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LIFE, LIBERTY, THE
AND
PURSUIT
OF BREAD
LIFE, LIBERTY, A N D THE PURSUIT OF BREAD By CARLISLE and CAROL SHAFER
New York : Morningside Heights COLUMBIA
UNIVERSITY 1940
PRESS
COPYRIGHT
1940
COLUMBIA U N I V E R S I T Y PRESS, N E W Y O R K Foreign agents: OXFORD UNIVERSITY PRESS, Humphrey Milford, Amen House, London, E.C. 4, England, AND B. J . Building, Nicol Road, Bombay, India; MARUZEN COMPANY, I.TD, 6 Nihonbashi, Tori-Nichome, Tokyo, Japan M A N U F A C T U R E D IN T H E UNITED STATES OF AMERICA
PREFACE Twenty million Americans are dependent. They are, for the most part, the unemployed, the insufficiently paid, the destitute aged, the fatherless children, and the poor in health. The problem of dependency is stark, overwhelming. But the people of the United States can solve it. They can because unlike most of the peoples of Europe they are free to find a sane and logical solution. In America there is still life and liberty. So long as liberty remains, and our citizens have the opportunity to think, we can obtain for all our people that bread which is the prerequisite of happiness. The following letters, the combined product of a social worker in the field and a teacher of the social sciences, see dependent men and women in the concrete personal as well as in the abstract general. They are offered with the hope that they will give to citizens some of the information and knowledge that is necessary for intelligent social thought and action. The letters do not pretend to cover all social problems, nor do they exhaust the topics they treat. They simply attempt to discuss those hazards which most often lead to dependency and to suggest some possible ways either to eliminate these hazards or to alleviate the distress they bring. Professor John Fitch of the New York School of Social Work read the manuscript and gave expert criticism and encouraging advice. CARLISLE
SHAFER
CAROL SHAFER MENOMONIE, WISCONSIN
November 30, 1 9 3 9
CONTENTS Unemployment
i
In Pursuit of Jobs Low Incomes In Pursuit of Higher
27 Wages
Old Age
59
In Pursuit of Security in Old Age Fatherless Homes
90
In Pursuit of Security for
Children
Health In Pursuit of Good
123 Health
Social Work In Pursuit of independence pendent
152 for Those Who Are De-
Bibliography
183
Index
197
TABLES 1 . Indices of Pay Rolls in All Manufacturing Industries
40
2. Average Income and Expenditures of Wage Earners and Low-salaried Groups in Various Cities 3. Income and Medical Care
44 45
4. A : Percentage of Older Workers among All Workers Declaring Themselves Gainfully Employed B: Percentage of Old People Who Were Employed 5. Social Insurance Benefits
72 84
6. Status of Female Heads of Families in 1930
105
7. Survivors' Benefits
121
8. Number of Handicapped Individuals in 1937
135
9. Illness and Disability in Various Age Groups
137
10. Distribution of Sickness Costs
143
UNEMPLOYMENT
AT T H E P U B L I C W E L F A R E SOUTHTOWN,
DEAR
OFFICE
WISCONSIN
CARLISLE:
This afternoon the relief office has been packed with people. I thought the doors would never cease banging. Bang! Strained, hurt, angry, tired faces came in and asked for help. Bang! Strained, tired faces went out, some less anxious, some less stunned, none bright with hope. Surely this cannot go on forever! There must be some way to change dependence to independence. The founding fathers made a great declaration of independence once in order to preserve for themselves life, liberty, and the pursuit of happiness. Today life with liberty is more an object of faith than experience, and the pursuit of happiness has become first of all the pursuit of bread. Right now I am especially puzzled by the continuous inflow of the unemployed. At times this welfare office looks as it did in 1 9 3 3 and 1 9 3 4 when there were lines of jobless. I cannot understand why people are still without work when economic conditions are supposed to be better. I wish I could see you soon to discuss all this with you. T h e job of case work supervisor may be provocative, but it can also become quite overwhelming. Couldn't the trustees of your college be persuaded to move the school to the southern part of the state so we would be closer? Of course we can thresh out some problems by mail, and that is what I am starting this very moment. Long-range dis-
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cussion may even have advantages. The questions will be neat, calm sentences unmodified by gestures or tone of voice. There will be no rude interruptions for definitions or for the elaboration of a point already weak. I shall be able at no stage in the argument to suggest a cup of coffee or welcome an unexpected guest (however propitious the move might be for m e ) . Alas, there will be no obstacle; we shall miraculously stick to the subject. And the subject of this letter is, who are unemployed, why are they unemployed, and how can we put them back to work. The more I think about the unemployment situation the more discouraged I become. Must there always be men and women, willing and able to work, in need of relief? Late this afternoon a tall, lanky man came into our office and marched up to Miss Jones, who was at the intake desk receiving applications. He looked her straight in the eye and began talking at once. "Lady, my name is Joe Smith. I've never set foot in this or no other relief office before. When all the other guys was hollerin' for help in bad times I took care of myself and the family. Now I'm in the same boat they was. Bad times has struck me too. It'll be ten months come Monday since I've put my hands to a regular job. Every damn day I been poundin' the streets lookin' for work. You see I'm a molder, used to work at the Johnson plant. Well, lady, when I tried to get on at the plant today and they turned me down, I says to myself, 'Joe, looks like the end of your rope. Nothin' left for you but to eat dirt and charity.' And I kept right on walkin' out from that there factory gate till I come to this place. By God, I always managed before, but since they changed from hand to machine moldin' I ain't had nothin' in my line. I won't take no handout—I want work. The kids gotta eat. "Perhaps if I went over to Centerville (I hear things are openin' up there) I might find somethin'. But it's too blame far to move without any dough and not bein' sure of keepin' the
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job when you get there. Can you get me a job? Or am I goin' to get the run-around from you, too?" Well, Mr. Social Scientist, brain-truster, what can be done about Joe and others like him? W e can not sit still and expect to find ourselves someday in a Utopia in which everyone will be working at a job that he likes and for which he has been trained. I don't know what direction we are drifting, but it certainly is not toward that economic paradise. How caji it be, as long as we have depressions and as long as new machines continually cause some men to lose their livelihood? Should we go back to Erewhon and put all our machines in museums and revert to the simple pastoral life? (I was ready for that this morning when the Plymouth wouldn't start!) You said once that many economists assert that technological changes do not cause permanent unemployment. Won't new machines always throw someone out? Even if we were in that most prosperous state of affairs where people had enough money to buy all that was produced, it seems to me that technological improvements would still make men jobless. Maybe the whole question is too involved for me; or am I just "too too feminine" to get economic reasoning? N o w this man, Joe Smith. He is forty years old and, as he put it, " I got a woman and three kids, some busted-up furniture, a 1 9 3 3 Tin Lizzie, and 500 bucks of debt." Mrs. Smith has been ill, and the oldest son had an appendectomy this year. According to the report from the foundry Mr. Smith was discharged a year ago when some new process in molding was installed. He had been with the company for six years, earning about $ 1 0 0 to $ 1 5 0 a month during the time the plant was in operation, which was about eight to ten months a year. Since he was laid off he has driven a truck, worked in a garage, and picked up a few odd jobs, but has found nothing in his line as a molder. What hope is there for Joe? He is a skilled though not an
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expert workman, a molder who knows no other trade. He had some experience on the farm as a youth, and has had a primaryschool education. As he says, "There just ain't no jobs for the like of me." I wish I knew how many men are in the same situation as Joe. What are the latest figures on the number of unemployed? I wonder, too, what chance Joe has at forty of finding another job which will be more than a makeshift. Is it too late for him to develop a new skill? Relief is no remedy; Joe needs work. The social worker can give him advice and financial aid and may even certify him to a public works project, but none of these will make a job grow where there is none. Just what is the trouble, anyhow? T h e upturn in financial conditions which began in 1 9 3 3 did not seem to produce more jobs automatically. And the drop in 1 9 3 7 and 1 9 3 8 caused many who did find work to return to the list of unemployed. T h e business indexes say that business is picking up again, but there seem to be just as many out of work. America has the resources as well as the need for greater production, but it certainly lacks "that something" which will synchronize an unemployed molder with a new job. According to my college economics this condition was never supposed to occur except temporarily. Those vague "laws of supply and demand" which were so satisfying except when applied to a particular case were supposed to bring men and jobs together automatically. Of course, I know we now have unemployment insurance, but the $98 Joe had coming didn't keep his family long. I can hear you say, "Perhaps you can find a place for Joe on W P A or other government jobs. They are for able-bodied men who want work." Well, W P A is being curtailed. There are no more jobs; our quota was filled in this district long ago, and men are now being dismissed. In any case a W P A job is a makeshift, it pays barely enough to keep a man alive, and no one regards it as a real job. I do not understand it. Who is to blame? Should we blame
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Joe for choosing a skill that industry does not want any more? Is he at fault because he did not foresee and prepare himself for this change? Hardly. Is the government at fault for not providing a place for Joe in the public works program? As it is, most of the government projects around here provide only construction jobs. Not all construction jobs are constructive ones, either. Should Joe get work his skill as a molder would be useless to him and would be wasted. If I were out of work and the government offered me a chance to wash dishes eight hours a day I should do it because I prefer work, almost any kind, to idleness or to relief. But what would happen to my ability as a case worker? Even if I endeavored to perfect rainbow-tinted soapsuds and ever more sterilizing rinses, I'm afraid most of the incentive I now have to work would go down the drain. It seems to me that industry itself is to blame when it cannot furnish continuous work for its men. Yet one could hardly expect industry to have a social conscience about such matters. Even if it did, present industry cannot act according to any organized plan. I might pass the buck to the vast abstract economic system which does not furnish work for everyone. But to do that would make me feel about as futile as if I had thrown a stone at the Atlantic Ocean. The social worker can give Joe relief to tide him over or to supplement the insufficient wages he may earn at part-time jobs. W e can help him keep his family alive and give him a certain sense of security (slightly false, to be sure). But this does not solve the problem. Does not the relief department become a garbage disposal plant for industry, taking what it casts off, taking material which might be developed into byproducts or used by industry as steam for greater production? Social workers, who see healthy men spoil like refuse when they are unemployed, have always fought for work, even "made work," rather than relief. W e just can not see men and
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willingness and ambition with no place to function. If business itself cannot provide work for all, I suppose the government is the only logical agent to see that this is done. I know that in theory the government can do anything. But in practice what can it do? W h a t should it do? W e l l , dear, I've worked myself into quite a muddle. I have many ideas and some facts. Yet I cannot put them together and construct a logical plan which will put the millions of jobless to work. I must go home now, as it is late. T h e doors have ceased banging long ago. My room is growing cold and the whole building is dark and deserted. The air is clogged with smells—the strong odor of damp shoes and of clothes worn by third- and fourth-degree owners, a hint of naphtha soap, a reek of stale tobacco, faint whiffs of far-away kitchens wherein is boiled much cabbagc, and over all the general stagnant smell of an old rotting low-rent building. Nightly the janitor tries to dispel this odor with Lysol in his mop water, but he only makes the air more stifling. T h e relief we give to the unemployed is about as effective as the Lysol; in fact, it is not even as good a disinfectant, for it never seems to kill the germs that cause poverty. And yet I can isolate one of those germs. It is unemployment. What is its cure? So many families are poor just because their breadwinners are jobless There is Pedro Martinez who is too old, and young cousin T o m who never has been able to find a place because he lacks experience. There is Erik Johnson who never has work for more than the three months during which the sugar-beet factory operates. And there are a thousand more in our district alone. I am really stopping now. I send you my love, which is more than all the unemployed in the world times my hours of loneliness when I am not with you. Your full-of-duty wife, CAROL
UNEMPLOYMENT STATE LAKEVIEW, DEAR
7
COLLEGE WISCONSIN
CAROL:
The "Case of Joe Smith," the unemployed molder, arrived just as I was about to lecture to my Labor Problems class this morning. I am certainly disappointed that you cannot drive up for our usual week-end companionship and lively discussion. But in the United States we can still correspond without having our letters opened by a censor. We have at least the liberty to pursue life and bread, though we may not be swift enough to catch them. In spite of all your trouble and worry about Joe's case and others like his, I am afraid I agree with you that with our present economic system social workers cannot really help much. I, too, sometimes feel that relief only makes matters worse. The causes and remedies for unemployment lie deeply rooted in the economic system. Unless changes are made there you social workers only too often deprive one man of bread when you help another to obtain some. Life, liberty, and, yes, happiness are possible in America, but not until our economic machine clicks better than it has. Joe's problem is the problem of many million Americans, as you well know. I cannot give you the exact number of the unemployed. Reliable statistics on the extent of unemployment do not exist in the United States. Until the National Unemployment Census in the fall of 1 9 3 7 , the various administrations, Republican and Democratic alike, either were afraid of the political repercussions of such an enumeration or were oblivious to the need for one. In two of the recent decennial censuses statistics were collected, but a census made only once every ten years is of little value in the intervening periods. The last census year, 1930, for example, was relatively prosperous;
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compared to the depression years of 1 9 3 2 or 1938 there was little unemployment. For that matter, that part of the 1 9 3 0 census devoted to the question of unemployment was carelessly taken and is consequently unreliable. According to its count, only 2,429,062 of the 48,829,920 "willing and able" workers in the United States were totally unemployed. But according to an authoritative later estimate the number totaled 4,388,587. If one wanted to be flippant about the matter, one might assert that we have known more about the number of pigs in the country than about the number of jobless men and women. Of course, profits could be made in the market places if the number of pigs were known. But if the full extent of unemployment were known, governmental appropriations and taxes might have to be raised. The United States ought to have a regular monthly check upon the extent of joblessness. W e have not, however, and that's that. Here are the best figures available: In midNovember, 1 9 3 7 , according to the National Unemployment Census directed by John D. Biggers, 7 , 8 2 2 , 9 1 2 persons voluntarily registered themselves by mail as being unemployed. The census officials did not claim accuracy for this total, however. A house-to-house sample check of a cross section of the United States made a month later indicated that about 3,000,000 of the jobless either had not responded in the mail census or had become unemployed after it was taken. Since then, because of the present upturn in business, the number of unemployed has been reduced a little. As I write, only guesses are available, but possibly the American Federation of Labor errs on the conservative side when it estimates the unemployed at over 10,000,000. Unemployment in America is not a phenomenon of depression years only. Depressions severely accentuate the problem, but the problem is an ever present one. If approximately 33 percent of our nonagricultural workers were jobless in 1 9 3 3 , at least
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1 0 percent were in 1 9 3 0 . From 1890 to 1 9 3 8 the number of unemployed was never less than 1,000,000, and it mounted to perhaps 15,000,000 in 1 9 3 2 - 3 3 . At no time during the past fifty years were all willing and able workers employed. Some are always losing their jobs and failing to find new ones. Changes in the market demand for goods and in the methods of production are constantly occurring. N e w technological and efficiency devices are introduced every day. Hence the number of available jobs varies constantly. It does appear that Joe was the victim of advancing technology. Statistics mountain-high could be piled up to show that one man can now do the work that six or sixty formerly did. Thousands of examples could be cited in nearly every field of man's endeavors. One need only think for a moment of some of the more obvious technological improvements, the teletypewriter, the sound moving pictures, the dial telephone, to realize what tremendous effects technological change has upon employment. In manufacturing, the productivity of the worker increased by 53 percent in the ten years from 1 9 1 9 to 1 9 2 9 ; 5.5 percent fewer workers produced 45 percent more goods in 1 9 2 9 than were produced in 1 9 1 9 . Cotton textile workers employed in a mill equipped with the most modern machinery available in 1 9 3 6 could produce one and one-half times as many yards of sheeting per hour as they could with the most modern machinery in 1 9 1 0 . In Joe's own trade, molding, the machine casting of pig iron has supplanted sand molding in many plants, and seven men, it is said, can do the work sixty formerly did. It is certainly true that machines do work that men once did with their hands. It is certainly true that Joe as an individual is unemployed because a machine does the work faster and more efficiently than he can. Nevertheless, I'm not sure that increased use of machines causes greater total unemployment. Why? you ask. Well, are more men employed today in making and caring for automobiles, airplanes, and locomotives
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than were formerly employed making wagons and buggies and tending horses? Obviously the answer is "Yes." The use of machines, then, does not necessarily decrease employment. T h e technological unemployment which individual workers experience is very real for them. But it is the result not of the introduction of the machines, but of the way their owners have seen fit to distribute the income which the machines have made possible. Your college economics course was right about the machines but evidently it failed to go below the surface otherwise. It is all too true that workers do often lose the jobs at which they are working when new machinery, processes, and methods are introduced. T h e more rapid the technological change, the more rapid, often, is the labor displacement; the more rapid the labor displacement, the greater are the number of the temporarily and sometimes permanently unemployed. To make matters worse, there is not much chance that the rate of change will slow up. As Professor Ogburn of the National Resources Committee has said, " T h e large number of inventions made every year shows no tendency to diminish. O n the contrary, the trend is toward further increases. N o cessation of the social changes due to inventions is to be expected." Let me admit once and for all that some men do lose, are constantly losing, the particular jobs they have because a machine which can do the work more swiftly, efficiently, and cheaply is installed. But this does not mean that there will necessarily be less total employment than before. In so far as production is maintained or increased, there will be as many or more goods, and there will be as much or more income. If there is as much or more income then there is as much or more buying power. In the end there will be as many or more jobs than before. Shall I draw a picture? Candidly, I don't think you need one. But here is a simple illustration. (I paraphrase here an cx-
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ample given by the economist Paul Douglas.) In the printing industry tremendous technological changes have taken place in the last thirty or forty years. Let us suppose that 100 men were required to produce all the materials for 100,000 finished copies of the Sunday Gazette, a paper which sells at a dime. One man would be producing 1,000 per week. Now if new processes and machines are introduced all along the line and 50 men can now produce the 100,000 copies, will 50 men then be laid off? Probably not. But if 50 are laid off, the labor costs will be lower. Since labor costs comprise most of the cost in the production of a newspaper, let us assume that the papers will then be sold at five cents. If the price falls the demand for the paper will go up. More than 50 workers will again be employed. If the demand for the paper is doubled, then 100 workers will again be needed. If the demand for the paper is more than doubled, and this might well be, then more than 100 workers will be needed. Aha! you say, but what if the demand is not greatly increased, what then? Well, again I have an answer. Again let us make an assumption. Let us say that with the price a nickel, the demand rises only to 125,000, an increase of 25 percent, then only 62 or 63 workers will be needed, and 37 or 38 will be jobless. But will they? Not permanently, at least not because of the new machines and processes. A few may remain out of work because they are too old to get a new place, or too firmly rooted in one community to wish to leave, but in the long run there will be just as much employment in total as before. The buyers of the five-cent paper will have more money left than they had when the paper was ten, won't they? The figuring is simple: 125,000 X = $6,250; 100,000 X = $10,000; $10,000 — $6,250 = $3,750. The newspaper buyers, hence, have $3,750 to spend for other things. This money they will spend or save. If they spend it, men will be employed in other industries. If they spend it on gum, then Wrigley will have to employ more; if on cars, then Ford or
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General Motors will. (The actual number of men getting new jobs will of course vary with the industries employing them, but this need not bother us here.) If buyers invest the $ 3 , 7 5 0 in new productive enterprises, more men will be then employed in these enterprises. There has only been a transfer of labor from one industry to another. This is precisely the history of what has usually happened in the United States. Fewer workers are employed in farming than in 1920, and about the same number in manufacturing, but there are many more in the service trades and professions, such as schoolteaching and beauty work. Before I leave this topic I'd like to make one more assumption. Suppose the owner of the newspaper decides not to reduce his prices, as he has a monopoly in his locality, and therefore makes twicc as much profit. Will fifty men then be permanently unemployed? Not if the owner decides either to use his profits to build up his plant, to loan it to others to build up other industries, or to consume that much more. In these last three cases there will probably be as many jobs as before. But, and here's the real catch, there will be unemployment if the owner's added profits (or the consumer's savings if the paper is five cents) are not used in production or consumption, and if these profits (or savings) lie idle either in his sock or in speculation in the investment market. My examples of the effects of technological change on employment may oversimplify the process that actually takes place. They portray, however, just what does happen and usually has happened in all fields of industry. The chief trouble arising from technological change lies not in the introduction of more efficient methods of production. It lies in the distribution of the rewards of production, as I shall presently show. Contrary to your belief, technological improvements in themselves do not ordinarily throw men out of work permanently. As you assert, it is true that new machines often do displace
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men, but whether the unemployment is permanent or not is another question. I f , when these technological improvements are made, the masses of people were able to obtain more goods because of either the decreased prices or the increased income, then little or no permanent unemployment would occur. The increased production would all be absorbed by the increased demand of the consumers for more goods of one kind or another. People's wants, are almost unlimited; even their fundamental needs are far from being filled now. There may come a day when their desires and needs are satiated, but it is far off. At present they could consume all that is being produced and so much more that factories would be forced to seek instead of to lay off men. You can find striking confirmation in the past. During the last two hundred years there has been rapid and constant improvement in the means of production. A n d yet during certain periods, such as the 1920s, as great a percentage of the workers was employed as ever had been; in fact perhaps a greater percentage was employed. This was because the savings arising from the technological advance were at the beginning of these periods either invested in new industries or were passed on to the consumer in the form of lower prices. The seemingly displaced worker was retained in the same industry or found a job in another field. When this has occurred the result has not been depression and unemployment but a general rise in the standard of living. Machines may make possible either more or less employment; it all depends on how the goods flowing from them are distributed. A few weeks ago I was reading an old French pamphlet written in 1 7 8 7 . T h e unknown author bewailed the fact that kitchenmaids were being forced to tramp the streets because of the introduction of a spit which turned the meat over the fire without the help of human hands. Technological unemployment 'way back there! Technological displacement if you will, but not necessarily permanent unemployment. Technolog-
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ical changes and technological displacements of labor have gone on since man first used a stick for an implement or tool in order that he might do his work more swiftly and efficiently. He could have used his hands if he hadn't cared about time or how much he had to eat, but he used a tool when he became wise, and he thus obtained his food quicker and with less bother. W h y don't we dig sewer ditches today with our hands and sticks or with wooden spades? More would be employed. The answer is obvious: because if we did we wouldn't have nearly as good or as many sewers, in fact probably no sewers. Each man's production would be so small that the people who wish the sewers couldn't pay him even a subsistence wage. Why use tools or machines? Why not use only our hands? Tools and machines are used because through them we can produce more goods and obtain a higher standard of living. If we used our hands only, we would have less to eat, less to wear, and worse places to live. Indeed, there are so many of us homo saps living today that we'd starve to death without machine production. Without machines there would be less unemployment, perhaps, but then we wouldn't be counting those who died from starvation. In the Middle Ages there may have been less unemployment, but fewer people existed and they had a lower standard of living. In so far as machines enable us to produce more, society has more, and hence if the distribution isn't faulty all of us have a higher income and a higher standard of living than in ye olden days. The chief trouble, I repeat, lies not in technological advance, but in distribution. When depressions begin either prices are so high or workers' incomes are so low that the masses of people do not have the buying power to purchase the ever increasing quantity of goods they help produce. When they cannot buy all that they and the machines produce, then there is a depression and severe unemployment. T o clarify your "muddled" mind you must understand the
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problem of distribution. A few years ago the Brookings Institution published a monumental study of the distribution of wealth and income in relation to economic progress. N o radicals, the Brookings men were sober, conservative economists. Moulton, who headed the study, was even a Republican in 1 9 3 6 . They weren't particularly interested in the problem of employment, but much that they have to say lies behind what I'm trying to show you. The chief problem of American business, they point out, is not how to produce more but how to sell the goods it is capable of producing. The Brookings men declare that three-fifths of the people in the United States did not have a health and decency standard ($2,000 a year for a family of five) in 1929. And yet all of us could have used much more than we were using. Could you use more dresses, hats, shoes? ( N o , I'm not offering! Let's not speak of Utopias!) T o give all families just a $2,ooo-a-year standard in 1 9 2 9 , industry would have had to produce 35 percent more. Here is industry on one side, not able to sell what it could produce. Here are the people on the other, desirous, but not able to buy. N o w if people could buy what they needed and desired, manymore would be employed. Our problem would be solved! What was and is wrong, then? During the late 1920s too much money was put into idle savings and nonproductive foreign and domestic investments. Remember the example of the newspaper owner and technological change and the ill effect when the newspaper owner failed to put his increased earnings into increased production or consumption, either of which would have employed more workers? During the '20s, to paraphrase the Brookings report, only a fraction of the funds available for new plants and equipment was used for this purpose. Savings were not used often enough to finance capital construction which would have created work but were used too often to build up investment trusts and holding companies, in bidding up the prices of securities,
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or in financing foreign enterprise while foreign people could not buy American products in proportion because of debts and tariffs. May I illustrate? If General Motors sold stock to get capital to build a new plant and actually built the plant, then employment would rise, but if you or I simply bought existing stock with our savings there probably would be no increase in construction, no new employment. If our funds or those of the investment trusts came from increased profits which resulted from the use of new machines (and this is often what actually happened) there would be less employment than before. Remember our newspaper owner who, having a monopoly, refused to cut prices when he introduced new machines, took increased profits, and then did not use his savings to build a new plant or to consume. In the 1920s, savings increased faster than consumption and faster than capital construction. Hence demand for workers decreased. "This is all very well," I hear you say, "but what can be done about Joe and those like him?" As I'm getting tired I feel like answering as do some of my students who are lazy now and tired far into the future: "Nothing; what's the use of being bothered?" Wait till I fill my pipe, though. I'm tired, but not into the future. My pipe is lighted. I think something can be done. If prices are continually lowered as more machines and better engineering make possible more and cheaper goods, the problem will be partially solved. Or if as production is increased the income of the workers increases proportionately, then, too, the problem will in part be solved. In either case the resulting increased demand would mean increased employment. A third possibility is to have the government take, in taxes, those savings which are not productive and use them to employ more men on public works. To be more specific, every time a new machine makes possible faster and cheaper automobiles, then somehow or other it must be made possible for your Joes to buy more cars and
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thus maintain or increase employment. In any case it should be noted, too, that your Joes will have to be more versatile and better able to change jobs, but of this more anon. Which method is best, decreasing prices, increasing wages, or governmentally financed public works? The Brookings Institution suggests decreasing prices. A good many economists argue that this need not mean decreased profits. If prices are decreased, demand will usually increase, and a small margin of profit on many units may in total even exceed the total of larger per-unit profits on fewer articles. But—! Will capitalists, will those in control of industry, reduce prices or will they be tempted (as they usually have been in the past) to take as much profit per unit as the traffic will bear? Monopolies and trade associations up to the present have tried to fix or increase prices in order to make maximum profits. Probably they will continue to do so in the future. While there may be no more monopolies than formerly, there are, especially since the N R A , more and bigger trade associations, and big business is bigger if not better than ever. If prices are to be reduced without actual governmental price setting, then competition must be restored. Monopolies must be broken up and trade associations carefully restricted—a difficult task. Of course it may be possible to educate, to show, businessmen, but they are hardheaded. I don't have much hope. But there is another point that needs making here. Restoration of competition is not a cure-all. Orthodox economists often forget that the restoration of competition does not necessarily lead to lower prices. T o increase the number of businesses is often to increase costs, is to lose the advantage of mass production and mass sales. Especially is this true in distribution, where duplication of effort greatly increases both the capital and operating expenses. For instance, look at the many filling stations. One big station employing several men can do the work of several one-man stations. When many small stations take
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care of the demand there is a duplication of both capital and overhead. As gas must then be sold at a higher per-gallon rate, less gas will be sold and in the long run fewer workers will be employed. Personally I don't think privately owned big businesses will see the light and reduce prices enough to help. Glance at the earnings of corporations and at the price indexes of 1 9 3 7 when business was relatively good, if you are skeptical. Prices went up and corporations made more money; a terrible recession ensued. Under capitalism the incentive to obtain immediate high profits is great; the temptation cannot be resisted by most of us. W e should remember, however, that if prices are decreased more employment is possible and this is always a way out. A more likely way to reach this goal is to allow the federal government, through taxation, and through acts like that for Interstate Commerce, to limit profits, and through measures more stringent than the Securities and Exchange Act, to prevent the too rapid expansion of the investment market. This is probably what will happen, in fact is in the process of happening. Such a program may not be completely or ultimately successful, but it will help. Some men doubt whether governmental control and regulation short of actual governmental ownership can ever be effective. Socialists and communists, of course, desire social ownership of the means of production, claiming that through socialism depressions and unemployment would be ended. Social ownership might be the solution. But any party or group which believes in a like program has little chance of obtaining the necessary power in the United States without a revolution. And if a revolution should occur now, conservative rather than radical groups would probably be successful. The property-owning classes are strong. Before they were pushed to the wall, they would vigorously resist (they are resisting) any attempt to use their property primarily for the social instead of their own wel-
