Poverty and painting: representations in 19th century Europe.

The social gradient in health is familiar to many readers of scientific journals as a diagonal line on a graph showing the almost universal and often linear relation between people’s social and economic circumstances and their health. The pathways to and from poverty and poverty’s impact on health, however, have also vividly been represented in paintings, particularly in 19th century Europe. These paintings let us see what was considered important by the artist and by the wider society. Aspects of poverty that are directly or indirectly related to health were also painted frequently in the 19th century, which suggests that references to the health effects of poverty in these paintings were important in raising and reinforcing concerns about poverty. To early 21st century spectators, these paintings are visual reminders of the values that helped to create the modern welfare state. In the 19th century the images in paintings had wide circulation, as they were often copied by engravers and reproduced in popular magazines such as Graphic and the Illustrated London News. The 1900 Paris Exposition Universelle attracted more than 50 million visitors in five months and had two palaces of contemporary art, where well heeled visitors were forced to confront the plight and potential power of the urban poor in paintings such as Jules Adler’s The Weary. This is an example of the work of artists who, with homage to Victor Hugo, were occasionally dubbed “Miserabilistes.” Today, visiting galleries remains a popular leisure activity and a common school outing. The visual arts help to tell and re-tell important national stories and not only form a “collective memory” that helps people to define themselves in relation to others but may also illustrate what Emile Durkheim called the “collective or common conscience.” We have developed a classification for the iconography of poverty, including the health effects of poverty, as represented in 19th century European paintings. We have identified six main categories of images: sin and charity; poor housing, evictions, and homelessness; working conditions; hunger, crime, and lifestyle risks; disease and death; and revolution and visionary societies. We illustrate this classification with examples, without any pretension to completeness (see appendix on bmj.com).