In 1824 Smith was appointed physician to the London Fever Hospital.8 The following year he began to write papers on public health. His post gave him the opportunity to study diseases of poverty. In the late 1830s, with Neil Arnott and James Phillips Kay, he was one of the first doctors brought in to report to the Poor Law Commission. In 1842 he was one of the founders of an early housing association, the Metropolitan Association for Improving the Dwellings of the Industrious Classes.