UNEMPLOYMENT
19
fare. For some time, consequently, business will very probably operate within the limits of capitalism, unless we desire a nationalistic, totalitarian economy (fascism) which would put men to work (on a lower standard of living) building battleships and making bombs. Effective action is still possible within the limits of our present political economy. Fascism has no monopoly of action. Democracies can act, too. While there is liberty there is hope that we can obtain bread and life, not bullets and death, for all. The number of unemployed can be reduced. The various governmental units, state and federal, should continue to try to persuade businessmen that lower prices are necessary, and to control profits through taxation and through regulation by expert commissions. Above all, to solve the immediate problem, they should employ the jobless on extensive public works. The public works program of the present administration has been heatedly criticized. When the critics speak of the wastefulness of the present program they are not altogether unjustified. It is true that much of the W P A "made work" results in little or no creation of wealth, and that the W P A is in part only a makeshift stop-gap devised to make men work for their relief money. In their fury, however, the critics ignore some salient points. Public works programs are not always wasteful; they can and often do create wealth, and in so far as they are wealth producing they raise the standard of living and create buying power and permanent employment. Like private industry, the government can create work which will pay for itself. You will remember what difficulty we have had in securing decent living quarters. Our experience is that of millions of Americans. Ten million dwelling units are needed and should be constructed. The need for adequate housing in the United States is great, chronic, and crying. If houses were built with government funds, wouldn't men be given wealth-producing jobs, and wouldn't the standard of living of all of us be raised? What
20
UNEMPLOYMENT
difference would it make to either renters or carpenters whether a private contractor or a government agency built houses so long as the houses were actually built? A real government housing program would stimulate employment and it would be employment of the right kind. T h e various governments, state and federal, can help, too, by continuing to protect labor in its right to organize. I f and when labor unions and farm associations become strong enough to obtain higher wages for their efforts, and become wise enough (as in Sweden) to establish cooperatives, their buying power will increase and more employment will result. T h e Amalgamated Clothing Workers, a union led by Sidney Hillman, has set a striking example of the possibilities of these kinds of action. Even Henry Ford, in spite of some of his primitive economic thinking, long ago broached the high-wagepurchasing-power idea; and within limits this theory is good. Every time production standards are raised the worker's income should be increased in like amount. The unions can bring pressure on the employers to force the payment of higher wages as production is increased. As for cooperatives, their development in the United States lags far behind that in many other countries. In Britain and in the Scandinavian countries cooperatives have provided self-employment for many workers over a period of many years. In addition, cooperatives are a check on private business. By providing competition they prevent price fixing and charging all the traffic will bear. But again I hear you say, " Y e s , but what about Joe, you theorist; he can't wait for the millennium! Monopolies still exist, trade associations which control prices are stronger than they used to be, price decreases are not coming as rapidly as technological changes and technological changes are coming at an ever increasing rate. The acts passed by the government are neither very effective nor comprehensive. The Constitution and the Common Law practices still stand as barriers to many kinds
UNEMPLOYMENT
21
of effective government control of industry. The property and liberty of corporations cannot be taken away without due process of law and without due regard for states' rights. The government is heavily in debt now (over $40,000,000,000) and cannot continue to provide public works jobs for all the unemployed. And in spite of the C.I.O. and the various farmer associations the income of the workers is still not large enough to enable them to buy all that industry can produce. Unemployment and Joe still exist. And Joe needs help now. Is there nothing that can be done for Joe now, immediately?" Yes, there is. And a little is being done for your Joes here and now. You mentioned unemployment insurance. Unemployment insurance should be regarded as a palliative and not a remedy, of course. Principally, as you know, it provides for weekly payments to the unemployed man of $5 to $ 1 5 for from eight to sixteen weeks, and it does not put him back on the job. Over 27,800,000 employees have earned credits toward unemployment benefits, and from January, 1938, to June 30, 1939, some 4,500,000 received either full or partial benefits for varying periods of time. All states are now issuing benefit checks. By October, 1939, payments amounting to over $739,000,000 had been made, and over a billion dollars still remained in the reserve funds. Joe was helped to the extent of $98; the benefits now average about $45 a month. Nearly forty states, through the use of a merit system for unemployment insurance taxes, give an incentive to employers of Joes to stabilize employment, the tax on the employer decreasing or increasing in proportion to the steadiness of the employment he provides. In Wisconsin, which is one of two states having the individual employer reserve system, an employer who provides steady employment may reach a time when he pays no tax, while one who cannot maintain steady work must pay a tax up to four percent (normal is three percent) of his pay roll. Does this reward-and-punishment plan help? In Wisconsin
22
UNEMPLOYMENT
the evidence seems to indicate that it does, a little. The evidence is not conclusive enough to prove anything, and we know that unemployment insurance won't end unemployment anyhow. But it does help your Joes here and now. Since Joe received unemployment benefits I suppose he has registered at the district employment office. This assistance he probably would not have received before 1 9 3 3 , and it does help now. Perhaps a job of some kind may come through it, especially since employment offices are serving increasingly as clearance houses to coordinate the jobs and the jobless. Government employment services need to be still further amplified. Sometimes a job will open in one part of the country and a jobless worker will be available in another. If Congress doesn't cut the employment office appropriations for political reasons as it did in 1932, there will be more chance than formerly that Joe will get a place, but he will have to be willing to change jobs and localities. I know it's hard for workers with families and perhaps a little property to move from one section of the country to another. But it's a difficulty that the unemployed will increasingly meet. Unfortunately, at present both capital and labor are too immobile. If an industry, such as the textile industry, moves southward, it should be possible for the workers to follow. If capital becomes frozen in one enterprise, it must be made possible for the Joes to move to other occupations. The modern worker needs to become more mobile. Employment offices are helping him to become so. In another way, too, the jobless can be assisted. They can be made more versatile. Joe needs guidance and training for another job. You, the social worker, can give him the guidance. The growing vocational school movement will to some extent enable him to get the training if governmental aids are continued. It's unfortunate that Joe can't use his particular skill. Let's be realistic though, Mrs. Social Worker, not sentimental.
UNEMPLOYMENT
23
Joe will probably have to get a job in another field. If he can learn another skill his aspirations will not go "down the drain" altogether. Is there a vocational school near you? Investigate its possibilities. So far, vocational schools have been primarily concerned with the training of new and young workers, or with education that will make the worker more skilled in the job he has. Vocational schools do provide occupational guidance, however, and to a limited degree are training the unemployed for new jobs. The federal emergency adult education programs are helping a little too. Is Joe willing to undergo the hardship of learning how to do another job? If not, there is room for social work on your part. Joe at forty is rather old to begin anew (sometime we must discuss the problem of old age) but he isn't too old to learn, as the psychological experiments of Thorndike show. What happens to Joe in the meantime is up to you. It's hard to maintain morale, but the tasks of a social worker were never easy. I suppose I haven't really been of much assistance to you. The outlook isn't too bright for Joe. Let's face the facts. As long as there are serious maladjustments in the economic system there will be serious unemployment. As long as technological changes come about without planned provisions for the displaced workers, as long as some people are able to employ their savings not in consumption or production but in the investment market, as long as the masses are not able to buy what industry can produce, there will be willing and able, but jobless, workers. The capitalists should allow the income to be better distributed through either lower prices or higher incomes to the workers. If they cannot or do not, the government ought to step in with more economic planning and control. There is danger in this last; there may be too much bureaucracy and red tape, too few intelligent and informed government employees. But unless the capitalists control themselves and reduce profits, lower prices,
24
UNEMPLOYMENT
and raise wages (a vain hope, I ' m a f r a i d ) the government must step in. I ' m not optimistic. Y o u and I shall probably always see idle men w h o wish to work but are unable to find a job. Even with the fluctuations in economic conditions which seem to be inherent in capitalism, however, the number of unemployed can be materially reduced—// w e use our brains and become intelligent brain-trusters! T h o u g h our conservative friends may be skeptical, there is nothing wrong with using our intelligence. If our politicians and business executives use their uncommon sense, much can be done to eliminate or reduce the number of jobless. H e r e is a brief outline of the proposals I would make: I. Palliatives for those unemployed 1 . Relief Private Governmental: local, state, and federal if necessary 2. Unemployment compensation State with federal assistance as at present but with two changes: extension of insurance to workers not now covered, and greater uniformity in state laws 3. Work relief or made work As W P A and other work relief projects 4. Old age pensions and assistance Social Security Act (perhaps modified) II. Regularization of employment 1 . Use of plant throughout year By elimination of seasonal employment through planning of production as Fels Naphtha or Nunn-Bush Shoe companies have done 2. Planned introduction of technological devices Individual companies can plan the rate of technological change and coordinate hiring, firing, and retraining policies. The American Telephone and Telegraph Company did to some extent when it introduced the dial phone. 3. Stimulation of regular employment by governmental action Government regulation of production through codes for or licensing of industry
UNEMPLOYMENT
25
Government tax penalties for irregular production as in Wisconsin Unemployment Compensation Act III. Coordination of workers and jobs 1 . Public employment offices with extended facilities 2. Retraining of jobless Vocational schools Adult education sponsored by governmental agencies, as are W P A classes IV. Restriction of labor supply (should be practiced only with some socially desirable goal in view) 1 . Prohibition of child labor Federal amendment is still possible 2. Restriction of employment after 65 3. Immigration quotas As at present 4. Reduction of hours If it does not reduce total production or individual wages V. Increasing number of jobs 1. Through a permanent government public works program Housing Conservation, as in C C C Public assistance in utilities as rural electrification 2. Through self-employment Cooperatives VI. Increasing buying power of masses of people 1 . Through increased production (This is the most fundamental step of all.) 2. Through higher wages 3. Through lower prices 4. Through organization of workers (Government action is necessary if industry itself is passive or antagonistic to any of these four.) I could a m p l i f y this outline. Y o u could, too. It does indicate that the situation is not hopeless even if the outlook is dark. T h e r e need be little unemployment in America, if w e think and act. T h e diseases of unemployment will not be cured by simply having confidence and saying that America is "fundamentally sound."
26
UNEMPLOYMENT
Well, good night, Carol. Keep yourself in good health, don't work too hard. The battle will not be won in a day we shall need all our energy and resistance. But it will be as long as we are free, to help the unemployed get jobs bread.
and and fun, and
Love, CARLISLE
LOW INCOMES
SOUTHTOWN, WISCONSIN SUNDAY EVENING
D E A R CARLISLE:
After your last letter I feel like addressing you as "most learned professor" and signing myself "just a question mark." Y o u are grand to take time to write so fully on these matters. For once my thinking on the prohlem of unemployment is at least organized. If you are conscientious, the Education of a W i f e , or should I say the Education of a Social Worker, may progress rapidly. Y o u can see that I am in a humble mood, a mood, perchance, that might be generated more by my fatigue than by my awareness of my ignorance. If I were not so tired I'd argue a point or two with you. I still think the machine is more responsible for unemployment than you seem to say. Even with perfectly planned distribution men would still be displaced when technological advances were made. Since we are not living in a time of planned industry, technological unemployment, even though temporary, is real and extensive. W e have had a terrifically busy week! Although the steel company is working about 56 percent now, not all of its employees have been put back on full time. Not long ago when steel production was around 30 percent we were swamped with unemployed steel workers and with those who wanted aid to supplement their irregular wages. This week Mr. Kaczmarek was in again! Y o u may recall my telling you about this Polish family, especially the children. We first knew the family early
28
LOW
INCOMES
in the great depression (in 1 9 3 1 , to be exact), during which they needed considerable assistance. However, they have maintained themselves with only occasional aid since late in 1934. Mr. Kaczmarek's hours were cut way down last summer and we gave them some food and when school started this fall we helped out with clothing for the children. But now Mr. Kaczmarek is in need of assistance again. His wages just cannot meet all the family's expenses. Mr. Kaczmarek is a stolid, square-jawed person born of Polish immigrants. He is forty-seven years old and has known little but labor since he was a child; for the past fifteen years he has been on the pay roll of the small steel company in this city. Mrs. Kaczmarek is of Polish peasant stock too. She takes great pride in her home and her few possessions, works unceasingly, manages carefully, and nags continuously. About twelve years ago the Kaczmareks bought a small house within soot range of the steel plant. Their home differs from all the other gray boxlike structures in the block only in that it has a picket fence, a green patch of grass in the front yard, and petunias lining the walk. The back yard, save for the vegetable garden, is worn bare from the play of children. T o Mrs. Kaczmarek her tiny front yard represents respectability and she guards it valiantly, with much rapping on the window and broom-shaking at the children. The four children range in age from eight to sixteen. Mary, the oldest, is specializing in business training in high school and expects to graduate next year. Did I tell you how she worked nearly all last winter as a cigarette girl in a night club on the north side, until her father discovered that the place was more than the ordinary restaurant she said it was? Mary wanted desperately to have clothes like the other girls in her class at school and, being very attractive, secured this job. She told me later that after she had paid for lunches (really early breakfasts) and carfare she cleared only about three dollars a week. Her school work suffered alarmingly because she was so
LOW
INCOMES
29
sleepy during the day. N o w she is in the top tenth of her class. On Saturdays she works in the dime store, earning two dollars, with which she tries to clothe herself and pay school expenses. Every time I see Mary in the store she points out some smartly dressed stenographer and speaks of the day when she too will be an independent working girl. Adolph, age fourteen, is the oldest boy and already an inventor. His shop in the basement is the hangout f o r all the neighbor boys who have mechanical hobbies. One day when I stopped at the house it smelled most vile, like a rendering plant. Mrs. Kaczmarek explained with great impatience that, " A d o l p h up to more troubles, now he make gas in my best cooking p a n ! " Adolph was elated over his brew, and explained the whole complicated process to me. That Adolph will have the educational opportunity to develop his ability seems unlikely. H e will become a steel worker like his dad as soon as the company will take him. I haven't time to tell you much about the two younger children. Henry is the leader of a rowdy gang of seventh-graders bordering on the edge of delinquency. H e has neither the pride and stubbornness of Mary nor the scientific talents of Adolph. H e shuns the home and seeks all his companionship with "the fellas" who follow him on all kinds of escapades. The activities of the gang have become more serious of late, stealing milk bottles with which to ambush the Mexican boys who live in the next block, or collecting junk which is not always cast-off. Henry is really a very likeable boy, more or less neglected by his parents in their preoccupation with making ends meet. Freda, the youngest, is a very shy child, all legs and eyes. Ever since I've known her she has looked undernourished. Her pallor and knock-knees must date back to those years of painful scrimping in the early '30s. She has none of the boldness and assurance of her big sister—Freda is a depression child, definitely marked. (This, of course, may be a mere fancy of mine, but I have seen it in many lives.) One time when I met her
30
LOW
INCOMES
on the street she surprised me by becoming very confidential. She secretly showed me a nickel and told me she was saving it to buy some heavy shoes for winter. I noticed she was wearing tennis shoes and a thin sweater, so I asked her what else she would buy if she had more nickels. Believe it or not, she'd have not a leather jacket, not a scarf, but "a little violin like the music teacher plays "! Poor little kid! Well, Mr. Kaczmarek was in the office yesterday and said, " I can no make the money stretch. I no get raise like some guys. T w o months now I get only $ 3 0 on payday [every two weeks]. See, here is check they give me today, $28.60. N e x t time not so much as this—I got only three days work this week. Missus say Freda gotta have shoes today and Adolph gotta have sweater. See, here is my grocery bill, $ 1 9 . 0 0 , and store won't give no credit past payday if I don't pay on day I get my check. Mr. Johnson [mortgage holder] says 'Pay me today.' He come to house yesterday and talk terrible to Missus. She so scared, her teeth knocked. She been feelin' bad, too Doctor Baines, he say, 'You gotta take her to hospital for operation for tumor right away soon, John." Missus she talk all the time, say she die before she go to county hospital. I tell her I go talk to you, you help me before. If the company give me more hours, then I get along. I try, but ain't much use. I go over to plant every morning, and when company don't need me I try to get in at Jones company too. But they lay off theirs, no hire new men." It appears that we shall supplement Mr. Kaczmarek's wages with medical care and with either clothing or some food until his income increases again. When the plant runs regularly Mr. Kaczmarek earns about $ 1 , 0 0 0 a year. That has been his average wage the past three years, though it was much less for the two years before then. At that, he has been able to care for six people on this income most of the time. When $40.50 is the relief department's monthly food allowance for a family of this size you can see how far his present $60 a month will go. He is in a tight spot.
LOW
INCOMES
31
We are in a spot too. I always feel rebellious about having to supplement wages with relief. What right has a company to operate if it cannot pay its workers at least a living wage? Doesn't it deserve to go out of business and let a company that is more efficient carry on? It seems to me that in reality the public, through relief, is subsidizing low-wage industries, industries whose very existence prolongs the need for relief and whose practices lead to conditions we social workers are battling to overcome. Some industries I know consistently pay low wages. Which ones are they? Cannot they really increase wages without being forced to close down? Maybe in my work I see too dark a picture of this problem of insufficient wages. What, in dollars and cents, are workers actually earning these days? How does Mr. Kaczmarek's income compare with that of other steel employees? What are wages now in relation to the cost of living? Food prices have not changed much, but neither have wages, as far as I can tell. I have also been wondering how wages have kept up with the increase in workers' production in the last few years. Cannot anything be done to raise wages and incomes generally? It just occurs to me that were all these questions answered I would still lack perspective; I need an overview to see where Mr. Kaczmarek fits into the total wage and income picture. Where is his annual wage when compared with the salaries of the President of the United States, of movie stars, as well as with the earnings of unskilled laborers and workers in other industries? What about this distribution of income anyhow? I have read so much about it, so many conflicting statements. My college professor in economics used to be so cautious. Friends have said to me, "Oh, my dear, the poor are always with us; they are such bad managers. They are just ignorant, or they wouldn't be poor. They waste what they have because they don't know how to spend it! It's no use to give them more; their standards wouldn't allow it." Of course some are bad managers, but so are some of my
32
LOW
INCOMES
friends with so-called adequate incomes. C o u l d these friends, had they the same income as M r . Kaczmarek, do any better than he does? Indeed, the poor do not k n o w h o w to live if one includes season tickets to the symphony, trips to Europe, the latest books, f u r coats, town cars, and dining and w i n i n g among the essentials of living. T h e trouble is, as far as I ' v e seen, most workers do not earn enough to permit them even to work, eat, and sleep efficiently, not to mention well. T h e r e is M r . R o l f e , who
works
in the laundry
where
I send my clothes,
who
maintains a family of five on $ 6 0 a month, and he works seven days a week all summer. T h e clerk in the chain store near here —everybody calls him Jerry—supports his family
(they have
darling twin boys) on his earnings, which he told me w e r e $ 1 6 a week. M r s . Randolph, the stenographer in our office, is a w i d o w with t w o children and her aged mother at home; she supports them on her $ 7 0 a month. T h e s e people have never had to ask for relief. T h e y are existing on a minimum standard if there ever was one. It is a marvel to me the way people do manage on small incomes. Perhaps I should say it is not a marvel but a sad revelation. I worked out a budget with M r . Kaczmarek
Saturday,
trying to see h o w far his money w o u l d g o j u d g i n g by relief budgetary allowances. It looked something like this: BUDGET FOR KACZMAREK FAMILY AS DRAWN UP IN RELIEF DEPARTMENT Monthly Income Mr. Kaczmarek's wages Mary's wages
TOTAL
Monthly Expenditures $60.00 800
$68.00
Food Interest on mortgage; taxes Gas Electricity Heat (year-round av.) Clothing Incidentals TOTAL
$40.50 12.00 2.50 2.00 5.00 11.63 2.25 $75-88
LOW
INCOMES
33
Deficit
$7.88 Deficit between earnings and minimum relief budget $?.?? Deficit between earnings and budget if medical care, insurance, school supplies, and more clothing (all of which the family need) were included Y o u can see why Mr. Kaczmarek cannot pay for medical care, pay off his mortgage, or provide the proper clothing, education, and recreation for his children. Families like the Kaczmareks have no way of meeting emergency expenses without aid; they cannot have adequate security, health, and education or a host of other things. Even if most of them do not need actual relief they are still living at a miserably low standard. " H o w in the world have the Kaczmareks managed?" one asks. Like that of most low-income families, their story is an epic of economy. Their lives have consisted mainly of guarding pennies, scavenging for wood, bargaining over near-spoiled fruit, airing and fitting strangers' cast-off garments, shivering all winter, and scheming for transportation to the lake in the summer. Mrs. Kaczmarek has developed into a shrill-voiced dirt-and-penny vigilante. She is convinced that the world is against her; her evidence—the grocery bill, the mortgage, her poor health. She sews, cooks, and cleans all the day. This fetish absorption in work produces a numbness which isolates her from the world outside the picket fence and eases her despair. Only when Mrs. Kaczmarek goes to Mass, plants her petunias, or receives the seldom-given confidence of her children does she shake off her work stupor, a stupor to which she quickly returns at the sight of pots, broom, or washboard. M r . Kaczmarek is bewildered by the irregularity of his job, by his wage which will not stretch, bewildered by a wife who has withdrawn from him and is at times vindictive, bewildered by a houseful of children who demand shoes, schoolbooks, and dimes for movies, which he cannot provide, and bewildered by his own increasing
34
LOW
INCOMES
weariness and docility in the face of required effort. Yes, that is how the Kaczmareks meet existence on low wages. What income do you think is essential to maintain health and efficiency? I know what our relief standards are, but what items would an economist include in a minimum budget? How many workers earn more than such a minimum? When I see the privations to which hundreds of laborers are subjected I am baffled, and I get fighting mad. It all seems so utterly unfair, not being able to give children even a decent physical start in life, and spending all the years of a life laboring at a wage hopelessly inadequate. You answered my last letter so constructively. I probably know more than you do about the stunting privations of low incomes. But you could give me facts, and an overview. What must be done to raise wages? Should the worker do it by his unions? Should the government force wages up in some way? W e social workers can raise a howl and cite chapter and verse, but shouldn't the chief impetus come from the laborer himself? Or where must it come from? Well, I must stop and go to bed or tomorrow will find this worker without any impetus either. If you answer even half of these questions I'll promise you a chocolate cake when I am home. Till then, all my love, CAROL
STATE COLLEGE LAK.EVIEW, WISCONSIN M Y DEAR HARDWORKING W I F E :
So the pressure of work is to prevent our meeting again. So the woman of affairs is willing to ask her impractical husband a few more questions. Remember, my lady, it is sometimes
LOW
INCOMES
35
dangerous to make a man, especially if he be your husband, feel that he knows something. Perhaps I do know something about wages. I earn mine studying what others receive. Many American workers certainly do not earn enough to buy daily bread for their families. I remember the Kaczmarek family. You took me out to see them last summer. I liked Mr. Kaczmarek and the kids (especially the sly one who you say is a borderline delinquent). Years of hardship and scrimping have indeed left their marks on Mrs. Kaczmarek. She looked wan and tired and querulous. But that homemade bread and coffee she so humbly offered me made me feel kindly toward her too. Someday long since I suppose her face was fresh and rosy and unlined and she was eager and pretty like Mary. Mary took my eye more than once. It is terrible that people must live as the Kaczmareks do in this rich America of ours! N o doubt Mr. Kaczmarek is not above the average in intelligence or skill. N o doubt he does spend a nickel or a dime foolishly on beer and tobacco now and then. N o doubt he should have known more about birth control. But the fact that he cannot support his family on his low wages is not his fault alone. On his income smaller families than his would be poor. America is supposed to be a land where the free can pursue happiness. But how can any family be free to pursue happiness or anything else if they haven't bread? Shades of Thomas Jefferson! America can and should provide a health and deccncy standard and more for all those who, like Mr. Kaczmarek, are willing and able to work. If it does not, the Declaration of Independence was written in vain. You ask for facts; I'm full of them tonight. Here we go! In 1929, that most prosperous of time's fleeting divisions, nearly 6,000,000 families, or over 21 percent of the total number of families (I am using the best estimates, those of the Brookings Institution) received annual incomes of less than $1,000. Approximately 12,000,000 families, or over 42 percent
SHARE OF AGGREGATE FAMILY INCOME RECEIVED BY EACH TENTH OF NATION'S FAMILIES 1935-36
National
FIGURE
Resources
Board
I
PROPORTION OF NATION'S FAMILIES RECEIVING EACH TENTH OF AGGREGATE FAMILY INCOME 1935-36 AGGREGATE
INCOME HIGHEST TENTH NINTH
INCOME RANGE $16,000 a OVER 5,450
• 16,000
I23
UBS
EIGHTH
3,300
5,450
SEVENTH
2,525
3,300
SIXTH
2.075
2,525 I I I H I l B
M
M
FIFTH
1.725
2,075 l i l l i l i i f l
FOURTH
1.410
1,725 I I I l l l l i l l
THIRD
1,125
1.410
SECOND LOWEST TENTH
mmmm
820 •• 1,125 I I I M l i M l i m i l i H .UNOER •• $ 8 2 0
I I I I I I I I M i l l
I I I I U I
I I I I I M i l
m
^
^
H
Bach dollar »yrobol represents 1 percent of aggregate income of all families or S476.792.380 Each figure symbol represents I percent of all families or 294,000 families National
FIGURE 2
Resources
Board
LOW
INCOMES
37
of the total number, received incomes of less than $1,500. Only a few more than 2,000,000 families, about 8 percent, received more than $5,000; and approximately 600,000, over 2 percent, had incomes of $10,000 or better. The one-tenth of one percent at the top received about the same aggregate income as the 42 percent at the bottom. In 1 9 3 5 - 3 6 , according to the National Resources Board, the distribution of national income varied nearly as widely. The top one-half of one percent of the 29,400,000 families received the same amount as the bottom 38 percent. Only 147,000 families then obtained the same total income as did 9,261,000. The top tenth of American families received an average of $5,838; the lowest tenth received only $308. More than one-third of all nonrelief wage-earning families had incomes that were under $1,000, and more than two-thirds were recipients of less than $1,500. Those who received relief of any kind during the year had an average income of $740, a sum which included all relief, all earnings, and income from all sources. It is a peculiar world even from an ivory tower when the distribution of income is as unequal as the enclosed graphs [Figures 1 and 2 ] show. Mr. Kaczmarek is a steel worker. In March, 1939, the average hourly wage in the steel industry was $.75, the average weekly earnings, $27.01. If work were available for 52 weeks (which it will not be) the annual average wage in steel for 1939 would be about $1,400. Like Mr. Kaczmarek, however, few steel workers are fortunate enough to obtain full-time employment. From the previous experience of the industry I would estimate that 40 weeks at the most would be available, and that the war boom will not boost the 1939 average much beyond $1,000. In 1934, a year halfway between depression and recovery, the annual wage in steel was only $948, or slightly less than for 1939. You may say that 1934 and 1939 are not typical because neither is a prosperous year, that 1925 when
38
LOW
INCOMES
the average annual wage was $ 1 , 6 5 9 ' s more truly representative. I can only answer that in the United States depression years are about as typical as prosperous years. Compared to 1 9 3 3 , when the average weekly earnings were $ 1 1 . 1 1 in steel, the 1 9 3 9 steel wages are good; compared to average weekly earnings in June, 1 9 3 7 , of $ 3 1 . 0 6 , the 1 9 3 9 earnings are fair. The truth is that there are just about as many poor years as good years. Note, too, that there is at least one deception in the above statistics. I gave only average earnings. Many steel employees like M r . Kaczmarek make less than the average. In 1 9 3 4 over 80 percent of the steel workers earned less than $ 1 , 2 0 0 , 45 percent made less than $800, and about 25 percent received less than $600. The steel industry has long been regarded as the most important single barometer of American economic conditions. The wages paid in all manufacturing industries are not similar, however. In March, 1939, the average hourly wage paid in all manufacturing industries was $.65 compared to steel's $.75, while the average weekly earnings in these industries was $ 2 4 . 2 3 compared with the $ 2 7 . 0 1 of steel. I may be boring you with statistics, but facts are what you asked for. Average annual earnings are a better guide to the workers' welfare than are hourly or weekly averages. In prosperous 1 9 2 9 the average employed worker received the magnificent sum of $ 1 , 4 7 5 f ° r his labor. In depressed 1 9 3 2 the amount fell to $ 1 , 1 9 9 . neither year did he experience the difficulties of King Midas. Recovery was under way in 1 9 3 4 and 1 9 3 5 , yet certain industries paid less than even the 1 9 3 2 average. In 1 9 3 5 the average annual earnings in the soft-coal industry were $ 9 1 7 , or about $ 7 5 per month. Over 5 1 percent of the soft-coal workers made less than $ 1 , 0 0 0 that year. In the supposedly high-paying automobile industry the annual earn-
LOW
INCOMES
39
ings averaged less than $900 in 1 9 3 4 . Only one-third of the motor-vehicle employees worked throughout the year, and onefourth were employed less than six months. If you smoked any cigarettes in 1 9 3 4 the chances are they were made by laborers who averaged less than $ 7 0 0 for the year. These sums are small indeed when they are compared with the $ 1 0 0 , 0 0 0 to $300,000 that movie stars receive or even with the $75,000 and expenses of the President of the United States. Most large incomes, however, are derived from ownership of property rather than from labor. Extremes in income are much greater than those in wages alone. While cigarette workers averaged less than $ 7 0 0 in 1 9 3 4 , the reported income of thirtythree Americans was over $1,000,000 each. In 1 9 2 9 when the average annual wage was $ 1 , 4 7 5 , more than 500 Americans admitted incomes of $1,000,000 or more. Y o u ask about the trend of wages. The question must be answered with caution. There is no simple answer. The trend is either up or down depending upon the year taken as a point of departure. Wages are higher than they were in 1 9 3 2 , but lower than they were during the 1920s. From March, 1 9 3 3 , to the fall of 1 9 3 7 the trend was generally upward, then for nearly a year it was downward once more. Wages are again going up just now, but how long the upward trend will continue it is impossible to say. For purposes of comparison let us take the period 1 9 2 3 - 2 5 as our base (those are the years most often used) and let the level of pay rolls during that time equal 100. Then, expressed in a comparative figure or index number, the pay roll in manufacturing industries in March, 1 9 3 9 , was 86.9. This is considerably higher than in depressed March, 1 9 3 3 , when the pay-roll index was 37.9, but it is much lower than the index of 111.6 of prosperous March, 1929. Here is a little table [Table 1 ] , taken from estimates of the Bureau of Labor Statistics, which will show the trend for the last fifteen years:
40
LOW
Table i.
