Change and continuity in public health

"Public health improved more between 1750 and 1900 than in any other period." Using the concepts of change and continuity, how far do you agree? [12 marks]

Mark scheme (levels-based, AO2):

L3 (9–12): Sustained argument using both concepts. Change 1750–1900: professional medical officers; germ theory; sewage infrastructure; Public Health Acts; cholera drove action; life expectancy began to rise. Continuity: poverty still linked to poor health; miasma theory persisted until 1860s; 1848 Act initially voluntary and ignored. Comparison with other periods: medieval Black Death caused lasting change too; 20th century (NHS 1948, antibiotics, vaccines) arguably produced more measurable improvement in life expectancy. Strong answer gives explicit criteria for "most improvement" (life expectancy? legislation? understanding?) and argues which period best fits those criteria.