Rapid economic growth and ‘the four Ds’ of disruption, deprivation, disease and death: public health lessons from nineteenth‐century Britain for twenty‐first‐century China?

Rapid economic growth has always entailed serious disruption: environmental, ideological, and political. As a result the relationship between economic growth and public health is complex since such disruption always threatens to spill over into deprivation, disease and death. The populations of most current high-income, high-life expectancy countries of 'the West' endured several decades of severely compromised health when they first experienced industrialization in the last century Although health technologies have moved on, the social, administrative and political disruption accompanying economic growth can still impede the delivery of health improvements. The case history of 19th-century laissez-faire Britain is explored in some detail to demonstrate the importance of these social and political forces, particularly the relative vigour and participatory nature of local government, linking to recent work on the importance of social capital in development. For a country like China today, paradoxically, there is nothing that needs such careful planning as a 'free market' economy.