INCOMES
Indices of Pay Rolls in All Manufacturing Industries (as of March) Year
Index
Year
Index
1923
102.8
1931
75-4
1924
104.1
1932
53-1
1925
102.6
x
933
37-9
1926
106.6
J
934
65.6 71-7
1927
105.7
*935
1928
102.6
1936
77.6
1929
111.6
*937
IOI.I
1930
98.6
1938 x
939
73-3 86.9
Expressed graphically, the trend f o r the period looks like this [Figure 3 ] :
FIGURE 3
It must be borne in mind that the statistics and graph are somewhat deceptive. They show the trend in manufacturing pay rolls, not in individual wages. Though the trend in the latter tends to follow the trend in the former, the two are not always the same. During depressions, because of decreased em-
LOW
INCOMES
41
ployment the total pay rolls decline faster than the earnings of individuals who retain their jobs, while during the prosperous eras, because of increased employment the total amounts paid out in wages increase faster than do individual wages. For our purposes here, however, the total pay roll indices are sufficient. They do indicate the trend in wages for the workers as a group over a period of years, and this is what you wished to know. In any case money wages of individuals vary so greatly, and the wages of any individual fluctuate so much over a period of time, that it would be impracticable to use individual wages for comparative measurements to indicate a general trend. You ask whether wages have been rising as fast as the cost of living. The answer again depends on the years considered. The trend of real wages (money wages divided by cost of living equals real wages or buying power of wages) from 1890 to 1928 was generally upward. Paul Douglas, one of the best authorities, estimated that this period saw a 40 percent increase in goods and services for the workers. From 1929 to 1 9 3 3 , however, both real and money wages fell rapidly and the gains were more than wiped out. From 1 9 3 3 to the fall of 1 9 3 7 the total wages paid in industry rose a bit faster than the cost of living, so in 1 9 3 7 the working class as a whole was better off than it was in 1 9 3 3 . As I write, real wages are higher than they were in 1 9 3 3 , but not as high as in the early months of 1 9 3 7 . Those employees who are working have greater buying power than had similar workers in 1 9 3 2 , but they have not as much as they had in the spring of '37. You ask, too, whether wages have kept up with the productivity of industry. By and large they have not. Professor Douglas in his book on Real Wages in United States showed that real wages in manufacturing increased but 30 percent from 1899 to 1925, while the physical productivity of the worker increased 54 percent. There is no reason to believe that the trend has changed. During prosperous periods the productivity
42
LOW
INCOMES
of the worker has gone up faster than his wages have, and during periods of depression his productivity has declined less rapidly. It might be added that wages have also lagged behind the value added to each product by the process of manufacturing, and that they have lagged far behind the increases in horsepower equipment in industry. I cannot be optimistic. Like Mr. Kaczmarek, many American workers are not receiving enough to be self-supporting, and probably will not for some time to come, if ever. This is still true when certain qualifications are considered which make the picture a bit less gray. Some of the wage earners I have been talking about may, for instance, have been able to supplement their regular wages with earnings from other jobs which were held during slack periods. The additional amounts could not have been large, however. The Bureau of Labor Statistics estimated in 1 9 3 4 that "half of the workers who were employed by the motor-vehicle plants during the busy season earned wages of less than $947 from all types of employment throughout the year." Family incomes, it is true, are sometimes not restricted to one wage earner. In studies of wage earners in various cities it has been found that the total family incomes averaged from $ 1 0 0 to $400 larger than those of the chief wage earner because some other member of the family (like Mary Kaczmarek) also worked. On the other hand, while the above figures show the average wages, they are not completely representative because they include only manufacturing industries and average together the wages of skilled as well as unskilled workmen. Unskilled labor receives a much lower wage than skilled—for example, only $.44 an hour in July, 1 9 3 6 , when the average hourly wage in manufacturing was about $ . 5 7 . Many types of workers are more poorly paid than those in manufacturing, such as stenographers like Mrs. Randolph, laundry hands like Mr. Rolphe, retail clerks like Jerry, or country school teachers or hotel employees.
LOW
INCOMES
43
With all qualifications, the hard fact remains that the earnings of the majority of wage earners in the United States have not provided and do not provide a health and decency standard of living for their families. I well realize how ambiguous is this glamorous phrase "health and decency." I know from previous conversation with you that you are quite critical of the term, and rightly so. But let's not quibble too much about the words. T h e wage needed for a like standard does differ with place and time. Ordinarily the cost of living is a little lower in the South than in the North (though not as much lower as Southern chambers of commerce would have us believe). A higher income is necessary in Chicago than in a small Wisconsin town. As you know, too, the cost of living is constantly changing, and hence the wage needed to reach the standard varies. Nevertheless it is possible to estimate fairly scientifically, at any particular time and place, what money income is required to obtain the necessary quality and quantities of food for a family of any size. It is more difficult to determine the costs of adequate clothing, housing, medical care, educational opportunity, recreation, and savings and insurance, yet it is possible to make rough but usable estimates. For example, the clothing is usually supposed to be plain, warm, and sufficient in quantity to allow those changes that cleanliness demands. As a social worker you often have gone over budgets. There is not much use in going further with this phase of our discussion. Suffice it to say that in no case do the many health and decency budgets that I have seen allow much extravagance. In 1 9 2 9 probably $2,000 a year would have given a decent livelihood to an average family of five. Today in northern Wisconsin about $ 1 , 6 0 0 to $ 1 , 8 0 0 would do. As you point out, people, including some of our friends, sometimes declare (with barbed emphasis) that laborers could live well on their low incomes if they weren't so ignorant and extravagant. Well, perhaps they don't manage as well as col-
44
LOW
INCOMES
lege graduates (though I w o n d e r ) . But how do workingmen actually spend their money? What are the facts? T h e Bureau of Labor Statistics has recently made some very interesting studies of the expenditures of wage earners and lower-salaried clerical groups in various cities. These studies do not include those on relief or those with incomes of less than $ 5 0 0 . For this reason they are all the more valuable when the use to which wages are put is being discussed. Here is a table I happen to have at hand [Table 2 ] . It covers consumptive expenditure for
periods in 1933-35. Table 2. Average Income and Expenditures of Wage Earners and Low-salaried Groups in Various Cities Portsmouth, N.U.
Family income $1,402 per year Earnings of chief wage earner M51 Expenditures 1,369 Percent of income spent f o r : Food 34.8 Clothing 10.9 Housing 13-7 Household operation 15-5 Furnishings and equipment 3-6 Transportation 6.8 Personal care 2.0 Medical care 2-5 Recreation 5-7 Education .2 Vocation .1 Community welfare G i f t s and contributions outside family Miscellaneous items
1-4
Birmintham, Ala.
Grand Rap- Scranton, ids, Mich. Pa.
$1,440
$1,260
1,241 1,461
1,107
i,297
i,4'3
30.6
35-6
12.î
30.9 11.4 12.8
13-3 4-4
11.3
9.2
2-4 5-3 5-7 5 •5
New York, N.Y.
Columbus, Ohio.
Seattle, Wash.
$i,743
$1,404
$1,603
1,357
1,204
1,839
1,364
1.503 1.504
11.0 18.0
36.4 11.0 20.9
31.0 10.2 16.4
32-3 10.0
13.4
11.5
8.6
12.1
11.0
4-3 11.0
4-2 4-3
2.6
4.8
3-7 ri.1
2.1
3-9 5.0 .6
•3
3-5
9.8
4-7
3-8 5-6
1.8 2.2
.2 .2
2.2
.6
14.2
2.1
5-1 53 .8
•4
•5
1.6
1.8
•9
1.0
19
1.6
1.8
24
.8
•9
•7
LOW
INCOMES
45
In spite of our respectable friends and their uninformed comments it would appear that the workers in the United States are not extravagant. The above table indicates that laboring families spend, apparently must spend, at least 85 to 90 percent of their incomes on essentials. My contention is further substantiated when the statistics are again broken down and the family expenditures are classified according to relative income. As the income goes up the percentage expended for necessities like food and clothing becomes less. As the income goes down the percentages for recreation, transportation, and medical care grow less. This little table [Table 3 ] will illustrate the relation between medical care and income in N e w York City. Table 3.
Income and Medical Care
Income per Consumptive Unit of Family $300 300-400 400—500 500-600 600-700 700-800 800 and over AVERAGE
of Medical Care m Dollars per Member $ 4.70 8.29 13.10 18.05 21.17 25.OI 4°-97 $1749
I suppose workers, because of ignorance, do often mismanage their little income, but as the income goes down they economize on health too; they are the people who most need adequate medical care, and they can least afford to pay the $ 3 6 or so per year that this adequate care would cost. Medical care may be an extravagance which only the rich should have but I don't think so and neither do our respectable friends. You stress the fact that the Kaczmareks haven't been extravagant. How could they be on Mr. Kaczmarek's wages? If
46
LOW
INCOMES
they spent four or five dollars a month on shows, trips to the beach, and ice cream, if Mr. Kaczmarek drank a beer now and then, or bought a package of Mail Pouch, that still wouldn't be extravagance. Extravagance is relative and a matter of opinion. That last hat of yours was an extravagance to me, though I do think that it's just too stunning and becoming for words. Yes, extravagance is a matter of opinion. Remember the excellent panamas I saw at Knox's Fifth Avenue store last spring, only $ 7 5 to $500? Does Mr. Kaczmarek have a straw hat, perhaps purchased at Montgomery and Ward's two years ago for $ 1 . 2 9 ? Some of the choice New York penthouse apartments are now available for around $ 1 5 , 0 0 0 a year. Did the Kaczmareks pay more than $3,000 for their house? Rats! L i f e is full of "zounds and fooey," as Hyman Kaplan said. One of the fooiest of all is poverty in the midst of plenty and extravagance. I shall now make zounds about it. My academic calm is fleeting this evening, isn't it? Stark and real is the fact that a great many earners in the United States do not earn enough to make themselves and their families independent and secure. Mr. Kaczmarek is not an exception; he is but one of many. Some skilled craftsmen, like the printers and railroad engineers, it is true, obtain wages which allow them more than necessities. But as I pointed out earlier, the reality cannot be dodged that 42 percent of the 27,000,000 American families received less than $ 1 , 5 0 0 even in fabulous 1929. In 1929, $ 1 , 5 0 0 was not a health and decency wage by any reckoning. If some hardheaded skeptic needed further proof, other studies, like the following, would substantiate my case. Perhaps, having been a case worker in Chicago, you know the study made in the good business year of 1 9 2 5 to test the validity of the Chicago Social Agencies standard budget for dependent families. In that year $ 1 , 9 6 2 was set as a minimum
LOW
INCOMES
47
health and decency income for a family of five. Though the 467 families of wage earners studied were more stable than most similar families, the income of 89 percent of the chief wage earners was less than $ 1 , 6 0 0 . When all the income of the family (wages of mother and children, income from roomers, g i f t s ) was considered, about 70 percent of the families had less than the required $ 1 , 9 6 2 . Some people may object and say that $ 1 , 9 6 2 far exceeded what was necessary for health and decency then. Probably the contrary would be closer to the truth. But for the sake of argument let us say that $1,600, the approximate amount the charities of Chicago thought necessary for dependent families, would have been sufficient. Then, 45 percent of the families would not have had even this standard. If it be objected that even $ 1 , 6 0 0 was too high, listen to Dr. Leila Houghteling, who made the study: Analysis of the general living conditions of the whole group and of the f o o d consumed by a smaller number of families, has shown quite clearly that the families living on a lower standard than that provided by the budget estimate ( $ 1 , 6 0 0 ) are living under conditions that f a i l utterly to provide a standard of physical, mental, and moral health and efficiency of adults, the full physical and mental growth and development of children, and provision f o r their moral welfare.
Another study that I think would interest you is one made by the Children's Bureau of the annual earnings of 469 section hands in ten states for the most prosperous year of the golden glow, 1 9 2 8 . N o earnings were above $ 1 , 2 5 0 a year. About 78 percent were below $ 1 , 0 0 0 . If all the earnings and income of the families were considered, 85 percent received less than $2,000 and 73 percent received less than $ 1 , 5 0 0 . Here again the conclusion is pertinent (impertinent to our respectable friends! ) : With all their efforts, the living they got was usually all too meager, and the children were brought up in miserable houses—overcrowded,
48
LOW
INCOMES
poorly constructed, and with little in the way of modern plumbing —and in undesirable surroundings- They seldom went hungry, but their food was often monotonous and inadequate. All too frequently their clothing was shabby and patched, and repeatedly it appeared that normal social life and recreation were not enjoyed because of the condition of their clothing.
