Late 19th century novels provide graphic descriptions of working and living conditions and their impact on population health, in particular the detrimental effects of hunger, poor housing, environmental conditions, hazardous work and poor pay, smoking and alcohol and crime, but also the transformative possibilities of social and political action. The popularity of these novels helped raise the collective conscience of citizens and illuminated the direction for 20th century welfare reforms. Yet many of these problems remain and the pathways to and from poverty are still recognisable today. Although novels are now less central in conveying social information, re-reading these novels enables us to understand how social and economic circumstances were understood at the time and what led to social and political change.