Under the Public Health Act of 1848, any area could form a Local Board of Health by a process involving a local petition, an enquiry and the election of a local board. Local Boards had to appoint a surveyor and an inspector of nuisances, and were given powers to deal with sewers, drains, water supply, street-cleansing, nuisances, slaughter houses, lodging houses and cellar dwellings.
The population of the parish of Croydon in 1841 was 16,712, rising by 1851 to over 20,000. Although a board of Improvement Commissioners had been appointed in 1829, charged with lighting, watching and improving the Town of Croydon, by 1848 the population still had no piped water supply, drainage or sewerage. A questionnaire on the sanitary state of Croydon in 1848 described it as the worst of any district in the country, exclusive of the Metropolitan Districts. Hundreds of privies overhung the tributary streams of the river Wandle, using them as open sewers, and the towns two large ponds, Lauds and Scarbrook, served as cesspools. As late as 1861, the ponds were found to be choked with black, evil-smelling mud to a depth of five feet.
Early in 1849 two local reformers, Dr. Edward Westall and Cuthbert William Johnson, secured a petition signed by ratepayers to have the Public Health Act applied to Croydon. A preliminary commission of inquiry was held in March 1849, which noted the relatively high level of mortality in Croydon. One in seven people died in infancy, compared to one in eight for the rest of Surrey; average life expectancy was only 30 years and one month, compared to 36 for the rest of Surrey. The inquiry also took place in the midst of a cholera epidemic, which killed 53 people in Croydon in 1849.
As a result of the enquiry, it was resolved to create a local board by Provisional Order of the General Board of Health. The Order was published on 14 July 1849, and Croydon Local Board of Health came into being on 1 August, one of the first to be created under the 1848 Act. Twelve members were declared elected on 29 August, and the first meeting of the Board was held on 3 September. Its responsibilities included providing a pure water supply, drainage and sewers, collecting rates, town planning and building regulations, roads, street lighting, law and order and the fire service. In 1861 it was constituted a Burial Board, and opened the Queens Road Cemetery. In 1883 the Boards activities were taken over by the newly incorporated Borough of Croydon.