All our discussion of a health and decency wage and all the indignation aroused by the failure of American industry to pay this wage to all workers would be futile if such a wage were not possible. There is, however, little doubt that the rich soil, the inventive genius, and the great industry of the United States could produce enough to permit families like the Kaczmareks to earn at least a health and decency wage. Yea, verily! I should like to be a demagogue and shout this from the housetops with Bryan's silver tongue to the applauding millions. Remember, though, I said could produce, not did. Unfortunately the farms and industries of the United States have probably not yet produced enough to give every citizen a good living. In 1929 American families would have received $2,800 if the national income had been equally divided among them. This amount would have been adequate, but had the equal division been made, nothing would have been left over to maintain and improve the productive industries or to provide for levels of income varying with the social usefulness of the workers. Now it is a simple economic fact that, year in and year out, income roughly equals production, that the greater the total production the greater the total income. It is consequently a sound economic premise that production must be increased before incomes increase. Fortunately America can increase production. The Brookings Institution economists estimated that the industries of the United States in 1929 could have produced 19 percent, about $15,000,000,000, more than they did produce. Other estimates run even higher. A group of engineers and
LOW
INCOMES
49
economists whose work was financed by C W A funds thought our industrial plant could have produced $ 4 , 3 7 0 (instead of $ 2 , 8 0 0 ) per family in 1 9 2 9 . Let's be conservative, however, and see what the Brookings estimate would mean to families like the Kaczmareks. I quote the study: Such an increase in the national income [$15,000,000,000] would have permitted enlarging the budgets of 15 million families to the extent of $ 1 0 0 0 each, [or] adding goods and services to an amount of $765 (on a 1929 price level) to every family having an income of $2500 or less in that year, [or] producing $608 worth of additional well-being for every family up to the $5000 level, [or] raising the incomes of 16.4 million families whose incomes were less than $2000 up to that level, [or] increasing all family incomes below the $3500 level by 42 per cent, [or] adding $545 to the income of every family of two or more persons, [or] giving $ 1 2 5 to every man, woman, and child in the country. Y o u may have noted that the Brookings report speaks only of possible production in 1 9 2 9 . Today because of technological advances the United States could produce more. Perhaps Stuart Chase isn't too wild when he claims that we could attain the astounding sum of $ 1 0 , 0 0 0 a year per family. A l l this may sound like wish-fancy; I am skeptical of prophecy and prognostication myself. But one doesn't need to build air castles to believe that a health and decency standard can be obtained f o r the Kaczmareks and for all who work. It is, of course, easier to speak of possibilities than to realize them. But listen to my argument a while longer. Just now reality tells me that it is time for bed if I'm to rise at eight. W h e n I write about astronomical sums I think I'm Alice in Wonderland. Tomorrow I shall return again to this world of reality. Tonight you may visualize me as a dying pipe projected from a Cheshire grin. N e x t Day at 7 : 0 0 P. M. Last night I pointed out that production and therefore income could be raised by at least a fifth. Under a capitalistic
50
LOW
INCOMES
economic order with production carried on by private corporations the task will not be easy or simple. Nevertheless it can be done, though the Horatio Algers may all have disappeared. The capitalistic economic system may not be able to stand up under its inherent contradictions, but it has produced goods and can produce more. How? May I give you a brief outline? (I haven't time to write, and you wouldn't have time to read, a book on this subject alone.) Increased production and income are possible: 1. If every time technological progress results in lower costs of production, prices are lowered so that consumers can buy more. Lower prices mean a lower cost of living which in turn means higher real wages (wages in terms of buying power). I recall that in an earlier letter I stated that lower priccs do not ncccssarily mean less profits. Lower prices will often bring about such greatly increased sales that net profits can be maintained or raised. 2. If the wages of the industrial worker and the income of the farmer are progressively raised without a corresponding rise in the price of goods. Until greater production ensued, profits would be necessarily though not permanently reduced. 3. If employers and employees (cooperating through unions) continue to make their industries more efficient, less wasteful. 4. If our nation remains at peace and does not wage war. War, it is true, would temporarily call for increased production in certain lines (i. e., steel) but the increased amounts of goods would be used for destruction and would be themselves largely destroyed. N o real and permanent increases in the total national income would result. In the end, because of the destruction and economic maladjustments occasioned by the war, we would be poorer than before. 5. I f , when peaceful conditions again prevail in the world, tariffs are lowered, trade quotas are abolished, and foreign exchange is stabilized at a predictable level. If trade barriers are
LOW
INCOMES
51
lowered each nation can specialize in those things which it is able to produce most cheaply and efficiently. We, for example, can make automobiles more swiftly and inexpensively than can Frenchmen. The French can make many luxury products better and more cheaply than we can. A lowering of tariffs would reduce prices, increase the demand for goods, and hence increase production in all countries. Stabilization of foreign exchange would enable business to produce for foreign trade with some certainty of selling its goods at a profit. 6. If the various governments, federal, state, and local, will subsidize socially useful production in those fields like housing where private industry has lamentably failed. I don't mean that the governments should encourage made work. I mean just what I say, socially useful production. 7. If the federal government will take further steps to control monopolies and price-fixing associations which restrict production; if the government itself will not, except in rare cases, promote restriction of production as it did through the AAA. Y o u have, of course, noticed that I prefaced each of the above statements with an " i f , " and you have remarked to yourself, professorial theories again! Perhaps so, but theories which have some substantiation in fact and practice. Theories, yes, but theories well grounded in economic fact. These theories are better founded than the fancies of the Harding-Coolidge era when economic laws were supposed to work automatically and thinking was lost in the golden haze. Suppose, however, that the above proposals are impracticable at present. I don't think so, but let's make the assumption. Increased production is the most effective way to raise wages and incomes, but wages can be raised too by distributing the total income of the country differently. I am not here suggesting an equal division of wealth and income. That may be desirable, but its realization is far in the future. I do suggest a
52
LOW
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different distribution, more equal than we have had. T o obtain this different distribution, the federal and state governments, the employers, the workers themselves, all must act. Let me begin with the employers. Employers and managers are finding that it pays today to engage in a number of activities for the workers which add to real if not to money wages. A considerable number of the activities partake of the nature of welfare work as the case worker might conceive it, and employees often quite rightly resent the too apparent paternalism. There is a legitimate place for these employer services to the employee if they are rendered with no strings attached. Company housing and company stores, with few exceptions, have been established for the employer's profit, with strings attached and not at all for the employee's benefit. On the other hand, employers do sometimes provide recreational and medical facilities for the workers which the latter cannot otherwise afford. I doubt whether plant-sponsored recreational or medical programs have added or will add much to the workers' income. Every bit helps, though. More remunerative to the worker are the plans adopted by relatively few companies (compared to the whole number), plans for profit sharing, employee stock ownership, group insurance, mutual benefit associations, and various types of pensions. The last, pensions, are being taken over by the federal and state governments, as they should be. I shall not discuss them except to say that in isolated cases in the past they have been the means of continuing a workman's income when he was unable to work. Let's turn to the other possibilities. When employers establish or instigate mutual benefit associations and group insurance plans, the costs of insuring against the hazards of life become less for the worker as risks are diffused, and sometimes the employer takes part of the burden. To the extent that more protection, and protection at lower costs, is available, the workman's income is raised. By 1 9 3 2 about 7,000,000
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53
employees were covered by plans of this type and material savings for the worker ensued. O n the surface it would seem that profit sharing and employee stock ownership would be excellent ways to supplement wages. They have never been, and probably never will be, of great significance because the employer does not desire to share profits until the stockholders are satisfied (which is seldom). A n d employees, like M r . Kaczmarek, do not make enough to buy stock even if the price of the stock is reduced below market levels. Then, too, labor unions object strenuously to these kinds of " s h a r i n g " because they tend to make some workers "capitalistic" and do not materially aid most of them. Nevertheless, these plans should not be lightly or contemptuously dismissed. In a f e w cases, employees have really benefited. It has been estimated that over a half-million workers own stock in the 1 7 0 companies which have plans for employee stock ownership. M y own belief is that good management is the chief contribution the employers can make to the workers' welfare. A l l the other employer plans and devices ease the pain, but they don't effect a real cure. It is best that workers be given higher wages instead of services and stock, and that they be allowed to manage their own incomes as they please. Can the employee help himself? H e can in several ways. H e should try to obtain all the education and training he can. H e should join a union. It is all too true that many workers do not take advantage of their still-limited opportunities for vocational training. It would seem to me that you as a social worker would do well to persuade your clients to use every available educational resource. Of course it may be too late for Mr. Kaczmarek to help himself much by more training, but millions of others are younger than he, and can use all the training they can obtain. Does M r . Kaczmarek belong to a union? The old adage " i n union there is strength" is truer than ever where labor is con-
54
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INCOMES
cerned. Business is organized into huge combinations of capital especially in Mr. Kaczmarek's steel industry. Against these combinations of capital the individual laborer has little chance. Two hundred years ago conditions were different; capital was not organized and the journeyman dealt directly with the master. Can Mr. Kaczmarek interview the chairman of the board of directors or the president of his company today? If he and his fellow workers are organized, they can cope with company officials and can demand higher wages with some hope of obtaining them. Unionization is no panacea. Union men do not always receive higher wages than nonunion. And if unions push up wages, the employer often raises prices and thereby partly negates the workers' gains. And when prices are raised, demand may fall off and wage earners may lose their jobs. Nevertheless unions are helping and will continue to do so. Without the United Mine Workers the wages of coal miners would be lower than they are. The employers often cannot pass on all the extra costs when wages are raised by union effort, and even if they could the extra costs will not fall on the workers alone, but will be spread among all consumers. There are other ways in which unionization may help. T h e Amalgamated Clothing Workers pursues several policies which serve to raise wages materially. It has cooperated with employers in lowering production costs. It has aided in setting production standards. It has been able to cut down labor turnover (changes in personnel) in its industry. All these have enabled the employers to pay higher wages. T h e Amalgamated, too, has built cooperative apartment houses and operates a workers' bank and consumers' cooperatives. Several
unions
maintain homes for their aged and benefit systems for accidents, sickness, and death. In so far as cooperatives and union insurances and benefits lower the cost of living the worker's real income is raised. You, as a case worker, I as a teacher, ought to urge cooperation and cooperatives long and often. In Sweden,
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55
Great Britain, Denmark, and Norway the workers have pulled themselves up to a higher standard of living by excellently managed cooperatives. Why shouldn't the American worker? Why not Mr. Kaczmarek? Do not forget, however, that the wealth and income of any country depend not only on the production of the individual but on the policies of its government. If the government maintains peace within and without, then, and only then, is it possible to develop natural resources and increase the production of useful goods. The last war has cost the United States fifty billion dollars already and will cost as much more. Think of what this hundred billion dollars or so would mean if turned into wages. When a shell is shot, the steel itself and the property it destroys are both gone; wealth has gone up in smoke that might better have been used for clothes to wear, food to eat, houses to live in, a doctor's attention to keep healthful, or a park for play. The government ought to be much more than a policeman, however. The days of laissez faire, or less government in business, were going in the fabulous day of that Puritan in Babylon, Gil Coolidge, and were ended forever in the depression. I believe that federal and state governments should enact specific measures which will raise workers' incomes. In many ways various government services already contribute to real incomes. You and I as state employees render services in relief and education for which the people of low income do not pay directly or completely. Federal, state, and local governments build and maintain schools, post offices, highways, and bridges. And these are usually free to all and really increase our income and standard of living. Government services which directly or indirectly benefit the worker and raise his standard of living are more numerous than is commonly known. What about the Women's Bureau, the Children's Bureau, the Department of Labor, employment offices, and all the various governmental
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LOW
INCOMES
contributions to the various insurance and pension systems? W h a t about street lights and sanitation and vocational schools and parks? Don't all these and many other government activities raise the worker's standard of living? W i t h o u t present government aids I doubt whether most workers could afford education or even pure water. I think our governments should go further. Medical service should be provided on at least a partly socialized basis for those w h o cannot afford it, and governmentally administered health insurance should be provided f o r all workers. Subsidies for housing should be far larger than they are. As perhaps a half of our population live in substandard dwellings, a housing program should be part of a permanent government public works program. T h e federal, state, and local governments could profitably and usefully stimulate the spending of twenty billion dollars in the next ten years for housing, through loans and partial or complete subsidization. T h e workers' standards of living would be raised as rents were lowered and as housing was made more adequate. Naturally, government services cost money, and most of the requisite funds come from taxes. Increased government services will not raise the worker's standard if he pays for them all through taxation. More and more, the burden of taxation should be shifted from the poor to the rich. Under a capitalistic system it may be economically unsound to soak the rich because the rich control the productive wealth. But progressive income and inheritance taxes should be made to provide a larger proportion of governmental revenues than they do, and taxes like those on sales which fall heaviest on the worker should be lightened. If the owners of industry will not pay higher wages than they have been paying, then there is no alternative except to redistribute wealth and raise the workers' incomes through taxation. For the benefit of the most poorly paid workers the federal
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57
government in 1 9 3 8 passed a Fair Labor Standards Act which has minimum-wage provisions. This is a step in the right direction. The law makes it mandatory for employers (except in agriculture, purely intrastate commerce, and a f e w other fields) to pay their employees at least thirty cents an hour now and during the next five years, and thereafter forty cents. A minimum-wage law of this kind does not, of course, effect a material change in the distribution of income. The employers can still raise prices to offset partly the increase in wages they are forced to grant. Then, too, the present law will affect only a few hundred thousand earners in manufacturing, just those who are receiving less than thirty cents an hour. Some of the lowest paying industries like canning and agriculture are exempt. Nevertheless, the law helps some workers approach a subsistence income more closely than they ever did before, and it eliminates some of the most vicious exploitation of labor. Someday we should attempt to obtain minimum annual income legislation. W e should never be satisfied until all who work make annual wages which will enable families like the Kaczmareks to live in comfort. As you point out, some companies never seem to be able to pay decent wages. T o those not able to pay at least the present minimum we should say, " W e are sorry, but if you pay a lower wage you are a social parasite. We'll have to hold you to the minimum wage because if you don't pay it society will be forced sooner or later to make up the deficit with relief." A minimum wage, progressive taxation, and all the suggestions I have made are not cure-alls. If put into operation they would not make America a Utopia for workingmen. It is entirely possible that the only real way out is government ownership of the major means of production and, to use a much-abused phrase, production for use instead of for profit. But read Norman Thomas for yourself and see what he has to say. The suggestions I have made are possible without revolution and within
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the limits of a much-modified capitalism. Norman Thomas, or Earl Browder for that matter, may be right and I wrong. Thank God, in America we still have a chance to find out through free and open discussion who is right. Thank God, we still have a chance to determine what must be accomplished to enable Kaczmarek to earn his bread. I might keep up all night with suggestions. Fortunately for your sake, I'm not intending to exhaust the subject. The subject has exhausted me. My single bed invites me at the bewitching (and here quite forlorn) hour of ten-thirty. Hope to see you soon, Your dutiful husband, CARLISLE
P.S. Don't forget that chocolate cake you promised me. And make the icing thick.
OLD AGE
SOUTHTOWN, TUESDAY
WISCONSIN EVENING
M Y DEAR CARLISLE :
So much has happened that it seems ages since I left you on Sunday afternoon. I trust that my telegram yesterday relieved your worry. I am absolutely dog-tired. I feel as trembly and worn as old Peder Olson, but let me start from the beginning. About eight-thirty Sunday night the Plymouth and I were mournfully sitting in a ditch on that bad detour near Sioux Rapids. I waited an hour for the rain to slacken, but it didn't; so I finally got out in the mud to walk for help. A half-mile away I came to a sad old tenant house leaning against the fence, the rain sluicing in torrents off the eaves. A square stolid woman let me in and gave me a seat by the range to dry my feet. A whole Norwegian family, Olson by name, were there in the kitchen-living-room spending a quiet Sunday evening at home. An old man with bushy white hair was playing solitaire at the table. A long-jawed young man sat with his feet up on the oilcloth-covered table reading Collier's. And in an old cane rocker a buxom adolescent daughter with frizzled blonde hair was rocking herself lazily back and forth. The room was chilly; rain dripped in under the window sills and wind blew up through the cracks in the floor. The air was stale with the smell of damp boots drying behind the stove, work shirts soaking in a pail, doughy lefse, potatoes fried in lard, cow barn, and age-rotten wood. The furnishings were
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scanty: a few straight chairs, the rocker, a table, no rugs, and across the front window one skimpy strip of lace. After discussing my predicament it was evident that I would have to spend the night there, because the Olsons had no telephone, and no horses to pull my car out and neighbors were a mile and a half away. The girl Matilda offered to share her bed with me, but after one look at it I told Mrs. Olson I could sleep well on two chairs placed together near the stove. The family were quiet and no one seemed anxious to talk. Finally Mrs. Olson and I discussed the bad roads and the storm. The conversation passed to other topics. She said that she had not been to town for several months because she had no shoes or clothes fit to wear in public. She was wearing a nocolor washed-out house dress and a piece of gray blanket pinned around her shoulders. "Times can't get much worse," she stated, "Paw's too old now to work and I ain't so spry any more. The kids, they ain't able to help much." Pete, the son, became suddenly angry with his mother and told her to quit crabbing. The children were all doing the best they could, he insisted. Pete works as a hired man for a Mr. Jacobson, earning $15 a month plus his board and room. When he gets Sunday afternoon off he spends it with his folks. His voice was rough and edged with irony when he said, "I'd like to rent an eighty someday. I'd even like to get married before I'm an old man. But it don't look like there'll be a break for me." Matilda, who had been rocking and staring at me since I arrived, had her say too. She burst into the conversation, expressing bitter resentment—called the home a dump and said there was nothing for her to do. She couldn't go to high school, couldn't get a job as a hired girl, and her parents wouldn't let her go to town to try to get work in the overall factory. Mrs. Olson tried to calm her by telling her she was all that was left at home now. That started Matilda on an outburst against Olga, an older sister now married.
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"Olga went to high school, she got to go to dances and to church suppers. When she was my age she even had a beau, I remember. Y o u just wait 'til I'm old enough; I'll do what I want to, I will!" "Don't be smarty, Tillie," the mother said. "Talking back don't do no good; I found that out long ago. Maybe someday times will be better." After a while all but M r . Olson went to bed. He put more wood in the stove, filled his pipe, and drew up a chair by the fire. He had been so withdrawn all evening that I was surprised when he began to talk. Pulling softly on his pipe and speaking in a slow deliberate way, he told me of his youth in Norway, of his grandfather who taught him how to fish, and of his father whose parting words were "Fear God, be honest, work hard, and do good to all men." When Mr. Olson first came to this country he worked in a fish house, then in a butcher shop which he later purchased. In twenty years he had saved enough to buy a farm. Becoming a citizen, he served on the school board. He married the young schoolteacher. The farm prospered and the family increased. Of the four children, all but one were girls. Olga married a farmer; they now have three youngsters and a heavily mortgaged farm. Hilda, who is unmarried, works as a hired girl for a doctor at three dollars a week. Pete has always talked of going away to school to become an architect, but is now working as a farm hand, earning the family rent and $ 1 5 a month, half of which he gives to the Olsons. Mr. Olson lent money to his relatives, borrowed heavily for machinery, and assumed a mortgage on a near-by farm for a cousin. He found himself in debt at the beginning of the depression and never got out. T h e bank foreclosed in 1 9 3 1 . The Olsons then rented a farm, but the drought of 1 9 3 4 took all their livestock. Mr. Olson's health was too poor to permit him to start again; at the age of sixty-seven he gave up farming. "Nobody would hire Peder Olson, not even to milk vun
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cow," he said. When I asked about an old-age pension he replied that he had made application for one and expected to receive it sometime this summer. " D a pension vill help. Ve vill have meat to eat vonce in a vile. I can buy vood for da stove, maybe move to a better house. Mama, she can buy dress. Pete vill not have to vork out da rent and can save so he can rent farm for hisself. Maybe da doctor fix me op so I can vork again. I know many tings about da farm; I vould be good help vere I strong man again. Now, I do noting, noting, yust sit by da fire." All night I lay awake on those hard kitchen chairs and thought about Peder Olson and other old people I knew. How utterly unjust, even ironical, to have the accumulations of a lifetime of hard work vanish at the moment they are most needed! Peder Olson slaved years for a farm on which to spend his last days in comfort, for a farm which he might eventually give to his son. Like so many others, he lost his farm. Most men and women I know, by the time they reach sixty-five, seem either to have lost what they have saved or never to have earned enough to save. They either give up all hope or, like the sanguine Townsendites, deceive themselves with fantastic dreams of prodigious treasure. So many people today, having pursued their daily bread all their working years, arrive at that dreaded period, old age, with no savings, no more earnings, and hence no independence. At best they receive a sort of consolation prize, an old-age pension. Tell me, how many of us in this country are over sixty-five years of age? I am beginning to feel rather ancient myself. Do you realize that we have only to live less than once again our present years and we too shall be old folks? The forties used to be associated with nothing worse than baldness for men and plumpness for women, but now, judging from welfare experience, it evidently means joblessness. After all, when does a
OLD AGE
63
person become "old"? A man ought to reach his highest stage of mental development after forty, but apparently, in spite of Walter Pitkin, life doesn't begin at forty for many. Do you suppose that we shall grow old faster than our parents? It seems very likely when I interview men like a Mr. Dubowski who applied for relief last week. He was not taken back at the auto plant after the usual summer layoff, and has been idle for ten months. Although he is only fifty-seven the company considers him too old to keep the pace of the assembly line. Mr. Dubowski does not look old; in fact, with his military carriage, his black handle-bar mustache, and his guttural bark, he seems more like a forty-year-old top sergeant than a discarded factory hand. However, he is rather thin and nervous after years of the speed-up, and lately rheumatism has begun to stiffen his joints. Ten years younger than Peder Olson, he is in much the same position. He has a wife and two children at home. There are two older children, a son and a daughter who have married and have families of their own. The Dubowskis received relief only once before; in 1932 when their ten-year-old son was drowned. Wages were very low then; Mr. Dubowski averaged about $ 1 0 a week. However, he said his wages have never been over $30 a week since that time, and last year, with a seven-week layoff, they averaged $20. I talked to him about other work because I feel that he isn't really old yet and of course not old enough for a pension. He should be able to find another job. Do you think he has a chance? His savings of $300 are exhausted and his only resources are an insurance policy for $500 on which he has borrowed heavily, a secondhand 1930 Chevrolet, and rickety household furniture. Two hundred and fifty dollars would more than cover his total assets now. It seems strange that Mr. Dubowski doesn't have more after a whole lifetime of work. A few
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years back I would have called him improvident; today, I'm not so sure. With his low wages and irregular employment, how could he save? What do you think? Of course, I know one way we try to meet the problem of old-age dependency: old-age pensions. There are so many persons receiving old-age assistance in this county that I'm beginning to suspect that everyone is presented with an application blank the month before he is sixty-five so that his first check will be ready as a birthday gift. Oh, it isn't quite that bad— I seldom exaggerate more than fifty percent. There has been a definite increase in grants for old-age assistance, but how much I don't know. Perhaps you know the total number of dependent old people. How do you explain this boom in aged pensioners (and old-age relief recipients, too), Mr. Social Cause and Effecter? Are we just sentimental softies when gray hair is involved? I don't trust myself or county boards or legislators to be objective when it comes to grandmother. On the other hand, when I think over the old people who are securing help I cannot see where we have been at all generous. There is no mistaking the need of a feeble old lady without relatives, of a pathetically poor invalid requiring constant medical care, of a grouchy bachelor of eighty who has always before been selfsufficient, or of a stubborn old witch who refuses to leave her foreclosed farm which is the last mark of a former affluence. Only one case that I know of received a pension when not in need: a Norwegian woman who could not understand English. She signed an application blank stating that she had no money in a savings account and later $ 8 5 0 was discovered in the bank. In former years parents depended upon their children to keep them in their old age. They coasted along on family good will, the traditional insurance against destitution. But today relatives who will take care of the old folks are scarce. The Wisconsin law holds children responsible for the care of their parents, but the legal phraseology offers easy evasion. It en-
OLD A G E
65
forces responsibility only upon the children "of sufficient ability, having due regard for their own future maintenance . . . " ; such terminology can be interpreted to suit the convenience of anyone wishing to shift his burden. It seems as though more children could help if they only would, but they won't. Why not? I remember a quavery old woman who was dumped in the relief office not long ago by a stout shrill-voiced daughter who said she was washing her hands of her mother. The daughter had a family of her own and could not afford to feed an extra mouth any longer. The old lady had three other children and we discovered that they felt the same way. Another old woman, I recall, was more resourceful. After she secured an old-age assistance grant, she persuaded her five married children to buy her a trailer or house car and she lived in that, moving it every month or two to the back yard of a different relative. Each child was apparently willing to give her parking space and fuel, even though they could not help with food and clothing. Neither of Mr. Dubowski's married children admitted the ability to help him. Bessie, whose husband is a steel worker, said, "Jerry earns $ 1 0 0 a month when the plant's working full time. When he don't get full time, which is mighty often, we have to live on what we manage to save. With two kids to take care of we just can't help at home." The oldest Dubowski boy, who drives a beer truck and looks like Dempsey, said he wished that he could help his parents, but " M y job isn't steady. I haven't even paid the doctor bill for when the boy was born. Since I was a kid of fifteen I've worked and taken care of myself. I ain't goin' to starve myself now to feed the kids still at home, no ma'am." Well, there we are! Don't you think it alarming, more elderly people getting old-age assistance and relief every day, many of them in need because their children refuse to assume their duty? How can we stop it?
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Growing old did not present such a problem in my family. I can remember both of my grandfathers. One was a pioneer farmer who kept the home place thriving until his death. True, he died in his late sixties, but until he went he enjoyed the products of his land and the prestige that comes to the head of the family. The other grandfather was a missionary and teacher among the Indians for fifty years. He retired at eighty and spent the last two years of his life with the family of his eldest daughter, reading and reminiscing, revered as almost a saint by us grandchildren. Old age seemed to hold no fear for them. It was a natural stage in the development of a full life, not a dread disease as it seems today. At Dubowski's age my grandfathers looked forward to years of economic independence, or care by their children if necessary; today, all Mr. Dubowski and men like him can expect is dependency on a pension. I'd like to ask you a few questions about these pensions. If the government is trying to assure basic essentials to the needy of over sixty-five why are the old-age grants so small? Y o u and I both know that Mr. Olson cannot care for himself, not considering Mrs. Olson and Matilda, on $ 2 0 a month. Our county pension board insists that pensions cannot be higher. The average monthly grant last year was $ 2 1 . 3 5 . H o w do we compare with other counties and other parts of the nation? Do you happen to know the total number of persons receiving old-age assistance? I do not see the essential difference between old-age pensions and relief as they are given today, do you? They are both granted according to need, and give about the same allowance. This plan seems to segregate the old people and increase administrative work needlessly. What is the difference to Mr. Olson if he gets a pension or relief since he must face the embarrassment of a means test anyhow? Of course if there were no means test, pensions would have to be given to everyone who asked. Is it conceivable that all the Olsons and Dubowskis, every
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person over sixty-five, could be given a grant? Are the Townsendites as crazy as they sound? I am bothered too about the danger of undue political influences shaping the administration of old-age assistance, especially as the number of pensioners increases. There is very little political interference or dictation around here, but I have seen allegations in the newspapers. It seems that almost all political candidates feel it now necessary to take a stand for higher pensions. Old folks can vote and they are promised the world for only an X . To give them that world is quite another thing, usually forgotten by post-campaign legislatures. But isn't there danger that the aged will be helped at the expense of other needed social reforms? You perceive I have a feeling that something is wrong, but not sufficient insight or adequate facts to define the trouble or to point out a cure. Is this just feminine intuition that is leading me on a goose chase? Does the masculine scientist have a one-two-three plan? I am truly more serious about this than you imagine. Soon we too shall be old; some of our relatives are already. The Social Security Act does have another provision for old age, the insurance scheme. I've read a few bulletins on the act, but still have a lot of questions. Old-age assistance is easy to understand—it is so much like relief—but the calculations for the benefits are confusing. They must be a composite of complications invented by people whose fathers were insurance agents, and my father never could sell insurance. Charlie, the clerk in the drugstore where I usually stop for coffee, was asking me the other day about these benefits or annuities, or whatever they are called. He said, "Someone was in here yesterday tellin' me about the new benefits. He said I was goin' to get more now. You helped me figure it out once before that I'd get $25.25 a month when I'm sixty-five. What's Congress tryin' to do, fool around and gyp me or am I goin'
