an economic system based on unrestrained exploitation and competition. It followed that if poor health was socially determined then society could improve health by improving the conditions of life of the population. The horrific conditions which Engels describes clearly provided an impetus for the public health movement of the late nineteenth century, although the extent to which such social (collective) intervention reflected a new-found benevolence on the part of the ruling class and state or served their economic self-interest, by securing a healthier workforce and armed force, is open to debate.