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to really get more? I always thought that $ 2 5 . 2 5 was darn small, but if I'm goin' to get more now, just how do they figure it? The government is takin' the same amount out of my pay check, and the boss said the other day the tax wasn't goin' to be changed like it was. I hope not. Seventy-five cents may not look like much to you, but on my $ 7 5 a month it looks big, 'specially when you don't know what those politicians are doin' with your money down there in Washington. A fella' was sayin' here today that they were goin' to use the money up and tax us again before we get our benefits. The way it stands now, I'd be ahead to take a pension. Old Frank Hill takes in $ 3 0 regular and never had to pay the tax either. "Understand me, I'm not kickin'. I suppose the Missus and me ought to be glad I got somethin' comin' in when my joints are stiff. But if I ain't goin' to get $ 2 5 . 2 5 , just what am I goin' to get? What's goin' to happen if I should kick the bucket, will they just take the money? I'm forty-eight now and a lot a guys like me don't Jive to any ripe old age. If they're goin' to just take the money when I die, maybe I'd better lay aside the seventy-five cents myself. It's a pretty good thing, this social security, but I'd like to get it straight, just once." I sat down with Charlie and tried to compute his benefit, but I'm not certain I had it right. Just how would you figure it? Charlie is forty-eight years old and earns $ 7 5 a month, and his wife is seven years younger than he. A l l Charlie could see was that he and his wife could not live on $ 2 5 to $ 3 0 a month. I tried to convince him that his return would be much greater than his investment, but I too had to admit that the payments would be low. Couldn't the government make these benefits at least as high as old-age assistance? Several other points perplex me as well as Charlie. Will the tax remain at one percent? If it goes up to three percent as originally planned, the low-wage workers cannot afford this tax plus unemployment compensation taxes and the inevitable rise in prices through which employers will pass on their tax
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to consumers. Then too, what is going to happen to the reserve fund now? W e talked about it one day and I know you were opposed to the huge sums being laid aside. I may be dumb, but can't the government pay out these benefits as the money comes in and eliminate any storage of idle cash? I suppose I should know all these things but I just haven't had the hours necessary to make a thorough study. I'm not even sure who is covered and who isn't. N o w I don't pay a social security tax because I'm working for the government. The farmers don't pay a tax because they are working for themselves. Who is covered, then, and how many individuals does that include? If only part of our population is protected, what will happen to the others? It seems to me that the Peder Olsons, the Mr. Dubowskis, the grandfathers and grandmothers have something to contribute to society even in their old age if we knew how to use them. Giving them $ 2 1 . 3 5 a month and placing them on a shelf is a form of social wastage. If we are to support an increasing number of unproductive aged and get nothing in return, our system will be thrown off balance. Better to sail off in a ship never to return, like the Eskimo grandpa, than to live on as a useless burden. Communities should find a function for their oldsters. They would then have more of a reason to live beyond sixty-five. I didn't intend to retire from all activity at that age. N o more than Peder Olson do I want to sit by the fire. I hope I can continue to be useful to society as long as I have my senses. Life is too interesting; it seems a shame that we have to accomplish all in sixty-five years. I wonder what plan of security will be in effect when we reach old age. Do you see any farther ahead than I? Will relief and our present annuity plan prove to be the best solution to the problem of old age? I must stop. Late hours do not add to my youthful appearance. Even if it means one more gray hair among the red I hope you will take the time and have the patience to answer
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this letter. With promise of all my love until I am sixty-five— after that, my passion may be a pension instead! Always yours, CAROL
STATE LAKEVIEW,
DEAR
COLLEGE WISCONSIN
CAROL:
I told you to drive carefully and to stop if it stormed. Was it your sense of social responsibility or your obstinacy that made you go on? Social workers do indeed feel a deep sense of social responsibility if they are willing to risk their own lives and health in a terrific storm just to avoid returning to the job a couple of hours late. If my opinion about social problems is as carefully heeded as my advice about driving, perhaps I should not write you these letters. In America a wife is free, thank goodness, to disregard her husband's or any male's advice. But I'm just a little exasperated, and I can't resist an " I told you so." Like roads, people get old. Unfortunately no detours are possible while repairs are being made. Mr. Olson can hope for little more than a chair by the fire. Cruel as it may seem, I'm afraid his creative, constructive life is over. There is nothing for him to do in the future except to hope for whatever bread he can obtain with a monthly pension of twenty or thirty dollars, to play around with his hobbies, if he has any, and to live with his memories. One should not become too exercized about one or two cases. ( Y o u social workers really need this advice.) There are millions of Peder Olsons. Approximately 8,200,000 people are over sixty-five years of age. Two-thirds of them are wholly or par-
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tially dependent. Both the percentage and the number of old people in the total population are constantly increasing. Medicine and science decrease the death rate but do not stimulate the birth rate. Now approximately 6.3 percent of our population are sixty-five and over. By 1980, from present indications, probably 14 percent will be. There is no evidence that you and I shall live longer than our parents or that our children will live longer than we, but since infant mortality is lower and fewer children are being born, the population as a whole is getting older. When is a person old? I suppose you mean too old to work. In theory probably not until he is feeble or bedridden. In practice, the demands of modern industry for speed, agility, and firm muscles materially limit the jobs open to workers over forty and make it almost impossible for men like Dubowski to get another job once they become unemployed. Businessmen are in business not for their health but primarily for profit. Young men can do certain jobs more swiftly and with less danger of disabling accident or sickness than can old men. When laborers are being hired in industries and on farms, the young are taken first, not the Dubowskis. Pete, not old man Olson, was hired by Farmer Jacobson. Nevertheless, all men are not through at forty or forty-five, as is often believed. From 1890 to 1930, among all those declaring themselves gainfully employed, the percentage of those in the age group 45 to 64 increased from 20 percent to 25.5 percent, while the percentage of those of sixty-five and over remained about the same, 4.4 percent and 4.5 percent respectively. Looking at the problem in a different way, about 5 2 percent of all those people who were over forty-five were employed in 1890, and about the same percentage in 1930. To be sure, only 33 per cent of all those over sixty-five were working in 1930, while in 1890 42 percent of the age group over sixty-five were employed. Here is a table [Table 4], taken from the 1930 census, that might help you:
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Table 4. A : Percentage of Older Workers among All Workers Declaring Themselves Gainfully Employed Age
Percent in 1890
45-64 65 and over
20 4.4
Percent in 1950
25.5 4.5
B: Percentage of Old People Who Were Employed Age
Percent in 1890
Percent in 7930
45 and over 65 and over
52 42
52 33
A s the table indicates, industry
and agriculture use
older
workers more than is supposed. T h e depression probably increased the percentage of jobless old workers, but many of the older workers still hold jobs. T h e trouble lies in the fact that an ordinary worker finds it increasingly difficult to obtain a new job after he arrives at forty. If he has a job at forty he may be more secure in that job than he would be if he were younger. But if he finds it necessary to g o to factory employment offices when he is graying around the temples, the chances are that he will be received with, " W e aren't hiring just n o w . " Industrialists might like to take older men, but older men do not bring in as much profit as the younger ones. In N e w Y o r k state it was recently found that workers over thirty-five were barred f r o m 59 percent of the available jobs and suffered discrimination in 89 percent of the manufacturing plants. Modern assembly lines take those Jacks w h o are nimble and quick and can jump. I know that a man's highest mental powers are probably reached somewhere between forty and sixty. In the professions and in many skilled trades a person may well be doing his best work in this age span. L i f e sometimes does begin at forty. On the other hand, at forty a man's muscles are growing soft, his adaptability is lessening, his reaction time and learning processes are slower. Even earlier the opportunities for work begin
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73
to be restricted. A baseball player is old at thirty-five. "His legs," they say. A college professor may be writing his most scholarly book at fifty or sixty, but at fifty or over it is too late to begin to learn to be a college professor. An application of a college mate of mine for a teaching position was turned down last year on the ground that a young man was desired. He was thirty! Only in exceptional cases can a man enter a skilled trade or occupation after twenty-five. He has already lost valuable time in which he might have become trained, and if he has taken on family responsibilities he can no longer afford either the time or the money required to secure this training. A chair by the stove is about all that is left for your acquaintance, Peder Olson. Like at least half the men of his age, he is through as far as working for a livelihood is concerned. Olson is not unusual either in the fact that he lacks funds to support his family. In 1934 there were 700,000 people over sixty-five on Federal Emergency Relief Administration rolls. More than a million were receiving public charity of one kind or another. Several state surveys have indicated that from 30 to 50 percent of the people over sixty-five are supported by relatives. Few American families are not supporting at least one of their oldsters. More than 5,000,000 men and women of sixty-five and more are dependent today either on public or private charities or on relatives and friends. Why so many dependent? Why so many old poverty-stricken Olsons and Dubowskis? The reasons as I see them are: 1. There are more old people. The life expectancy at birth just before the Civil War was forty years; today it is close to sixty. In 1930 about 5 percent of the population was sixty-five and over. In 1980, as I said before, probably 14 percent will be. 2. Old age brings infirmities. These infirmities work more hardship in a machine age than they did in a handicraft era. The United States is today a huge, urban, industrial nation. It is no longer a small, rural, agricultural community. Old men
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OLD AGE
once could putter around a farm; today they cannot putter around in a factory. Speed and efficiency are the desirable characteristics in an economic system where horsepower doesn't mean the power of horses. 3. The majority of workers and farmers do not make enough during their working life to support themselves during old age. It is not queer that Dubowski did not. Remember the facts and figures I sent you about wages and incomes. Well, can a man and wife rear a family and save for old age when their average annual income is less than $ 1 , 5 0 0 ? The fact cannot be overlooked that forty-two percent of American families were making less than this amount in good old 1 9 2 9 . Your Mr. Dubowski, like so many workmen, did not earn enough to save for his old age. Though his weekly wage may have been $ 3 0 occasionally, his weekly wage through the years averaged much less. During periods of unemployment and sickness he received no pay check. When ability to save is being discussed, the life income, not the weekly or hourly, should be the measure. T o have an income of only $ 2 5 a month for the rest of his life (the average may expect eleven to twelve years) a man of sixty-five would need to have accumulated about $ 3 , 3 0 0 which would draw three percent interest. With her longer expectancy (twelve to thirteen years) a woman would need $3,600 at three percent. A s the life-insurance men tell us, comparatively few men save $3,000, though they work long and hard. And those few who do save too often see their little hoards wiped out by individual catastrophes or economic depressions. Like your grandfathers, Mr. Olson was apparently neither a ne'erdo-well nor a fool. It wasn't his fault that he had to take over mortgaged land, that a depression and a drought wiped out his years of sweating effort. He was unlucky. Your grandfathers were lucky. It is all very well to say, "if Olson had been wiser—." How many are or can be? Illness, joblessness, layoffs, dependent children or relatives, bank failures, droughts, a
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hundred misfortunes beset Mr. Everyman whichever way he turns. Most farmers and laborers never make enough to save for their later years. Many who can save see their savings disappear before they reach old age. O f course people have been getting old for quite some time now. Of course, too, some old people have always been unable to take care of themselves. American society, however, did not pay much attention to the old-age problem until the last few years. The county had a poorhouse, and the Ladies' Aid delivered baskets on Thanksgiving and Christmas. Customarily dependent old people were considered the responsibility of children or relatives or were left to shift for themselves. Why, you ask, cannot the immediate families continue to assume the chief responsibility? Why should the governments, local, state, and federal, take on still another burden? You are such a "whyer." Do you ever ask purely rhetorical questions? I suspect you do in this case, for I know you are convinced of the need of public assistance for the aged. Yet the questions do need discussion. At any rate, I may have an idea that will be new even to you. That old people have increased in numbers and that they are less able to care for themselves I have already pointed out. The converse of this is also true: the proportion of young to old is diminishing, and the burden on the children, if they support their old folks, thus becomes heavier and more costly. The attitude of today's children toward their aged relatives has changed from that of their fathers. The Dubowski children not only do not have the means to support their parents or a room in which to house them, but, what is more, like many of their generation they probably do not wish to have their parents around. W e might as well face the fact that the functions of the family in the present urban, industrial environment are different from what they were fifty years ago in rural, agricultural
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America. A half-century ago all group activities centered in the family. Today they no longer do. T h e family is seldom together. T h e parlor has been replaced by two seats at a movie called the Gay Divorcee
or something like that. It is baker's, not
homemade, bread that is broken over a none-too-festive board. T h e kitchen is fast becoming a place where mother opens cans but does no canning; the vegetable garden is either nonexistent or planted in flowers. Except in rural areas, the family washing seldom hangs behind the house on Mondays. T h e washing has become the laundry. Since a large part of people's time is spent outside the home and children are fewer, "dwelling units" (the very words are significant) are smaller. In cities, three- to fiveroom apartments (not houses) are most in demand, and in smaller towns f e w families except the conspicuously wasteful rich desire more than a four- to six-room house. Then, too, economic and social pressures have changed family planes of living and desires. T h e competitive struggle
for
existence and the desire to get ?head and to be free have all been accentuated. M e n and women are more dependent upon wages and salaries, and less upon the crops and cattle they raise for their livelihood. It's harder to provide for another mouth these days when food must all be purchased than it was in the gay '90s when food was g r o w n behind the house. A t the same time, ambitions are different. People wish more of the world's goods and more freedom and independence. They strive to get a car. They wish to go and come more, to travel, and to be unhampered in their activities. Even husbands and wives wish to be freer, to come and go as they respectively wish, as the rising divorce rate and the diminishing birth rate show. Hence is it to be wondered that the children do not wish to be responsible for their elders, that they say, "It's our life or theirs; why should we be bothered with the whims of
mothers-in-law,
uncles, and grandpas"? A s the family has lost its nineteenth-century functions, the state has assumed new responsibilities. W h a t the family for-
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77
merly did is now often considered the charge of the government. The depression years have shown many people that they cannot take care of themselves, much less of their relatives. Naturally they have turned to the only agency available, the government, and a different feeling of social obligation has arisen. The most extreme example of this feeling is Father Townsend's movement. Fifty years ago the Townsend Plan could not have been conceived. Though it is economically ridiculous, it has apparently won hundreds of thousands of adherents. The aged once were satisfied with room and board from their children; now some old people expect $200 a month from the government. Fortunately for us, the majority of those who perceive the necessity of state action are not crackpots. The problem has been faced more realistically. Five million old people are dependent; more will be. The question no longer is whether we should take care of them, but how we can best take care of them. What is the best way to give them bread so that they may live and pursue happiness? The old-age provisions of the Social Security Act are one answer. Your pertinent questions concerning the act show that you have been studying. Y o u rightly divide the old-age provisions into two types, the old-age assistance (which you sometimes wrongly call pensions) and the old-age benefits or annuities. Y o u know, of course, that the old-age assistance plans are not all like Wisconsin's. Nevertheless, here are some generalizations which might help you. The plans are set up by state laws, though the federal government requires that certain minimum standards be attained before it will subsidize the state's grants; the federal government matches state funds up to $20 a month per person receiving assistance; $ 3 0 is now nearly always the maximum legal state allowance, though since the federal government raised its contribution from $ 1 5 to $20 many states will soon raise this to $40; usually the applicant must show a residence of five years (out of the nine or ten preceding appli-
78
OLD AGE
cation) in the state granting aid; assistance is given only when need has been demonstrated, though a small income (less than $ 3 0 0 a year) and a little property are usually allowed. Ordinarily the age requirement is sixty-five (in a few states seventy). A state agency usually makes the final decision concerning eligibility, though in about one-third of the plans county or local officials decide whether or not an applicant will be aided. Though the state laws are fairly uniform, practices are not. Your county last year paid $ 2 1 . 3 5 a rnonth. In July, 1939, the grants averaged $6.00 in Arkansas, $ 3 2 . 4 3 in California, and $ 1 9 . 4 7 in the nation as a whole. Throughout the South the grants averaged less than $ 1 5 a month, but in Colorado, California, and five other jurisdictions they averaged over $ 2 5 a month. In some states assistance is given to many, but in others the recipients are relatively few. Seldom if ever have state appropriations been sufficient to grant the maximum amount of aid. Since the inception of the Social Security Act, assistance has been suspended in Oklahoma, Maryland, Illinois, and South Dakota, and in several states the grants have been reduced for short periods because funds have not been available. Y o u say you have not seen an unusual amount of politics in the administration of this aid. Your observation, thank goodness, is not devoid of truth, but politicians have not always been able to avoid temptation. A former governor of Ohio, for example, raised the assistance grants a few days before his reelection in 1 9 3 6 and sent the beneficiaries letters telling them that he was responsible for this increase. In Oklahoma unwarranted payments to the extent of several million dollars were discovered. Too often politicians have used "ham and eggs," " $ 3 0 every Thursday" schemes to win votes. There is real danger that the aged will benefit further only at the expense of other needy groups. I suppose we should not expect too much. After all, as late as the 1920s advocates of old-age pensions were considered either crazy or bolsheviks. In 1 9 2 8 only six states had old-age
OLD AGE
79
pension laws and only twenty-five were granting assistance before the federal government began to subsidize the state plans. Since the Social Security Act went into operation, progress lias been rapid if uneven. All the states, the District of Columbia, Hawaii, and Alaska are now aiding their aged. In July, 1 9 3 9 , approximately 1 , 8 6 1 , 2 0 5 needy old people received $36,230,939, or an average of between $ 1 9 and $ 2 0 each. It cannot be denied that these figures and facts do show truly remarkable progress in our care of the aged. As your critical questions indicate, however, much remains to be done before essentials are assured to all the needy aged in the United States. Yes, as usual, I have a number of one-two-three suggestions. Here they are, four of them: 1 . The amount of assistance should gradually be increased until it reaches an actual maximum of $ 5 0 a month per person. 2. The age requirement should be lowered to sixty or, better still, abolished, and individual need plus incapacity to earn should be declared the criteria for the granting of assistance. (In the latter case we would have an invalidity instead of an old-age pension.) 3. All political influences in the administration of the acts should be vigorously fought and eliminated. 4. The laws and practices of the states should be made uniform. The present old-age assistance grants, as you say, are scarcely as large as relief allowances. Little difference does exist between relief and these pensions. Old-age assistance is, I concede, considered to be more respectable. But $ 1 9 a month does not supply the essentials of life for anyone anywhere in the United States; it only supplements the income of the recipients. Ideally, the goal for the aged should be a health and decency income, or $80 to $100 a month. But until the United States produces more wealth than it has this ideal goal cannot be attained.
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OLD AGE
Assistance grants must be paid out of the total current production and we simply are not wealthy enough now to help the aged as we wish to help them. For the present, we should attempt to reach the maximum of $ 3 0 in all states, demand the $40 that is now possible, strive for $50, and, as the national income rises, increase the assistance until we can say it really takes care of basic needs. Old-age assistance even with the $ 3 0 limit is going to be costly. If all the dependent aged over sixty-five (5,000,000) were given but this amount monthly the bill would be $150,000,000, and the yearly cost would mount to $1,800,000,000. If $ 5 0 a month were given, the total cost would mount to $250,000,000 a month and $3,000,000,000 a year. Of course not all the dependent would apply, and many who do apply will not need this maximum. Then, too, as the annuity plan of the Social Security Act really begins to operate the number of those needing assistance will decrease. But at any time the nation will find it economically difficult tc give freely and generously to those who no longer produce wealth. For the present, probably a half a loaf will have to be accepted as better than none. My second suggestion, lowering the age to sixty, will likely come very soon. Public opinion seems favorable to such a change. Incapacity to earn, as in Dubowski's case, often begins earlier than at the age of sixty-five. Sometime in the future I would like to see the age requirement eliminated altogether. Dubowski is only fifty-seven, but he needs aid as do thousands of others under sixty-five or even sixty. Several countries, for example Australia and France, give invalidity as well as oldage pensions in order to cover the younger man when incapacitated. You ask if all the Olsons and Dubowskis and everybody over sixty-five should be given pensions. N o , it would be neither practicable nor desirable. Many do not need assistance, and, as the figures above indicate, the cost would be prohibitive. More-
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81
over, old people are not the only ones who are unavoidably dependent and who need public aid. Assistance should be given whenever there is need, and need should be the only reason for the giving of aid. N o one should receive help because he knows someone who knows someone. The elimination of all politics in any assistance program is a hard nut to crack. The assistance laws themselves were made by political bodies and, indeed, as long as we have liberty in this country all laws will be the result of some kind of collective political action on the part of the people. Politicians are elected, do not forget, by votes, and they usually support measures to obtain these votes. The "Grandpa and Grandma shall not suffer" slogan is one that appeals to us all. When I say politics must be eliminated, I mean that politicians should not be allowed to use the pensions to get votes as the Ohio governor apparently did. I mean, too, that jobs in the state bureaus should not be awarded because of membership in a political party, and that assistance should never be given as a bribe for a vote. It is not possible at present to transform our political system. It is possible to put all old-age assistance officials on the merit system (civil service to you). And it is possible for the Federal Social Security Board to cool overzealous Democrats and Republicans by simply withholding grants-in-aid, as it did in Oklahoma, when they obviously try to win friends and influence people by giving or withholding assistance. Somewhere earlier in this letter I pointed out that the various state laws have general similarities, but that great diversity in practice exists. The Federal Social Security Board could demand greater uniformity and I believe it should. A state which now assists few or which pays but a few dollars monthly harms its own needy. On the other hand, a state which is now more generous either in the number of recipients or in the amount of aid penalizes its own citizens to the extent that they must pay higher taxes than the citizens of states which give less. To be sure, some states, such as the Dakotas, are poor and other states,
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OLD AGE
such as N e w Y o r k , are relatively rich. Uniformity may be difficult to obtain, but nevertheless that should be the aim. When the old-age benefit plan has been in effect for a number of years a considerable burden will be lifted from all the states and then it will be more possible to treat the needy of all states alike. My father was not an insurance man either. Still I don't think the old-age benefit plan difficult to understand. Perhaps you need to study the Social Security Act a little more! Social workers, I sometimes think, should devote more time to the general causes and cures of dependency, and less time to the individual case. The old-age benefits, unlike old-age assistance, are handled by the federal government. The Social Security Act and its amendments established an Old-Age and Survivors Insurance Trust Fund in the federal treasury. Employed workers (with some important exceptions) and their employers contribute to this reserve. From it insurance benefits will be paid to all contributing wage earners and wives after they reach sixty-five, or to their wives and young children if the wage earners should die before that age. T o be more specific, the federal government now and for the next three years requires each eligible worker to pay a tax of one percent on his wages. The employer is required to match the contributions of his workers. After January i , 1940, when a worker reaches sixty-five and retires he will receive a monthly income. When the Social Security Act was originally passed the benefits were calculated on the basis of the total wages earned, but now they are computed on the basis of the average monthly earnings (up to $3,000 a year) while the worker is subject to the act and the number of years he has worked in covered employment. At the age of sixty-five the insured worker gets a basic benefit of 40 percent of the first $50 of his average monthly earnings, plus 1 0 percent of any earnings over $50 up to $ 2 5 0 , and one percent of his basic benefit for each year in which he has earned $ 2 0 0 or more in covered occupations.
OLD AGE
83
Moreover, his wife receives, in addition, 50 percent of his primary benefit if she is over sixty-five. Should he die, his widow, if over sixty-five, or if there are children under sixteen (eighteen if in school), obtains three-quarters of his benefit for herself and 50 percent of the benefit for each young child. Y o u ask about Charlie's benefit. His future work record cannot be exactly determined at present, but as he is forty-eight, let us assume that he will be lucky and continue working until January, 1 9 5 7 , or seventeen more years at a salary averaging the same as he now gets, $ 7 5 a month. On retiring at sixty-five he would get per month 40 percent of the first $ 5 0 or $20, 1 0 percent of the remainder or $ 2 . 5 0 , and one percent of the basic benefit for every year he has worked in covered employment or $4.50 (20 years = 20 percent; 20 percent of $ 2 2 . 5 0 = $ 4 . 5 0 ) . His total monthly benefit will be $ 2 7 . 0 0 or $ 1 . 7 5 more than he would have received under the original act. As his wife is seven years younger than he, she will not receive any additional funds until she is sixty-five. At that time, if he is still living she will obtain $ 1 3 . 5 0 a month, which will be in addition to the amount Charlie is already receiving. If Charlie has died, she will nevertheless receive three-fourths of his primary benefit, or $ 2 0 . 2 5 , a month for the rest of her life, unless she too has been working and is eligible for a benefit of her own. In the latter case she has the choice of either her own or three-fourths of her husband's benefit, whichever is the larger. Should Charlie die, however, before his wife reaches sixty-five, then she would receive a lump-sum payment equal to six times his monthly benefit, although when she became sixtyfive she would again be eligible for the $ 2 0 . 5 0 a month for the rest of her life. In case both Charlie and his wife die before they are sixty-five, Charlie's parents, were they over sixty-five years of age and dependent upon Charlie, would each be given one-half of his primary benefit per month. If both parents were dead, his estate would be paid a sum equivalent to six times the amount of his monthly benefit. This all sounds very compli-
84
OLD
AGE
cated, doesn't it? But it isn't. Sit down with a pencil for a few minutes; make the necessary calculations yourself and outline the possibilities. I think the reckoning is easy for any individual worker and his wife if you know his average monthly earnings, how many years he has worked in covered employment, and whether his wife is over sixty-five or not. Y o u undoubtedly have a table of these benefits in your office, but here is a short one just in case: Table 5. Years of Coverage
Social Insurance Benefits
Benefit of Single or Married Worker with Wife under 65
Benefits of Married Worker and Wtje if over 65
AVERAGE M O N T H L Y WAGE OF $ 5 0
3 5
$20.60 21.00
$30.90 3I-50
io 20 30 40
22.00 24.00 26.00 28.00
33°° 36.00 39.00 42.00
AVERAGE M O N T H L Y WAGE OF $ I O O
3 5 10 20 30 40
$25.75 26.25 27.50 3000 32.50 35°°
$38.63 39-38 4r-25 45.00 48.75 i2?0
AVERAGE M O N T H L Y WAGE OF $ 2 5 0
3 5 10 20 30 40
$41.20 42.00 44.00 48.00 52.00 56.00
$61.80 63.00 66.00 72.00 78.00 8400
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85
Before I go any further I ought to point out a number of qualifications and exceptions. Although 45,000,000 (the number includes persons who have died since January 1, 1937) oldage benefit accounts have been opened, a number of employed persons are excluded from the act: most agricultural and casual laborers, most domestic servants, fishermen, newsboys under eighteen, state and federal government employees, railroad workers, most of those persons engaged in religious, educational, charitable, literary, and scientific work, and those, like farmers and businessmen, who are self-employed. The unemployed who have never held a job in covered employment since the inception of the act in January, 1937, are, of course, not included as they have never paid a tax. About 35,000,000 workers are at present subject to the provisions of the law. Possibly 18,000,000 to 20,000,000 other willing and able (though not always employed) workers, businessmen, and farmers are not. Only the first $3,000 a year of any individual's wage are taxed, and no individual may receive less than $10 or more than $85 a month in benefits. Y o u ask what will happen to those who are not covered. Where is their bread to come from when they are old? For railroaders and some teachers and government officials separate retirement funds have been established. Agricultural workers like Peder Olson's son, most domestic servants, casual laborers, the self-employed, and the unemployed are, as one of my students put it, just out in the cold. If they become needy in their old age they will have to depend upon old-age assistance grants. Why isn't every worker included? The chief difficulty is the necessary bookkeeping. Agricultural, domestic, and casual laborers change jobs more often than do industrial employees, and they work for thousands of small employers, many of whom do not keep business records. It would be almost impossible to force every housewife and farmer who employed help to send in pay-roll taxes; it would be exceedingly difficult to keep track
86
OLD AGE
of isolated workers in order to maintain their separate accounts. In addition, their cash wages are so low that the benefits would be negligible. As for the self-employed, they ordinarily do not pay themselves in wages, and consequently could not be taxed in the same way as other workers. When the system becomes firmly established and the administrative personnel becomes trained and experienced, it will be possible to cover more workers. I cannot see any serious obstacle to the eventual inclusion of all employees. More serious than the exclusion of certain categories of the employed is the exclusion of those who are not employed (Dubowski) or who have never been and could not be employed (Peder Olson's w i f e ) . But so long as the old-age benefit system remains like insurance those last two groups cannot be covered. Y o u are perfectly right when you say that Charlie's benefit will be low, and that it will not be any higher than old-age assistance. Charlie will get but $ 2 7 a month because those who wrote and amended the law believed that old-age benefits should, like private insurance, be based upon actuarial calculations, and that the benefit payments should be based in part at least on contributions. As long as the present plan is maintained I don't think it would be possible to give men like Charlie more. If the present one percent tax on his earnings and on the employer's pay roll is retained (it may be raised after three years) Charlie will, by the time he is sixty-five, have contributed only $ 1 8 0 and his employer a like amount. If, however, he has the average life expectancy, eleven years, at the age of sixty-five, his benefits will have totaled $ 4 , 2 1 2 at his death, or twenty-three times the amount he was taxed. For the first seven years he will receive $ 2 7 a month or a total of $2,268. The next four years, because his wife will have become sixtyfive, his check and hers will total $40.50 a month. During this four-year period they will receive $ 1 , 9 4 4 more. Perhaps, too, Charlie's wife will continue to live on several years after he
OLD AGE
87
dies, receiving each month a widow's benefit of three-fourths of her husband's benefit, or $ 2 0 . 2 5 . At the age of sixty-five she would have a life expectancy of twelve to thirteen years. If she lived twelve years she would get her check for eight years after the death of her husband, receiving $ 1 , 9 4 4 more. In consequence, I really don't see how Charlie could be given increased benefits, at least as long as the present plan is retained. True, the amount he will obtain per month is not sufficient judged by any standard budget, but unless the taxes are raised I don't see how it could be increased. As it is, Charlie will be able to obtain much more in benefits than he contributed in taxes only because many workers will die before they reach sixty-five. Estimates are that 40 percent of the persons now twenty-one will not live to be sixty-five. Much of the money they will have contributed will be used for their longer-lived fellows. In the long run the benefits will, of course, approximate the contributions for the majority of the workers, but some like Charlie will get a greater and some a lesser return than others. I happen to be in favor of keeping this insurance principle, especially since the original huge and unwieldy reserve feature has been eliminated. According to this plan each worker will save for his own old-age income, although of course the money of all the workers is pooled in the reserve fund. Moreover, when he contributes he will realize that he has a responsibility for and a right to benefits. He will not feel that he is a recipient of charity. Some critics of the old-age benefit plan have attacked the tax on the worker, suggesting that the needed money be raised entirely through taxes on the employer or through other general taxes. The idea is excellent, but general taxes are not sufficient now to meet the running expenses of government. If the tax were shifted entirely to the employer he would be able to pass it on for the most part to the consumer. The workers and all the rest of us would pay it anyhow in the form of increased prices.
88
OLD AGE
T h e tax on the workers should by no means be raised. There is no need for a reserve fund larger than the one now required by law, about $3,000,000,000, or an amount equal to three times the highest annual benefit total expected in the next five years. Seventy-five cents a month does mean much to Charlie. It decreases his present buying power by just that amount. Since underspending on the part of the workers has been one of our chief economic troubles, his buying power should be carefully guarded. Charlie and those like him should be the last persons to pay any increased taxes. In the future, if and when the national income rises, it should be possible to raise the benefit checks of the workers. If necessary this could be done by direct government subsidies. Progressive income taxes might be raised slightly, and at the same time extended downward. Government securities could be taxed. But the principle of a small tax on the workers should be kept. Charity tends, as we have said so often, to be demoralizing. And Charlie should feel that he has a responsibility for as well as a right to his old-age benefits. W e should guard against increased assessment on the worker, and we should advocate increasing benefits as the national income goes up until every older worker is assured of not only his bread but a good living. It would be only ordinary justice, also, to extend the coverage of the act. N o reason exists for the continued exclusion of any employed person. Farm laborers, domestic servants, and small farmers and businessmen could be included within the next few years. The first two types of workers need social security more than do most employees. A different method of collecting the taxes from and for them might have to be devised, but nevertheless they should be included. Ten years ago the people who advocated social security measures were called bad names—agitators, communists, bolsheviks. N o w social security is generally accepted even by conservative
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OLD A G E
Republicans. N o one will decry the distribution of $ 1 , 7 5 5 , 0 0 0 , 000 in old-age benefits during the next three years. A n d yet we haven't found the final solutions. Again I shall have to repeat, I have no cure-all for our economic and social problems, particularly for the problem of old age. Men and women will get old, their tissues will deteriorate, and their senses will dull. N o elixir or fountain of youth has ever been found, and gland surgery does not renew life. And I'm neither Ponce de Leon nor Vornoff the gland surgeon. Y o u are right, however, when you say that old people should have economic security plus something more. What this something more can be for men like Peder Olson and Dubowski I am none too sure. Let us respect and care for the aged; let us give them economic security; but let us also expect that old men and women will contribute something themselves. The American dream of a free full life is not yet realized. A few more can be taught to appreciate and enjoy the arts and sciences; many can be trained in the handicrafts and in the art of living which some Chinese seem to have found, or at least so says Lin Yutang. If social workers and educators like you and me can bring a rich, full life to the young, perhaps when old they will have "that something." Y r obedient husband (how obedient the years may tell), CARLISLE
P.S. I shall prepare an instruction sheet on driving on a detour and send it along.
FATHERLESS HOMES
AT T H E P U B L I C W E L F A R E O F F I C E SATURDAY A F T E R N O O N
D E A R CARLISLE:
W e l l , another week is over! It has been such a heavy one that I am certainly glad to see Saturday come. I did so appreciate your letter about the problem o f old age, but what do you mean by "yr obedient husband"? As if I am not an obedient wife! I tell you, the trip was perfectly safe, and I would have made it all right if there had been no detour. Another point worthy of mention is the fact that the road and not my driving was at fault. Now that that is cleared up I shall turn to more pertinent matters and tell you that I have asked the stenographer to type off some of your last letter to pass around among the case workers. D o you object? It will help them as much as it did me, I am sure. There were a few more questions I wanted to ask you but I seem to have forgotten them right now because I am so perturbed about something else. Among the applicants this past week seven women, five of them widows and two of them deserted wives, applied for relief for themselves and their families. As we took on only sixteen new cases this week I have suddenly become aroused about the widows and orphans. I feel I must discuss some of these cases with you. I wish I could see your expression right now to gage the reception of more questions. Is the countenance serene, amused, or exasperated? W i l l there be another deserted
FATHERLESS
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HOMES
woman in the town if I g o on? The tune, " W h e n Irish Eyes A r e Smiling," seems to come to me as a mysterious message, undoubtedly a sign of your approval! So I shall continue. T h e case workers rechecked their case loads this morning, and do you know, practically one out of every six relief families is headed by a woman! In addition to these on relief there are other dependent women in the county who are receiving mothers' pensions or aid to dependent children. I have never realized so forcibly how many dependent families have no father in the home. Few are their chances for independence and the good life! It was a Mrs. Thomson who really started me off on this mental cruise, fuddle, or whatever you call it. T h e pastor of the Norwegian Lutheran Church telephoned me about her. H e said M r . Thomson, who had been a staunch member of the church, had died a month ago, leaving his family in
financial
difficulties. U p to a f e w weeks before his death from pneumonia he had worked in a responsible position as secretary for the milling company, earning between $ 1 0 0 and $ 1 2 5 a month and supporting his family adequately. Since his death, however, the family has had no income whatsoever. The pastor regretted that the church had no funds to aid them, but he had persuaded M r s . Thomson, who was very proud, to come to the relief department and talk over her situation. Yesterday she came in, a tall woman dressed in black—somber eyes in a set pallid face. At first she barely saw me or realized what was being said. She pulled at the tips of her black gloves and looked straight before her. When I asked her if she wanted us to help her in any way she wept quietly and said over and over that she didn't know what to do. Clouded with sorrow and disgrace at the thought of relief, she was completely bewildered. Composure returned when she told of her children, of Helen, a junior in high school who is planning to be a sten-
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ographer, of the lively sixteen-year-old twins, John and Peter, and of little Bertha who is only nine but can play the organ in Sunday School. Mrs. Thomson sobbed again, saying she didn't know what would become of them when the insurance money was gone. The life insurance had been only $ 1 , 0 0 0 and her social security lump-sum check but $ 1 1 5 . After she bought a four-room cottage for $600 "so we would be sure of a roof over our heads at least," and had paid doctor and funeral bills, only $ 1 2 5 was left. W e offered to recommend Helen for a National Youth Aid job (really got one for her today) and talked to Mrs. Thomson about securing work for herself. It was explained to her that our county did not permit the relief department to give any financial aid to families as long as they had some cash on hand. "So you really don't want to help me after all," she said, " I have to go out and spend our last penny before we get anything here. Oh, that is terrible!" and she started for the door in a daze, a handkerchief over her mouth. I hastened to say, " I realize how difficult it is for you to talk about these financial matters now; they seem so unimportant beside your great loss, but if you care to take the time today we might be able to work out a few plans." She sat down again and we did finally straighten out some things. W e talked over the possibility of government aid for dependent children, but as the twins, because of their age, will not receive the grants for long, soon only Bertha will be eligible for this assistance. Since the allowance for one child could not help the whole family much, they would still need other aid if Mrs. Thomson didn't find work. Mrs. Thomson is unskilled in anything but housework and a job for her will be difficult to find. Helen, who is eighteen, might secure a stenographic position by next summer when she finishes her junior year in high school. Her mother feels it her moral duty and
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93
I feel it a public duty to keep Helen in school. Apparently little help can be expected from relatives, although we have not had time to check thoroughly. I can't get Mrs. Thomson out of my mind, her vague floundering in a great emptiness, no adviser, no support, knowing she must assume responsibility yet distrustful of all to whom she turns. T h e flint-hard business world from which her husband shielded her now is her concern. Even the effort which I know she will make will seem so useless when she has to keep on living alone. O f course the children will occupy her thoughts and time will ease the ache, but for a long time Mrs. Thomson will need help. That she should receive financial assistance if she doesn't find work is hardly a disputable issue any more. D o you agree? But how much of the economic burden should we assume, how assume it, and how far can we and should we go in providing opportunities for the education and training of the Thomson children? Just what should the state do for children when parents cannot assume their customary roles? W i t h the funds available in our county we are doing as much as we can but there's much more that we should do, I believe. When I think of "widow" a fleeting picture of a certain Mrs. Gomez invariably flashes across my mind. If the angel of death carries around a list of families most vulnerable to his maiming visit, the name of Gomez must head the list. Eight years before I knew the family Mr. Gomez had emigrated from Mexico to Chicago to work for a steel company, later drifting to our city with his large family and working part time in the steel plant. At the time of his sudden death from peritonitis his family were on relief. Because landlords do not care to rent to Mexicans, the Gomez household, seven children in all, were living in two basement rooms of a squalid bungalow, with two other Mexican families in addition to several roomers living upstairs. I called to help Mrs. Gomez with arrangements for the fu-
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neral. It was a cold raw day in March, and the air, the streets, the buildings were all the same dark slate gray. The entrance to the cellar was through a passageway dug out beneath the front porch. An older girl opened the door to me and then ran quickly to get Mrs. Gomez's brother, who lived upstairs and was also on relief, to act as interpreter. Mrs. Gomez and I held hands for a minute, then she made a waving gesture as if to say, " A l l is gone." When her brother came we all stood awkwardly (there were no chairs) and talked hesitatingly. The little Mexican woman picked up the baby and jiggled it nervously to quiet its whining and agreed to everything we said. " M y sister, she is stranger to this. She know nothing what to do." The room was dark and damp; soot sifted in through two small windows near the ceiling. Three of the oldest children sat quietly on one of the cots lining the wall. T w o little fellows who had been playing in the dirt-pile under the porch chased in with shouts that were quickly silenced by a big sister who dragged them over to one side of the room and sat between them on a bed. T h e baby in the mother's arms looked as small and delicate as a black-haired china doll. Mrs. Gomez's eyes were feverishly bright. She nodded "yes" to all the questions that were broached, some of which were deciding the shape- of her future. Please don't think I am maudlin and sentimental over widows and orphans, but I do believe they face serious problems. Widowhood means a revolution in most mothers' lives, a doubling of responsibility with a halving of the strength to meet it. The amendments to the Social Security Act passed by Congress in 1 9 3 9 should help the future widows of employed workers. But the problem still remains but partially solved, as I see it. I don't understand these amendments as they apply to widows very well (explain them to me) but I know there will be thousands of widows who will receive little or no benefits.
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95
In any case, how many widows and fatherless families are there in our country? How big is the problem and what more should we do? N o doubt you are familiar with those speakers and writers who assume that a widowed woman with several children is undeniably, albeit mysteriously, invested with all the properties of beatific motherhood, a symbol for all those crusaders who would preserve the home at any cost. But there are times when I am a bit in doubt about this sanctity-of-the-home slogan. Some women, in all leniency, still cannot be said to be fit mothers. The death of one's husband does not suddenly endow one with virtues formerly lacking. In fact I wouldn't be surprised if the father in many cases is the force that keeps the home organized. That must have been true in the O'Donnell family here in town. For years Mrs. O'Donnell has been receiving a mother's pension. Before the Social Security Act was adopted the county judge had charge of aid to dependent children in this county. This judge, an old bachelor, believed at all times in the inviolability of the home and because of her six children allowed Mrs. O'Donnell a grant for their care. T h e woman had so much difficulty in making her monthly allowance last more than a week or two that the judge, who had increased her grant to his maximum, grew discouraged and finally asked a case worker from our relief office to advise Mrs. O'Donnell with her buying. Apparently she could not be advised. Every three or four days a grubby youngster would appear at the office with a note from Mrs. O'Donnell
(written by one of the older children in
school) telling of the desperate need for coal or shoes or flour or some other necessity. T h e case worker planned meals with her, even went to the store with her sometimes to help her keep within her budget, which was small though adequate for essentials. But all in vain. T h e storekeepers who knew Mrs. O'Donnell refused her credit, and were always afraid, when
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she entered their stores, that she would scream and make a scene, as she often did when she couldn't have her own way. Apparently this behavior was not a trick but just a childish fit of temper. T h e children were often ill and absent from school. One morning Mrs. O'Donnell poured too much kerosene in the kitchen range when starting the fire and an explosion occurred, fatally burning a nine-year-old daughter. I could go on with details, but enough. This woman who could not remember or concentrate on anything that was said beyond "yes" and " n o , " who appeared to be definitely of low mentality, who after four years of guidance could not begin to buy wholesome food for her children, who could not cook on anything but a frying pan, and who saw no need for children going to school except to get them out of the way, this woman was given a mothers' pension in order to keep the O'Donnell family intact. Don't you think, too, that there are times when the place and people that produce a child justify his removal from them? O f course not all fatherless homes are due to an "act of G o d " ; some are due to the acts of the men and women concerned. In homes where the mother is divorced or deserted, or in homes with illegitimate children, the problems are often more complicated. Fewer divorced than deserted women ask for help. I suppose this is because those who can afford a divorce seldom need to come to relief departments. But both divorce and desertion cases present complex situations to the social worker. Sometimes it is possible to bring about a reconciliation and save the home, but more often the family comes for help after the break has occurred. W h e n a man deliberately slips away and leaves his family destitute some agency must come forward with aid. I don't believe I ever told you the story of the Boja family, although I know you have met Anna. She was the bright Croatian girl who rode with us out to camp last summer and
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97
who told me solemnly after she met you that she understood why I got married! Remember? M r . Boja left his wife and four children about ten years ago. Working as a housekeeper here and there and with supplementary aid from the relief department, Mrs. Boja has managed to maintain the family. True, the house still has its mortgage and the children have sprouted up without much supervision, but the family has remained a unit. T h e first time Mr. Boja left home he merely moved to a cheap hotel near his home and kept some contact with the faiiiily. A social case worker, according to the old record, tried to effect a reconciliation, but Mr. Boja, a Croatian immigrant, had refused to return. " M y wife, she yell at me all the time," he was quoted as saying. "She won't let me have my money to buy one glass of beer. She never go to Croatian society meeting. W o n ' t go any place with me. Say all the time—'work.' Even to go to bed with her is no fun no more. I have enough." Boja did return, however, but not for long. The next time he deserted he went out of the state, and he has eluded the spasmodic efforts that have been made to locate him. Mrs. Boja shouted unexpectedly to me one day, " I f that man Boja ever comes in a block of this house I'll call the police. He should be in jail for all he did. He ran around with young girls, I know. He would drink up all he earned if I'd let him. If he knows what's good for him he'll stay far away from m e . " Anna is the oldest girl. She is sixteen, very bright and ambitious. I f financial arrangements can be made, she plans to take up nurses' training when she finishes high school. She works in the dime store on Saturdays now and picks up odd jobs caring for children in the evenings. " I don't ever want a beau," she confided to me not long ago, " I had one once and he tried to get smart with me. When I told him not to kiss me he laughed at me and said, 'You're John Boja's daughter, ain't ya?' I'm scared now to go out with
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fellas. Maw said that she thought Paw had been saying lies about me when he was in town, so as to get even with Maw. Yes, he was here a year ago. He came one night and pounded on the back door until it was about to fall in. Maw told us all to shut up. It was all dark anyway and we were in bed. He yelled for Maw and he yelled for me. He did remember me. After a long time he went away. I peeked out the bedroom window and saw him going down the street. He was quite big, real nice-looking, my father was." John, the oldest boy, overtook me one afternoon on his way home from school. "What study do you like best?" I queried. "Geography now, but I know I'll like science and metal work best when I get to take them, if I ever get that far in school. I want to be a foreman in the steel works like my Dad was. Uncle Adolph says Dad was the best steel man there ever was, and you got to know science to be a good steel man." He appeared slightly embarrassed at having mentioned his father, and added, "Maw says Dad drank up all he earned. I don't think drinkin' is really bad, do you? The guys in our gang all of them can hold their beer. Maw, she's an old-timer. She don't know so much as she thinks." It is very unlikely that Mr. and Mrs. Boja will ever live together again. Mrs. Boja works and worries and wonders why these children for whom she is wearing her fingers to the bone will not obey her, why they are ashamed of Croatian songs and Croatian people, why they are not grateful for all that she does for them. She sees nothing left for her but work and ingratitude. Mr. Boja himself, wherever he is, is likely not very happy in his freedom. The regrets of his failure as a father and husband must often assail him. What misconceptions the children are forming of their parents! Lacking an understanding mother and father, they are growing up haphazardly, without emotional security and balance. Someday, when they themselves are parents, they will be at a loss for a pattern to make their own homes successful.
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HOMES
99
Surely society can do something to prevent families from breaking up like this. Using the strong arm of the law (which is about all we do n o w ) does not seem to stop men from leaving; it only makes them go farther away from home. I would grant that separation is the wisest course for some mismated pairs. Still, as a social worker, I know that many families could be and have been happily saved from going to pieces. What worries me is the fact that apparently the number of broken homes is constantly increasing. Don't parents still love their children, don't men and women still find that marriage provides their greatest emotional satisfaction? I think they do. What is it then that has changed families and made them more unstable? If we were fully aware of the larger social forces leading to family disruption we might know where to begin plans for the preservation of the home. A s a social scientist you should be able to help us out here. The legal cancellation of marriage vows through divorce does not make the situation less perplexing. I remember Mrs. Hall, a quiet little woman with a twisted smile and a hard hurt look, telling me her troubles last winter. Three months before she asked f o r help she had secured a divorce from her husband, and he had agreed to pay her $ 3 5 a month alimony for the care of the two children. Ten dollars was all he had ever paid, and when she tried to enforce payments through court she was advised by the judge to drop the matter as M r . Hall was not earning more than his own board and room. She said, " W h a t ' s the use of having him arrested? It will only make him worse. H e doesn't want to help us; I guess I can't make him do it." W e helped Mrs. Hall until this spring when she secured a job as housekeeper on a farm, supporting herself and her two children. Widowhood doesn't leave this kind of hatred behind. There isn't the same sense of personal failure when a couple are parted by death. Memories of the deceased father or husband can be revised by time and expediency, but memories of live men are always subject to a jolting revision by reality. In
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fact, memories o f any husband, whether dead, deserted, or divorced, are flimsy comfort and support. T h e r e is another type o f incomplete family that we social workers meet quite o f t e n : the mother with an illegitimate child. It seems as though illegitimacy is more prevalent here in this rural area than in the city. I've often wondered if there were any statistics to prove my observation. I can't figure it out. Either the country girls are dumber than the others or they have never had a chance to learn the " f a c t s o f l i f e . " D o you have any information on this matter? I remember visiting a farm family one winter day, in answer to their application for relief. T h e mother and I were talking in the big kitchen while an older girl was ironing and several little youngsters were running in and out. " i s this your youngest?" I asked when a towheaded toddler offered me a wooden spoon with which he had been playing. " O h , n o , " said the woman, "that's T h e l m a ' s k i d , " and she nodded toward the girl at the ironing board. I remarked that T h e l m a looked very young to be married. " O h , she's not married. She didn't want to be hitched to the kid's father; he's no account anyway. Used to hire out to my brother down the road. Sure a shame, but what's done is done. T h e kid's one more mouth to feed in these hard times." Such nonchalant acceptance of a nameless child is not the customary attitude, I know, but it does seem rather characteristic o f the rural areas around here. T h e point most often lamented is not the disgrace felt by the girl and her parents, not the doubtful future o f the daughter and her child, but the fact that the child is an additional economic burden. ( I suppose you will use this as another example to prove the strength of the economic basis o f behavior.)
In spite o f
frequent blizzards
around here I have yet to hear of a melodramatic father throwing his wayward daughter out into the storm. M o r e than likely he makes the man marry the girl, if the number of obviously
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HOMES
101
forced marriages in the relief records means anything. Judging from the marriage relationships that follow shotgun weddings, I believe I should choose the storm. Yet, if there is no later marriage the fatherless child begins life under terrific handicaps. The unmarried mother who must take care of herself is saddled with a baby and a questionable reputation, making it doubly hard to find a place f o r herself where she can be free, happy, and independent. Illegitimacy is hardly a gage of our declining morals, as some people say it is. It has existed at least since Biblical times; we have found no better ways of meeting it. Probably we are using the wrong approach. I am convinced that greater effort should be directed first of all toward the prevention of illegitimacy. But since children will continue to be born out of wedlock f o r some years to come, we should also be concerned about giving them a more secure legal and social status in society. Scandinavian countries are far ahead of us with such provisions. Before I stop writing I want to ask for your suggestions f o r meeting the economic difficulties of these families which have lost their chief breadwinners. So many of these families will not be helped by the social security old-age benefits and will find the grant f o r aid to dependent children insufficient. If only every married man could carry insurance—but, as in Mrs. Thomson's case, the money is usually soon gone. Then, too, insurance wouldn't help the deserted or the divorced woman. The private insurance now carried by low-income groups covers little more than burial expenses. It provides little or nothing for the survivors. Y e t the wage earners cannot afford to pay the higher premiums necessary f o r larger policies. The aid to dependent children grants average only about $ 2 5 a month in this county and provide less than minimum subsistence. The social security benefits are higher, but they will not provide more than the barest necessities, and not even these for the families of the unemployed and the farmers. More has to be done. Public
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relief and pensions based upon need have a demoralizing tendency and cannot be the most satisfactory answer, especially for families with growing children. There must be a better way. Here it is, almost five o'clock. I wanted to tell you something about the emotional difficulties that face widows and deserted women, and about the slender chance their children have for normal development. How hard it is for a boy to become a man without a father as a guide! Much of a girl's attitude toward the opposite sex is determined by her relationship with her father. W h a t understanding will children from broken homes bring to their own marriages and their own family life? But I guess I'd better save those topics for another time. W h e n I was a child our family paid a visit to my Aunt Edith almost every summer. Aunt Edith was a widow with two children. ( O n e was a girl of my age.) She lived on a small farm which had belonged to her deceased husband and through careful planning and very hard work managed to make ends meet. Aunt Edith's kitchen door was a novelty to us children; it had two parts so that the upper half could be opened while the lower section remained locked. W e cousins devised all kinds of tricks and games around this old-fashioned Dutch door. One night we were sitting out on the stoop and Aunt Edith said something that transformed that door from a plaything to an object of respect. " I need a double door like that because I am a widow," she explained. " Y o u see, I never have to open the door way down for strangers. They might take advantage of me if they knew I was a widow." T h e word " w i d o w " had meant little to me, but at that moment it became the name for brave women who protected their homes and children from strangers and who needed double doors to do it. Since then, double doors have had many meanings for m e : insurance, relief, mothers' pensions. At this writing they stand for economic security below, and the offer o f guidance and advice as a substitute for the absent parent as
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HOMES
the upper part of the door. It is the top section we may have the most difficulty in providing in the future. Well, dear, I am stopping as it is time for dinner. Have pity on my gropings and write me what you think about all this. Farewell! I go home to a husbandless and childless home. Tableau! Loving you, CAROL
P. S. I hope my questions are at least legitimate! How does it feel to be a work-widower? Maybe it is better than being a contract-bridge widower, at that?
STATE COLLEGE LAKE VIEW, WISCONSIN
DEAR
CAROL:
Yes, your questions are legitimate, and, I might add, much more intelligent than those my students ask every day. As I am a wifeless husband I should be able to answer some of them from experience gained firsthand. But tell me first, am I a work-widower or am I deserted? Tell me, too, I ask with trepidation, do you have double doors at your apartment? Frankly, though, I've learned more from your letter than you will learn from mine. All of us in our democracy need to learn much if fatherless children are to be given the freedom and security necessary for a good life. All the personal tragedies of the world do indeed bother you. As a social worker your business is tragedy, I suppose. Broken families, death, divorce, desertion, illegitimacy, dependency! If I were an old-fashioned husband I should tell you those are not your concern. But, alas, we are modern, you and I, and I shall discuss them with you. If some day we should write a book on fatherless homes (or
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should it be wifeless homes, since I am an expert in the field?), let us pray that we will not indulge in the sentimental hokum written about marriage and divorce even by reputable sociologists. I told you once how unsatisfactory the factual data on unemployment are. They are infinitely poorer on broken families. Facts and figures! If only sociologists could be scientific instead of romantic when they discourse on family discord! Ugh! T h e literature devoted to family disorganization, with but f e w exceptions, contains random facts, unreliable and incomplete statistics, and a great deal of preachment and nonsense. Some sociologists should preface their articles and books, " I have a statistic," but I would add, "It doesn't mean anything." It's time to do some hard, cool, and, yes, calculated thinking about marriage and the family. It's time to omit the sob story, the true confession, and the prejudices of the hoop-skirt era. "That's all very w e l l , " I can hear you say, "but get down to the hard cold facts yourself." I will, but I warn you, my facts and figures and conclusions are drawn from relatively few studies, for but f e w good studies are available. A l l your cases, the Thomson, the Gomez, the O'Donnell, the Boja, the Hall, and the farm girl who went wrong, all your cases have two things in common. They are fatherless families with children and they are dependent. Could not, then, all your questions be resolved into these: How many fatherless families are there? What are the chief causes of family disruption? And what can be done to prevent it? W h y do broken families so often become dependent? And what obligations should the state assume when this dependency occurs? As a social worker you know more than I do about individual eases. I shall try to give you the general information I have. H o w many fatherless homes? The 1 9 3 0 census takers counted about 28,000,000 families in the United States. Of this number 3 , 7 4 2 , 4 3 2 were families with female heads. Because the population has increased, doubtless both figures are larger today.
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HOMES
There must be in the neighborhood of 30,000,000 families, including about 4,000,000 headed by females, at present. T h e 1 9 3 0 figure is broken down as follows: Table 6. Status of Female Heads of Families in 1930 Status of Head
Number of Families
Widowed 2,534,630 Divorced (not all divorcees will admit their marital status) 235,893 Married, husband not present (probably separation or desertion) 400,695 Single 57I>2I4 Of these 3 , 7 4 2 , 4 3 2 broken homes, 1 , 5 4 2 , 2 7 8 had children under twenty-one; 1 , 0 5 5 , 0 5 3 were headed by widows percent
of
all
widows)
with
children
under
(41.6
twenty-one;
4 3 1 , 4 2 4 were headed by widows with children under ten. In 1 9 3 0 about 20 percent of all the homes in the United States were broken—one out of every five. T h e majority of these homes were headed by women, and nearly one-half of the fatherless homes had children under twenty-one. Popular alarmists would have us believe that the proportion of broken homes in the total population is materially increasing. The inconclusive figures available do not support this contention. Professor Ogburn, who made a sample study in four Middle Western states of the broken homes in which the men were younger than forty-nine years of age and the women younger than forty-five, found the percentage of such families to be about 1 4 both in 1 9 0 0 and in 1 9 3 0 . Of course the percentage of broken families increases as older people are included, but since the death rate is declining the number of homes broken by death has decreased. Moreover, the percentage of broken homes with children dropped from 1 0 percent in 1 9 0 0 to 9.2 percent in 1 9 3 0 , a fact to be explained, I suppose, by the declining birth rate. What is true is that homes broken because
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of death during youth or middle age are decreasing, while homes broken because of divorce and separation are increasing. T o quote Professor Ogburn's study, " T h e percentage of homes broken by divorce, annulment or separation . . . has increased from 6.7 percent in 1 9 0 0 to 9.8 in 1 9 3 0 . " T h e percentage of homes with children which were broken by divorce and separation rose also, from 3.4 percent in 1 9 0 0 to 4.9 percent in 1 9 3 0 . A n d , more pertinent here, the number of fatherless homes needing aid has increased and is increasing. T o you as a social worker the most significant point is the number of broken families needing assistance. In August, 1 9 3 4 , when surveys were being made f o r the Social Security Act, approximately one out of every five families on relief was a broken family. Of the fatherless families in 1 9 3 4 ,
358,000
households headed by widowed, divorced, or separated women were receiving relief, and these families contained
719,000
children under sixteen. This was 8.8 percent of the total of 4,059,605 families receiving relief at that time. A n d 1 0 9 , 0 0 0 (usually widowed) families having 280,500 children were receiving aid to dependent children (often called mothers' pensions). In addition, about 250,000 children were being cared f o r in institutions and foster homes. It is safe to estimate that over 1 , 2 5 0 , 0 0 0 children under sixteen are still dependent on public assistance of one kind or anothei, and many more need such assistance. A f e w more facts might be enlightening. Death of the husband as in the Thomson, Gomez, and O'Donnell families is the major reason for broken homes, though the declining death rate, as I said above, makes this cause less important than it once was. On the other hand, divorce rates have been steadily increasing, and divorce is becoming more important as a factor in broken homes. T h e Hall type of family, as you know, is more and more common. For every 1 , 0 0 0 people but .47 divorces occurred in 1 8 8 7 , but in 1 9 3 0 the number per 1 , 0 0 0 of
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107
the population rose to 1 . 5 6 . Every year sees an increase in the proportion of divorces to marriages. In 1 8 8 7 only 5.5 divorces were granted per 1 0 0 marriages performed, but in 1 9 3 0 the proportion rose to 1 7 divorces per 100 marriages. For desertion, "the poor man's divorce" (or "vacation"), no comparable statistics exist. It is difficult to determine the facts about desertion, especially for purposes of enumeration; it may or may not be permanent, and women often refuse to admit that they are deserted. The 400,695 families of the 1 9 3 0 census in which the husband was not present, though not divorced or dead, were quite often deserted families. Doubtless during the depression desertion has increased. As you probably know too well, desertion leads to dependency more often than divorce. According to studies made in Chicago and Boston some years ago, desertion accounted for ten percent of the welfare society cases. I don't know whether a mother and her illegitimate child or illegitimate children constitute a broken family or not, since the real family relationship is never formed, but for your purposes I suppose it might be so classified. Again, for obvious reasons figures are hard to obtain. A l l we know is that about 75,000 babies are born out of wedlock every year. Illegitimacy occurs, contrary to your snap judgment, more often in the city than in the country. The sex impulse is not less powerful among farmers, as their larger families show, but temporary illicit relationships are simply easier in the city than on the farm. Whether or not illegitimacy rates are higher among poor than among rich families the statistics don't tell. Probably they are, but the rich are able to hide births more easily and know more about contraceptives than the poor. To say that broken families are caused by death, divorce, desertion, and illegitimacy is obviously superficial. In so far as broken families are due to divorce, desertion, and illegitimacy rather than to death, it is possible to delve much further into
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the " w h y . " T o say that it is possible is not, however, to say that it is easy. Many varied and interacting factors lead to these man-made family ruptures. T h e trouble lies deep in the physiological structure and personality of the individual and in the nature of our urban industrial society. It cannot be diagnosed as readily as many platitudinarian sociologists think. I am not a psychiatrist or a physiologist, but a social scientist. The social factors which cause divorce I know something about, and I shall have to limit myself to them. In any case, if one wishes to know why divorced and deserted families are increasing, one must look to the influence of social changes. I doubt whether the fundamental nature of man has changed much in the last fifty or five hundred years, but divorces nevertheless are increasing. Family ties are different from what they were fifty or five hundred years ago becausc the family environment is different. The days of the big family circle in the back parlor, of male domination (was that ever possible-') and female subservience, are over. Courting and recreation are changed, procreation is not as frequent, and the mother has almost as many rights and privileges as the father. The family is no longer the self-sufficing social unit it was once. It not longer dominates and controls even its own members. As it has lost or altered its functions, it has tended to become more disorganized. Here is a partial list of the social reasons why (some of them overlapping and interconnected ) , as I see them: i . The family is becoming smaller. In 1900 households averaged 4.7 persons. In 1 9 3 0 the average was 4.01. During the same period the size of the actual family declined from 3.67 to 3.57 persons. When children are fewer, family bonds tend to be less tight, family tensions more severe and disrupting. Less than 1 0 percent of the homes with children are broken, while 25 percent of the homes without children are disrupted. Only 5 percent of the homes with children are broken by di-
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vorce and separation, while 1 9 percent of the childless homes are. 2. More and more our families live in cities. Urban families break oftener than rural because in cities social controls like public opinion are weaker, because attractions outside the family are greater, and because the home has fewer functions. In Chicago, f o r instance, 1 9 percent of those homes where the man and woman are under fifty are broken, while in the rural Middle West but 8 . 1 percent are. L i f e is swifter, more complex, in cities. Interests outside the home such as movies, clubs (night and otherwise), and recreational centers tend to dwarf interests within the home. Dwellings are smaller; families live in apartments with little space for children instead of in houses with back yards. Unlike your Aunt Edith who raised her food, canned it, and f e d it to her brood, city families buy prepared food, seldom make much of the family meal, and often eat at restaurants. Y o u r Aunt Edith did her own washing. In the city 67 percent of the laundry is done outside the home. Y o u r Aunt Edith knew everyone in her neighborhood. Anonymity is much greater in urban areas. Mrs. Jones can go out with M r . Smith without any Aunt Ediths knowing about it. 3. T h e state and other social agencies have taken over many functions formerly performed by the family. Educational, recreational, health, economic, and other kinds of services are increasingly being considered obligations of the state rather than of blood relatives. Hence the family, once the center of the chief activities of life, has lost much of its significance f o r and value to the individual. T h e family gives less to its members. A n d its members cherish it less, give it u p with fewer qualms and heartrendings. 4. Women have become freer and at the same time more able to take care of themselves. W h e n they dislike their husbands they can leave with less fear of the outside world and with more chance of finding happiness elsewhere. Public opin-
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ion no longer condemns a woman for leaving a man she dislikes, and young women can often find jobs more easily than young men. Secular, not religious, sanctions increasingly determine conduct. 5. Divorce has become more respectable, less sacrilegious. Hence new laws have been made which make it easier to untie the once sacred bonds of matrimony. Wives and husbands can now leave their mates when before it was legally almost impossible, and they can do so without much fear of social disapprobation. 6. Economic tensions have steadily increased both within and without the family group. Material desires are more numerous and cannot be as easily satisfied within the home. Once mothers and fathers provided for the family almost entirely on the stove, with the sewing machine, and from the soil of the old homestead. Today the clothes and food are purchased downtown at the store. At the same time has come a further awareness of what others are eating and wearing and a keener desire to keep up with the Joneses. Since necessities and luxuries are increasingly purchased, and a greater desire to obtain them has arisen, cash is more in demand, and the pressure to make money is stronger. As the number of gadgets one just must buy grows, so does the economic strain on the family relationships, a strain which often ends in disaster. Outside the home the wage earner finds competition stiffer and is more subject to the vicissitudes and vagaries of an economic system that he controls less and less. While the family demands more, the wage earner cannot often promise more, unless he buys on the installment plan. Ragged nerves and tempers thrive under such conditions. Under these conditions, too, poverty is even more likely to cause family disruption. Poor and little food makes anyone dissatisfied, irritable, and irritating, especially when abundance is seen everywhere and yet seems unobtainable. Poverty, of course, has always caused trouble in families, but today,
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when attitudes and conditions have changed, it is more likely to cause not only trouble but divorce or desertion. A broken family, as you know too well, is liable to become dependent unless it has private or public insurance. The very social and economic conditions which disrupt it are often those which contribute to its dependency. The problem of dependency is hence particularly acute among broken families. Widows are often in need because their husbands, like Thomson, Gomez, and O'Donnell, could not or did not carry enough life insurance to support their survivors. Most workingmen, as you say, do not earn enough to allow them to insure much more than their own funerals. Until changes were made in the Social Security Act their families were often left without any means of support. Unfortunately the wives and mothers usually cannot work to support the families. Sometimes they are too old to obtain jobs that bring in more than a pittance. They are usually unskilled in industry or business because they became wives. Even if they are young and skilled they must (and often should) stay at home to care for children. And in this urban industrial world women and children cannot maintain themselves by work in the home or on the farm as did your Aunt Edith's family. Well, what are the conclusions? T o be realistic, just this: for various reasons and causes, inherent in our modes of living, 4,000,000 fatherless families are a present fact. Perhaps 400,000 of the families, with over 1,000,000 children (my figures are rough estimates, remember), need public assistance of one kind or another. Can we do anything to prevent and check family disorganization? Yes, but first let me point out some very real limitations. W e ought to realize that some family disorganization is inevitable, and that the potentialities of preventive legislation are limited. Poor men, like Boja, cannot easily be prevented from taking vacations from wives they dislike. Incompatible marriages
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like that of the Halls cannot be made successful simply by laws regulating marriage and divorce. Husbands do die and their wives do inevitably become widows. N o law can make men live again once they are dead. A n d girls and boys, men and women, in this world, at least, cannot always control their impulses even though a minister hasn't consecrated their union. Little will be gained by making those laws which concern divorce and desertion more strict, by limiting women's freedom, by outlawing birth control and forcing parents to have more children. N o more will be gained by trying in our urban industrial environment to increase the functions of the family through reducing those of the state. T h e fundamental social and economic factors and the basic family disharmonies which cause divorce, desertion, and illegitimacy would still remain. Nevertheless, something can be done. W e can hope to reduce the proportion of families which go on the rocks and we can cushion the rocks a little. First of ail we need much more information about the causes for and the remedial treatment of family tensions. As yet we know too little and that little none too well. W h i l e we arcwaiting for some truly scientific sociological and psychological studies, however, we can take a few positive steps, fully realizing the limitations of any single measure. Greater care should be exercised in the establishment of marriage relationships. T h o u g h men cannot be remade by legislative action, many of their actions can be curbed by law. State laws can further delimit the conditions under which marriage begins, and they should do so. Our marriage laws do cry out for revision. Written for the most part in the nineteenth century, the present heterogeneous and numerous laws lag far behind present-day knowledge and fail utterly to meet the exigencies of modern life. They should be modernized and made fewer and more uniform. Premarital blood tests for venereal diseases, as already required by several states, should be required
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by all. A waiting period of three to five days between the issuance of a license and the marriage ceremony, already the law in several states, is desirable. Though sterilization is a dangerous practice, it would be wise to prevent, through the enactment of carefully phrased and enforced sterilization laws, the further transmission of incurable mental defects and physical disease. It would be a step ahead if even the present laws against marriage of the feeble-minded and insane were enforced. All marriages of children below the age of sixteen for females and eighteen for males should be made illegal and prevented by refusal to grant licenses. A study in 1 9 2 9 revealed 600,000 such marriages, and they break oftener than do adult unions. More important and effective than these measures is the need of education for marriage and family relationships. Education (oh, blessed word!) won't make marriage invariably a howling success, but it will help explode a good many romantic fallacies, sex prejudices, and dangerous misconceptions about marriage. Too often the marriage ideal of American youth is a curious blend of Hollywood, puritanism, and the back alley. In spite of the seeming sophistication of the youth of the 1930s, sex is still a matter for whispers, glances, and giggles. Sex education should begin early in home and school and should continue throughout life. The sex urges cannot be stifled by "conscience." They can be controlled, sometimes sublimated, and eventually expressed in socially acceptable ways. Through early education in sexual matters, illegitimacy may be lowered and many of the tensions which lead to divorce and desertion lessened. Realism and intelligence can be applied to family relationships as well as to anything else. If the Halls and the Bojas had known more about sexual relations their families might still be together. Of course, not all the questions which arise after marriage can be settled before marriage. The enactment of laws and the best premarital education will not end conflict in the home.
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A f t e r marriage as well as before, m e n and women need advice and counsel. In the larger cities clinics for treatment o f marital and family troubles are being established. T h e s e should be much more numerous than they are. As rapidly as the acquisition o f funds and a trained personnel permit, they should be established throughout the country. T h e expense would not be prohibitive; less money would be necessary for divorce lawyers' fees. Privately financed family case work agencies, to be sure, are performing some effective service o f this kind at present, but these organizations are necessarily so occupied with relief and economic problems that they cannot adequately fulfill this particular function. Because they lack funds and time, their efforts are sporadic. At any rate, persons not on relief seldom avail themselves of their services. T h e r e is no reason why public courts everywhere should not assume some responsibility in this matter. In some cities courts o f domestic relations have already had signal success in the treatment o f family discord. Every court that grants divorces should have a judge who specializes in family relationships, and w h o has constantly available the services o f a psychiatric case worker and a physician. T h e chief effort o f the court might well be directed toward the creation o f stable family relationships rather than the granting o f divorce decrees. I f the family is the primary social unit in our civilization, should it not receive as much attention as the legal aspects of property rights? W e
train and hire skilled
arguers in the technicalities of contract. Should we not train and use skilled technicians in the intricacies o f family relationships? Material advancement toward durable families will not be made, however, until the economic hardships which confront so many families are alleviated. I f unemployment, low incomes, and bad housing could by some miracle be made to vanish, a real decrease in the number o f broken homes might be expected. M a n y families never really become economically established or
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experience an orderly comfortable family life. With the wolf at the door, who can be happy, orderly, comfortable? I'm not going to discuss with you again the various ways to drive away the wolf. Reread my earlier letters, or have you thrown them away? I well realize that none of the suggestions made thus far will establish normal family relationships for widows and their children. The only solutions for the problem of widowhood would be to secure new husbands for widows or to enable wives to keep their first spouses by decreasing the male death rate. Both of these solutions can have but limited application. Of course, public matrimonial bureaus for widows could be established, but the male applicants for those widows who have children and no wealth would be scarce indeed! The male death rate could be slightly lowered if industrial accidents and fatalities were reduced, but no safety measures could prevent some husbands from dying earlier than their wives. For the families headed by widows who are unable to work there are no real remedies except social insurance or public care. What can be done about dependency in broken families? Some kind of social action is necessary, I suppose, when the home is not a fit place for the children or when it is impoverished. You ask, " W h a t is a fit home?" I'm not sure, nor is anyone else. If the mother is feeble-minded or insane, if she is blatantly immoral or physically incapable, then the state should break up the home and take the children into custody. But there are so many borderline cases and so many interpretations of morality. Mrs. O'Donnell is a terrible mother, but she apparently is neither obviously immoral nor feeble-minded. If the criteria of the past were followed, then Mrs. O'Donnell would keep her children. Yet you and I know that she would harm her children more than many less circumspect women. Extreme caution in such cases is absolutely necessary. You and I are certain we know how to rear Mrs. O'Donnell's family better
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than she does. I suppose we do, but can we really be sure? T h e first and most vital consideration should always be, what is best for the children? But what, exactly, is best for the children? Even the care o f those mothers who are none too intelligent or who have transgressed moral codes may be better than that which institutions or some foster home could supply. I ' m not one o f those who say that mother's care is always best for a child. I, too, wonder about these sanctity-of-the-home stereotypes. B u t psychologists and sociologists are pretty well agreed that children thrive better in a home than in an institution, and that a mother's love does have certain emotional and cultural values which institutions and foster homes cannot provide. A widow may spoil her children by too fervent a love. T h e economic necessity to work may cause her to neglect them. She may, through what are called immoral actions, set a bad example for them. But an adopted or an institutionalized child is a transplanted child. I f taken from its most natural habitat, it may never again find roots and feel secure. I remember a sentence o f yours which is pertinent here: " T h e family is the most effective environment in which to meet the shocks o f l i f e and escape f r o m the anonymity and half-understanding o f an impersonal w o r l d . " I agree with you. T h e r e is, o f course, no dictatorial " m u s t " in any social relationship. Every situation requires different treatment. Some homes are not fit, but those who judge should remember that they are not omniscient. N o home should ever be broken up because of the political, economic, or religious ideas o f the parents (as has been done in Germany and occasionally
in the United
States).
In
Mrs.
O ' D o n n e l l ' s case I ' d suggest the treatment you outlined in a discussion we once had. Call a psychiatrist, a doctor, and a judge. G i v e her a mental test. I f she is feeble-minded, as you think, place the children in foster homes. I f she is not, perhaps you haven't discovered the right kind of treatment as yet, and can still develop in her the characteristics o f a good mother.
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If in the future the initial establishment of such obviously unfit homes could be prevented, then the ounce of prevention would be worth two pounds of cure. Public assistance to needy broken families, especially if the aid will prevent further disruption of these families, is now a generally accepted policy. But the state should not merely donate a pittance to keep the family alive. It should provide such economic assistance as will enable children to be reared with adequate provision f o r their mental and physical health. Alone, many mothers can't give children training and care and at the same time provide the economic necessities of life. A n y civilized, self-respecting society must feel responsible for the welfare of its future members, else it will commit suicide. Society, then, through the state, ought to provide the lower half of the double door, the economic basis of life, f o r needy broken families. It ought, as the President's Committee on Economic Security said in 1 9 3 5 , to "release from the wageearning role the person whose natural function it is to give her children the physical and affectionate guardianship necessary not alone to keep them f r o m falling into social misfortune, but more affirmatively to rear them into citizenship capable of contributing to society." It ought to do this not as charity, but as insurance against the future; not as relief, but as a social responsibility and a privilege. Social legislation should prevent further disruption of families on the ground of poverty alone, enable the mother to stay at home and care for her household, and release the mother from the inadequacies of the old type of poor relief and the uncertainties of private charity. I know I don't need to convince you; I know you are in entire agreement with this ideal. Fortunately legislation, f o r once, is beginning to approach the ideal. Aid to dependent children is now being given under plans approved by the Social Security Board in forty states, Hawaii, and the District of Columbia. Seven other states (all but Mississippi) are also grant-
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ing such assistance. This aid, however, is not as important as the benefit system established for widows and families of workingmen by amendments to the Social Security Act in 1 9 3 9 . Beginning January 1 , 1 9 4 0 , as you probably know, the United States will have what really amounts to survivors' pensions for the families of all those millions of workers who are insured under the old-age benefit provisions of the Social Security Act. T w o parts of the Social Security Act, then, apply directly to fatherless families. D o you have the provisions of both thoroughly in mind? Y o u seem confused about the benefit system. Probably I should outline both it and the aid to dependent children for you. I'll start with the latter. The federal government gives each state which has a plan approved by the Social Security Board an amount equal to onehalf of the sums expended for dependent children as long as these sums are not above $ 1 8 monthly for the first child and $ 1 2 for others in any one home. It hence allows $9 for the first child and $ 6 for the other dependent children if the state gives a like amount. The term "dependent child," according to the act, means a child under sixteen (eighteen if in school) " w h o has been deprived of parental support or care by reason of the death, continued absence from home, or physical or mental incapacity of a parent, and who is living with his father or mother" or other specified relatives in the home. The terms of the act concerning children, then, are broad. Any dependent child in widowed, divorced, or deserted homes in states with approved plans may receive some aid. Though the grants are still pathetically small, considerable progress toward security for youth has been made. Economic assistance has been granted to children in fatherless homes as a matter of right. The foundation has been laid. The lower half of that double door has finally been acknowledged a national responsibility. As late as 1 9 3 1 mothers' pensions (as this aid was then entitled) were given in only half of the subdivisions of the forty-
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five states which had laws on their statute books. The forty states which now have approved laws have aid to dependent children effective in all their subdivisions. More important, many more needy families and children are being assisted. In 1 9 3 1 but 93,620 families with 253,298 children received aid, in 1 9 3 4 but 109,000 with 280,500 children. By July, 1 9 3 9 , 720,809 dependent children in 298,956 families were being aided. That the grants are helping to preserve the family relationships the following facts show. In about three-fourths of these cases the children were living at home with their mothers. These mothers were usually (60 percent) widowed like your Mrs. Thomson, sometimes ( 2 5 percent) divorced, deserted, or separated, or cases similar to those of Hall and Boja, and occasionally (8 percent) had husbands in hospitals or jails. Their husbands had departed for one reason or another, but their homes were still maintained. Y o u may surmise that I'm looking through rose-colored glasses or that I've suddenly gone N e w Deal. Y o u know, however, that I never wear glasses and, admirable as is the N e w Deal's aid to dependent children, I believe it should be improved. Possibly 300,000 to 400,000 children in needy broken homes are not yet receiving this form of social security aid. Eight states and Alaska have yet to enact laws which are approved by the Social Security Board. What is worse, you are right when you say that the present grants provide less than minimum subsistence. The grants now average about $ 3 1 . 1 6 a month per family or $6.16 a month more than the average in your county, while the median payment is but $ 3 0 a month. One state, Arkansas, pays an average of only $ 8 . 1 4 a month, and in fourteen (mostly Southern) states the payments average less than $ 2 5 a month per family. These sums are meager, too meager. Though federal, state, and local appropriations for dependent children now total over $9,000,000 a month, it seems to me we could and should do more.
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Social security for the child will be attained only when families, broken or not, obtain a health and decency standard of living. For the immediate future we ought to demand that federal aid be pushed up to $ 1 5 for the first child and $ 1 0 for each additional child in any home, and that the first child in every dependent broken home be given at least $ 3 0 a month, the second $20. The federal government pays half the costs of old-age assistance up to $40 a month. There is no logical reason why it should not do as much for the young as it does for the aged. The cost of such assistance would not be small. If the average assistance per family were $50 and the number of families aided were 300,000 then the monthly bill for the local, state, and federal governments would be over $15,000,000 (including administration costs). Fifteen million a month, however, would be cheap even if we desired only future ablebodied soldiers instead of fully endowed citizens. We shall never need to spend this much, however, because in years to come widows and their children to a large extent will be given assistance from the old-age benefit funds, designated after January 1 , 1940, as the Federal Old-Age and Survivors Insurance Trust Fund. In the future, when a worker dies (whatever his age) his widow, if over sixty-five, will receive three-fourths of the monthly benefit that would have been due on the basis of her husband's wage credits. If she is less than sixty-five and has children below the age of sixteen (eighteen if in school) she will receive (with certain limitations) this same amount and in addition one-half her husband's benefit, for each child. In no case, however, can the total benefits paid be more than $85 a month, or an amount equal to twice the primary insurance benefit, or an amount equal to eighty percent of the average monthly wage, whichever is least. If Mr. Thomson had lived another year his family would not have been destitute on his death, as they now are. Let us suppose that Mr. Thomson had lived another year, that he had
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HOMES
hence been covered for three years by the old-age provisions of the Social Security Act, and that during these three years he had earned an average of $ 1 0 0 a month. Then, if you remember the letter I wrote on old age, he alone would have been entitled to a primary benefit of $ 2 5 . 7 5 upon reaching the age of sixty-five. His widow would receive three-quarters of this, or $ 1 9 . 3 1 , and for each of the four children until they reached the age of sixteen (or eighteen if in school) additional sums until the total family check amounted to twice Mr. Thomson's benefit. T h e total family income would be $ 5 1 . 5 0 a month, or enough to keep five people not comfortably but in the absolute necessities of life. This table, based on average earnings of $ 1 0 0 a month, will help you in your calculations: Table 7. Yean Husband Covered by Act 3 5 10 20 3°
Widow with One Child $32.19 32.82 34.38 37-5° 41.62
Survivors' Benefits Widow with Two Children
Widow with Three Children'
$45.07
$51.50 52.50
45-95 48.12 52.50 56.88
55-5° 60. OO 65.OO
" Maximum sum possible.
The United States has finally caught up with Germany, Russia, Great Britain, and the eleven other countries which have this type of legislation. Our legislation of the last four years does mark a long step forward. Single or married childless workers, it is true, may not receive as much in benefits as widowed families with young children. But this is as it should be. The risk of death will now be pooled for all families on an insurance basis. Before the amendments individual workers were really buying annuities for themselves after they reached sixty-five. N o w the workers are insuring themselves against oldage dependency and their families against the loss of daily bread that would in many cases result from their death.
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This guarantee of bread is indeed a prerequisite of democracy. But another prerequisite of democracy is equal rights for all. As you know, our old-age and survivors' insurance plan does not as yet include most agricultural, domestic, and many other independent workers and those who are unemployed. If they, too, are to have life and liberty they too should be covered. I suppose we are progressing about as rapidly as possible in the direction of social security for all. But we should not be satisfied until there is a guarantee of bread for all. Then, too, the present benefits are by no means magnificent. If her husband earned an average of $ 1 0 0 a month, a widow with two children would receive monthly but $45.07 to $ 6 1 . 2 5 her husband had been insured for forty years). These amounts do give bread and life to families like the Thomsons, but they do not provide opportunities for much educational and physical development of the child. They may be all we can afford now, but nevertheless they are not enough! W e should never be satisfied until every child in the United States is guaranteed that economic basis for life necessary for bread, health, and intellectual growth. It is getting late again. M y watch says twelve-thirty. I'm not sure I've discussed all your questions. Most of them cannot be answered with a simple "yes" or " n o " or with conclusive statistics. Y o u should have married a Thomas Aquinas. H e knew all the answers. Probably he knew so much because, being a churchman, he could not marry. I hope to see you this next week end. If you fail to keep our appointment I will either divorce or desert, depending upon how much alimony you would want if divorced. After all, I'm a poor professor. Desertion might be better, and I do need a vacation. Love, CARLISLE
HEALTH
SOUTHTOWN, WISCONSIN SUNDAY AFTERNOON
M Y DEAR CARLISLE:
After listening to the radio concert this afternoon I ran out to the hospital to see Mrs. Buchanan. She is very weak and I stayed only a minute. Hospital odors always depress me. Today I decided that the hospital smelled like those ghostly white fungi that grow on dead trees. You remember those large pale growths we often found in the woods behind the cabin, the kind that were so much fun to break apart? Probably a doctor would say a relief office smelled a bit stagnant too, and would remind me that social ills also have their stench. If so, I wish more people had sensitive noses. It sounds as though I'm not thankful for our little city hospital, but I am. In spite of its limited capacity and its equipment, in perfect harmony with its Victorian waiting room, it does fairly effective work for those who can afford its facilities. If only more people could afford that sanitized smell! You have never met Mrs. Buchanan but you have often driven by the little country church where her husband preaches. You remember it, about four miles south of town, the white church with a tall, slim spire that rises so perfectly against the sunset? I recall the evening last fall when I said it looked like a shining thrust of truth challenging the dark hills that surrounded it, and you insisted that on closer view it was an idea that had run downhill. Apparently, as usual (?), you were right.
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The Lutheran people of that rural community built their church and faithfully supported it in the days before rapid transit. But now the congregation is so small it can hardly sing a four-part hymn. Reverend Buchanan has been the pastor for the past ten years. A man of fifty-five years, he preaches quietly and deliberately on the meaning of the Bible and acts as the Lord's representative at baptisms, marriages, and deaths. He also advises the farmers on buying and selling and often enjoys an evening cigar with the men as they linger around the near-by village store. Mrs. Buchanan is as restless as her husband is deliberate. She chirps and bustles around, likely to lose her head over Christmas programs and missionary meetings. She does the worrying for the entire parish and often talks to me of some needy family she knows. T w o weeks ago she dropped in to see me, looking very pale and shaky. " D r . Baker says I have to have an operation right away. He said the same thing three years ago but I put it off. N o w I guess I can't wait. Reverend Buchanan and I have thought about it for a long time, and we have decided to ask the relief for help. Oh, it is terrible to come to this! Think of it, the pastor's w i f e getting relief! But there seems to be no other way. The church gives us our house and the collection, which is about $ 1 0 or $ 1 5 a month. You know all the subscriptions go to pay on the church and for heat and the orphans' home and missions. Sometimes those that can't pay anything bring us some wood or a chicken or some potatoes. They all do what they can. But we just haven't any money saved to pay the doctor. The Ladies' Aid can't raise enough money and I couldn't have them hold a benefit for me—you see it is female trouble I have." After consulting Dr. Baker, we realized the seriousness of Mrs. Buchanan's condition. The fact that she had postponed the operation for so long now made the outcome more doubtful. She may be invalided for years. When the social case worker
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brought the matter before the church treasurer he could promise no aid. He showed her the church books indicating a deficit in the annual budget and revealing that the cash paid the minister was even less than Mrs. Buchanan had implied. Finally, Reverend Buchanan made a special trip to town to sign the relief application, as his wife would not assume this responsibility. He cleared his throat several times, wiped his pen meticulously, wrote his name in beautiful script, and reread the signed document. " I guess the Lord has many ways of taking care of his people," was all he said as he left, but we sensed that he felt deserted by his congregation and distressed that anyone should discover how poorly the work of the Lord pays in worldly goods. Well, the operation was performed Thursday morning. She will recover, though slowly. The doctor said the whole thing might have been avoided had Mrs. Buchanan had treatments ten years ago, and that if surgery had been provided sooner her chance of complete recovery would be better. But she had never been able to afford the care. N o w the cost will be, not in terms of dollars, but in terms of days, even months, of lying quietly in bed or sitting in a wheel chair. The thought that hundreds of people need medical care and do not receive it haunts me mercilessly. How many people like that there must be! Among relief families who do obtain treatment for their most obvious illnesses we find endless and recurrent health problems. Over a year ago, when we were trying to arouse public opinion for a county nurse, we made a survey of the health needs in families on relief in this county and found some alarming facts. W e discovered that about onefifth of all our families were dependent because of the poor health or physical disability of some member, usually the head of the family. But that wasn't all: 6 1 percent of all of our families had some recognizable illness or health handicap. In-
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eluded in this list were 34 cases of total or partial mental incapacity, 3 1 cases of tuberculosis not in institutions, and 1 8 cases of appallingly malnourished children. When there is that much illness among people who have access to emergency treatment, how much illness there must be among poor people not on relief! D o you have any information about the total amount of illness in our country? I've often wondered whom illness strikes the hardest, what diseases are the most prevalent, and how much time is actually lost because of sickness. In fact, I don't have any idea of health conditions in the country at large, though I know them in this county only too well. There seem to be majiy families like the Buchanans who can meet their ordinary expenses but who have no reserve to depend upon in an emergency, such as an operation or accident. A young couple, the Whitmans, were in just such a predicament when Frank Whitman had an appendectomy five weeks ago. He has been employed steadily for two years by the Prairie Dale Creamery at $ 2 0 a week. The Whitmans live in a modern little bungalow which they have rented for the past four years. It has a well-mowed lawn, neat hedges, and a flower and vegetable garden at which Mr. Whitman works incessantly. They have a brown-eyed little boy of three and a baby born last week. Complications set in after Mr. Whitman's operation and he stayed in the hospital three and a half weeks. As soon as he was out he came to the relief office to discuss his financial problem. The family savings of $50 were gone. Mr. Whitman would not be strong enough to go back to work for almost a month. His medical and hospital bill, which, in spite of the leniency of the doctors, was $ 1 7 5 , loomed larger and larger as he worried over its payment. But uppermost in his mind was the desire for proper medical care for his wife, whose coming confinement, according to the doctor, might mean surgery and hospitalization. "Jane is in such a state I can't do nothing with her," he said.
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HEALTH
"She is scared the doctor wouldn't do everything his best when we owe him so much and can't pay him. Well, we've gone to the old doc a long time and I know he'll do it, but it isn't fair to him. Could the relief help us with her bill? If I hadn't took sick we thought we could pay for the baby in a year, but now! My father can't help me; he lives with my sister on the old farm and they don't have anything. Jane's folks are dead. Her sister promised to come in and cook for me and the boy when Jane goes to the hospital, but now I don't see what she'll cook. I can't get no more credit at the store; they're scared I won't get my job back. I tried to get a loan at the creamery, but nothing doing. Does the relief have some kind of a loan I could get? Gosh, I don't want charity, but the wife's got to have the right things or else—Well, I don't know what'll happen!" The relief department paid for Mrs. Whitman's confinement. (It was a girl.) This is the way the medical bill in this family looks: $
25 100 75
$200 75
B a c k doctor bill f o r boy's broken arm and measles Hospital and operating room f o r M r . W h i t m a n Surgery f o r M r . W h i t m a n
Total medical bill M r s . W h i t m a n ' s confinement
(delivery and
hospital),
if w e l f a r e had not paid f o r it $275
T o t a l cost of illness this year
In addition, Mr. Whitman has lost $160 in wages during his illness. The total cost of the family's sickness, then, is $435. Frank Whitman earns $960 a year, and the family illnesses cost almost half of this amount. His actual medical and hospitalization charges ($200) are 25 percent of his total actual earnings this year ($960 minus the $ 1 6 0 wages lost). If the relief department had not paid for his wife's confinement the medical costs alone would have equaled almost 35 percent of his yearly wage. It will take him a long time to pay off this debt; with
128
HEALTH
much scrimping and no more hard luck, perhaps three years. There was no way to postpone this expense and no way short of unhealthful deprivation to meet it. Surely in this day and age we can make a plan, other than charity, for meeting these emergencies. An insurance system of some kind ought to be feasible; we have insurance for almost everything else. In fact, what about state medicine, although I know most doctors object to it? As it is, the doctors receive their money from the government when the relief department pays for medical care, and they don't object then. People probably would say that the Whitmans are not the average American family, only an isolated case of hard luck. Granting that they are not typical of most families, are they not typical of most poor families in an emergency? What do you know about the "average American family "; what does it actually expend for medical care? Of course, when we know the amount a family really spends for medical care we still do not know what it should have spent to meet all its health needs, do we? T h e fact that people owe doctor and hospital bills is direct evidence of their inability to pay for medical care. Some time ago I made a careful study of the indebtedness of families in a rural county when they first applied for relief. I found that the average relief applicant owed $45 25 in doctor bills and $ 5 . 4 0 to hospitals, or about $ 5 0 for medical services. More conclusive proof that these families could not meet the cost of their health needs was the fact that 1 0 percent of the applicants at that time were asking for medical relief only. Of the cases who wanted help only with medical care, the average indebtedness to doctor and hospitals was $84.30- About 68 percent of all relief applicants owed something for past medical services. These people simply could not meet the cost of the little medical care they obtained, not to mention what they ought to have had. Where should we start? Should we try to reduce the high
HEALTH
129
cost of keeping in good health, or should we tackle the problem f r o m the other side by trying to raise incomes so the proper care can be purchased? People who live on the margin are really helpless when illness strikes. Like the two I have already mentioned, the Adolph Schultz family, with seven children, were certainly in a tragic situation when diphtheria broke out among the youngsters! Every one of the seven children had it. M r . Schultz was working in a paper mill. He earned $ 9 0 a month during the busy season, but his yearly earnings were seldom above $900. With a huge garden and two cows to supplement these earnings the family managed to exist without public aid. W h e n diphtheria broke out M r . Schultz had to stay at home to help his wife care for this small ward of patients. With no reserve, they were destitute and were forced to apply for aid. T h e relief department furnished food and medical care all during the quarantine. I remember my long telephone conversations with the doctor. A s he was the only one in contact with the family, he reported their needs. "They haven't a decent sheet in the house, nor really enough bedding," he said one day. " T h e y should have some fruit juices; Mrs. Schultz feeds them pancakes," he reported on one of his first calls. " N o use trying to take care of them, they'll die of pneumonia next," he complained, " I found two of the boys who are just out of bed wading in the mud in the back yard today, and they haven't rubbers to wear." That was in March! I learned things about antitoxin inoculations f r o m the doctor, and I believe I'd have made a social worker out of him if the case had continued much longer. I've been telling you about families who are able to meet their ordinary expenses but not the extraordinary costs of unpredictable illness.
There are other families, though, those
already receiving relief, among whom the incidence of illness seems unusually high. It makes one wonder if these people are on relief because they are ill or are ill because they are poor.
130
HEALTH
Maybe this is just another chicken-and-egg question. It is easy to see that the relief department would have to care for many families when the breadwinner is totally incapacitated, through either illness or a physical handicap. The Szymowski family is a good example of such a case. Peter Szymowski, although only thirty-eight, is a tottering wreck. His mind and body are slowly becoming paralyzed: he has paresis—advanced syphilis. He thinks he is improving, and the last time I saw him he was jubilant because he could walk the full length of the house again. His young wife is wretched. She has passed through a period of bewilderment and sorrow and is now disgusted with her husband in his childishness and hates him because she has the same disease. The two children seem to have escaped the illness so far. The venereal ward at the state hospital has been overcrowded, but I believe they will take him now. The local doctors have been doing all they can but they have concluded that his case is hopeless. He started treatments several years ago, but grew discouraged with the expense and slow results and dropped them. For a while he seemed better, then became far worse than before. He resumed treatments a year ago, but too late. Mrs. Szymowski, besides her venereal infection, has had trouble with her teeth. Never have I seen such teeth—mere stumps, rotten stubs! Yet it took about three months of persuasive effort on the part of the case worker to get her to a dentist. The teeth will all have to be extracted. Out of ignorance and fear as well as poverty she neglected herself so that now, a young woman of twenty-eight, she is almost as toothless as a grandmother. Before she came to the relief department she had had absolutely no dental care and had never had adequate medical care. Preventive health measures taken in time might have preserved this family of four. Now the family is broken, the man will live on in increasing disintegration, and the mother will
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131
need medical attention for several years and financial assistance for herself and the children from either relief funds or aid to dependent children. The financial burden, as a result of this neglect, will have to be borne by the government. I f one were to disregard all the more significant physical and social concomitants of neglected health, surely the financial cost alone would make preventive medicine a profitable investment. I had dinner last night with the county nurse. She is ostensibly a preventive agent, but finds herself hampered on all sides when she tries to work effectively. She was telling of a twelveyear-old boy, Harry, who was in the fourth grade in a country school. Harry was considered subnormal by the teacher and was becoming quite a behavior problem. When the nurse discovered that the boy was nearly blind, the cause of his supposed subnormality was revealed. She called at Harry's home and talked with his mother about the necessity of taking him to an oculist at once. The mother promised to do this, but when the nurse visited the school a month later Harry still had no glasses. Alarmed, she again called at Harry's home. The mother barely spoke to the nurse but directed her hurriedly to the barn where the father, the boss of the family, was working at the evening chores. "Lady," he said to the determined little nurse as he went on spreading straw in the horse stalls, "you say Harry's got to have glasses. He's got along twelve years without 'em, and I reckon he kin wait till them there pigs over there is big enough to take to town so I kin git some cash. We'll take care of ourselves, yes, ma'am. All right, lady, I'll take the kid in to see the eye doctor, but when I git good and ready, and not till I kin pay for it." The nurse and I sat a long time over our coffee discussing the health problems she encounters. The picture she draws of child health in this county is terribly discouraging. Almost half of the school children that she examines (and she covers the entire
132
HEALTH
county) have cavities that she can actually see in their permanent teeth. Yesterday she called at a home where a child seventeen months old had just died o f scarlet fever. " I t was really malnourishment that killed that child," she said. " W h e n I first came to this county I had nightmares from seeing all these pasty-faced children, stunted and undernourished, and living right in this dairy country too. I'm afraid that soon I'll become too much accustomed to them. If they had proper food their resistance would be up and they wouldn't catch all these diseases. And then, there are all the adenoids and tonsils that should come out. W e can get help when it comes to buying glasses for children, but not when an adenotomy is needed. A child may breathe so loudly you can hear him all over the schoolroom (as did two of them in a school today) and yet the parents won't have the adenoids removed. Why? Oh, they either cannot afford it, or some busybody scares them by saying the operation is too dangerous." W e l l , can v/e sit here calmly, knowing such things are going on, and not make a fuss? I want to do more than fuss; I want to be taking part in some plan that is a solution to this health problem. But what is the plan we should advocate? I know that the people in this country do not have adequate medical care; I know that many cannot alford it; I know that many are ignorant o f the importance of such care. O n the other hand, we have doctors, public-health officials, and a hospital. But our hospital needs enlarging and modernizing. T h e public-health officials, other than the county nurse, know less about disease than you and I and reach their height of achievement when they pound four tacks into a quarantine sign. W e have enough doctors, but they do not reach all who need them. T h e relief department pays out enough for medical care each month to hire two full-time physicians at a high salary. But that would be socializing medicine.
Socialized
medicine?
Oh,
never!
The
county medical association would kill in its prenatal stage a plan for public medicine.
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HEALTH
So this is what the situation looks like, my dear. What are your recommendations for meeting our health needs, even only the most conspicuous ones at first? If you say health insurance, remember it won't cover relief clients, although it might cut down their number. If you advocate socialized medicine, remember the sentiment against such a system, even in our own progressive community. Voila! Look at the questions I have asked you, a whole letter-full before I was really aware of it. It is almost eight o'clock, way past my dinner hour, and I feel slightly giddy. Don't worry, though; it is merely hunger that afflicts me, unless one might call it some stage of social fever that has infected my brain cells. More and more I am becoming feverish about social problems. We travel so slowly. This is the land of life and liberty. Can't we somehow make it possible for most people to have at least a healthy life? Loving you always, in sickness and in health, CAROL
AT
HOME
LAKEVIEW,
WISCONSIN
WEDNESDAY
DEAR
NIGHT
CAROL:
Your letter on the health problems in your county was most opportune. It humanized a whole series of lifeless facts and figures about medical care and costs for me. I have been plowing through dozens of reports, magazine articles, and books. I have garnered a stack of statistical and factual notes a foot high. But statistical compilations are cold and meaningless unless they have the breath of life blown into them. Your portrayal of specific cases has done just that. Social scientists too often view
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HEALTH
humanity only in the abstract. Social workers too often see it only in the personal. Together we can reach a truer and more satisfactory view. And we are free to do a little toward helping others to a healthy life. If social security in America is ever to be attained, much more must be done to prevent sickness, to treat it when it occurs, and to protect people against disastrous loss of income when they are ill. Like you, I believe we ought to make a fuss! It's time we did something about the Buchanans and Schultzes and Whitmans and Szymowskis. Before we do, however, we ought to know just what the facts are. If social action is undertaken it ought to be intelligently planned and based upon comprehensive studies of the actual situation and knowledge of what can and should be done. Because such studies have been and are being made I believe I can answer most of your questions fairly adequately. W e never have enough facts, but we do have enough to know that the situation is bad and that some remedial measures are not only possible but practicable. Though the general populace is healthier than it was fifty years ago, millions of Americans suffer from disabling illnesses and bodily handicaps for which they receive little or no treatment. The extent of illness in the United States is still astounding, and our failure to care for it is alarming. A couple of years age the United States Public Health Service published the results of a National Health Inventory. This was a house-to-house sample survey of 740,000 families comprising 2,660,000 persons. It was made during the winter of 1 9 3 5 - 3 6 by W P A workers under the direction of the Public Health Service. The inventory estimates (no one knows definitely) that because of illness, disease (other than venereal), or accident about 4,000,000 individuals are unable to pursue their regular activities on any average day. In winter the number grows to 6,000,000 a day. Every year 1 7 percent of the population, or 1 7 2 out of every 1,000 people, suffer illnesses which incapacitate them for a week or more. Over 22,000,000 such
135
HEALTH
disabling illnesses (not including those from venereal disease, malaria, and hookworm) occur annually. In round numbers, more than 2,500,000 of those disabled for a week or longer have a chronic disease such as rheumatism, heart disease, or tuberculosis; 1 , 5 0 0 , 0 0 0 are ill from respiratory diseases such as colds, pneumonia, and the like; 500,000 have been injured; and 2 5 0 , 0 0 0 have acute diseases of the stomach, liver, or appendix. Because of illnesses and injuries which last a week or longer nearly 1 , 2 5 0 , 0 0 0 , 0 0 0 days are lost a year from work at home or in industry or from school. If this incapacitation were divided equally among all the individuals in the United States, which of course it isn't, then every man, woman, and child would be disabled at least ten days each year. Y o u will observe immediately that the above figures do not at all represent the total number of illnesses and accidents. They include only those which disable a week or longer. N o r do they indicate the extent to which individuals are seriously and permanently handicapped through loss or crippling of some part of the body, feeble-mindedness, or mental disease. A s these handicaps usually impair the individual's activity just as sickness does, you should have some knowledge of their extent. Rough estimates must suffice, because accurate authoritative statistics are few. Table 8.
Number of Handicapped Individuals in 1 9 3 7
Handicap Permanently handicapped by crippling or loss of feet, legs, hands, or arms Permanently injured in back, spine, or trunk Totally blind Totally deaf Deaf and dumb Feeble-minded at least Mentally diseased (in institutions and hospitals sometime during 1 9 3 7 )
Number 1,200,000 300,000 107,000 65,000 75,000 1,000,000 700,000
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HEALTH
Probably, then, at least 3,500,000 people in the United States are seriously and permanently handicapped in the above ways. The total, of course, would be still greater were all those who are handicapped by chronic diseases like tuberculosis and syphilis included. Some of the estimated 6,000,000 syphilitic cases and a good many of the 680,000 people who have or are suspected of having tuberculosis certainly find their normal activities impaired. Handicaps of mind or body, it is true, do not always cause obvious disability, but they do constitute one of the major health problems. Anyone interested in obtaining medical care for the American people must consider them as important as any other form of illness. Millions of Americans constantly are undergoing the hardships of physical impairment or illness. Sickness, however, does not strike all men equally. It falls unevenly among the population and varies greatly in severity. According to the Committee on Medical Care, whose twentyeight volumes comprise a monumental study of health and medical care, the average family studied (4 to 4.5 persons) suffers 3.8 illnesses a year. But 8 percent of the families have no illnesses whatsoever, 40 per cent have two or less, and the others have more than two. If individuals rather than families are considered, out of every 100 persons, 47 have no illness during a year, 32 have one, 1 8 have two or three, and 2 have four or more. The burden of illness, it is apparent, is as unevenly distributed as are wealth and income. The incidence of illness varies according to three factors: the age, the sex, and the economic status of the individual. The Mrs. Buchanans are likely to be sick more than the Mr. Buchanans. The Whitmans and Schultzes are liable to be sick more often and longer than their rich compatriots. The very young and the aged are sick more often than those in between, and sickness among the elderly lasts longer. From the National Health Inventory I have taken the fol-
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HEALTH
lowing table [Table 9 ] , which illustrates the relation between age and the frequency and severity of and disability caused by illness. Table 9. Illness and Disability in Various Age Groups Age Group
All ages Under 15 15-64 65 and over
Frequency Rate (Disabling 111nesses per 1,000 Persons)
172 232 144 265
Severity Rate Disability Rate (Days of (Annual Days of Disability Disability per per Case) Person, Est.)
57 26 63 123
9.8 6.0 9.1 32.6
The healthiest age is between fifteen and nineteen. Until the period of adolescence is over, the younger the individual the more susceptible to illness he is. After he reaches nineteen he becomes increasingly susceptible again until he is thirty. Then for thirty years illness occurs a little less frequently. A f t e r senescence begins, in the late fifties, he is increasingly subject to sickness. Y o u and I are beyond our healthiest age; we are likely to have less sickness now, however, than after we reach sixty. As might be expected, women are ill more than men. For the first fifteen years of life illness does not discriminate between sexes, but thereafter, chiefly because of childbearing and its accompaniments, the female rate of sickness exceeds the male. Women live longer, as a rule (the sheltered sex, you k n o w ! ) , but while 5 1 percent of the men, on an average, live a year without illness only 44 percent of the women do. I don't know whether illness causes poverty or poverty causes illness. I do know that there is a close relationship between the two, and that one contributes to the other. As the poor get poorer they are likely to become sick oftener; if they become sick oftener, they are likely to become poorer. Poverty breeds dis-
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HEALTH
ease; disease breeds poverty. Y o u r question as to which causes the other is the chicken-and-egg question again. D i d the Schultz children get diphtheria because their father didn't earn enough to give them a healthful standard of living? O r is the Schultz family poor partially because of the illness it has suffered? I don't know, do you? T h e most significant fact is, as the Public Health Inventory and other studies show, that the poor are sick oftener and longer than are the well-to-do. T h e frequency and severity of illness varies almost inversely with income until the comfort standard of living is reached. Let me quote you parts of the summary of the inventory: The rate of illness which disabled the individual for one week or longer during a twelve month period was nearly 60 per cent higher among families on relief than it was among families with incomes of $3,000 and over. Acute illnesses occurred among the relief group with an excess of 47 per cent, and chronic illnesses showed the high excess of 87 per cent in the relief population as against the rate of the highest income class. Again, two persons on relief were disabled for one week or longer for every person in both the middle and highest income groups. And although persons in families just above the relief level (income under $1,000) experienced an illness rate lower than the relief population, their rate was 17 per cent higher than the rate for the highest income class, with the major part of this excess due to chronic illnesses. The part played by illness in causing dependency is indicated by the extent to which disabling illness incapacitates the wage-earner. Accordingly, the survey reveals that while only one in 250 family heads in the comfortable income group was not seeking work because of chronic disability, one in thirty-three family heads in nonrelief families with incomes of less than $1,000 annually was so chronically disabled that work was impossible. In relief families one in every twenty family heads was unable to seek work because of disability. Loss of employability through illness, therefore, quite apparently places a burden on wage earners
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HEALTH
of low income families which results in their high concentration among the dependent. Not only do relief and low income families experience more frequent illness than their more fortunate neighbors, but their illnesses are of longer duration. This duration of disabling chronic illness among the relief families was 63 per cent longer than it was in the group with $3,000 and over. Coupled with the higher frequency of illness in this relief group, this gives rise to an annual per capita volume of disability within the group that is three times as great as among the upper income families, twelve days as compared with four days per person. Also, the non-relief group with an income under $1,000 showed a volume of disability over twice that in the highest income group; the families with incomes between $1,000 and $2,000 showed a 20 per cent excess. N o t only do the frequency and severity of illness vary with income but so does the death rate. A m o n g the 40,000,000 to 50,000,000 Americans in families with incomes of less than $ 1 , 0 0 0 a year there are twice as many deaths from the ten major diseases as among a like number of the rest of the population. T h e death rate from respiratory tuberculosis is seven times as great among the unskilled as among the professional workers. T h e death rate from pneumonia is three and a half times as great among the unskilled as among the professional. From diarrhea and syphilis it is twice as great, and from cancer it is 50 percent higher. Infant mortality, too, is much greater among the poor. In families with less than $ 5 0 0 a year, 1 6 8 of every 1 , 0 0 0 babies born alive die before they are a year old, while in families receiving $ 3 , 0 0 0 or more they die at the rate of
only
30
per
1,000.
The
evidence
is conclusive.
The
Buchanans, the Whitmans, young and old, are sick more often and longer and have a higher death rate than people with comfortable or high incomes. If the sick and injured, whether rich or poor, were receiving adequate curative medical care, if they were protected by all known measures of preventive medicine, then there would be
140
HEALTH
no reason to become excited. The problem would still be a bad one, but it wouldn't do much good to make a fuss about it. But some people, especially the poor, receive far less medical care than they need. And preventive health measures, in spite of the valiant efforts of pioneers, are still woefully insufficient. Thousands die every year because they don't or can't have a doctor. And still more thousands die because, as you say, the height of achievement of local health officers is putting four tacks into a quarantine sign. The American people simply are not getting that care of their health which is desirable, or that care which is scientifically and medically possible. W e spend almost enough to obtain this care, but still we do not obtain it. An average of $ 3 0 a year per person is now spent on medical and preventive services, a total of nearly $4,000,000,000. But $6 a year more, or the sum of $ 3 6 per person, would probably purchase all the health services the average individual would need. Moreover, though medical facilities are not entirely adequate, we have nearly enough doctors and pharmacists, and within a few years we could, if we really wished, build enough hospitals and train whatever other personnel is needed in the way of nurses and scientific technicians. What is even more significant, through preventive measures now known, we could halve the number of illnesses and injuries. And yet during a year 52 percent of the people (most are not ill but should have medical examinations) receive no services of a physician, 79 percent do not receive the attention of a dentist, and 89 percent obtain no health examination or other preventive service! In spite of medical advance, the death rate among adults has not appreciably diminished in the last thirty years. Infant and maternal mortality rates in the United States are far above those in some other countries. The venereally diseased, like the Szymowskis, are far more prevalent in the United States than they are in most modern nations. And an
HEALTH
141
authority like Michael Davis estimates that 25 to 30 percent of the relatively serious cases of sickness in our country have no physician's care. Here is another pertinent quotation from the National Health Inventory: In this same eighty-one-city survey comprising over two and a quarter million persons, the proportion of cases of disabling illnesses receiving no care from a physician was 17 per cent for families with incomes of $3,000 and over, but was 30 per cent among relief families and 28 per cent for non-relief families with incomes under $1,000. But a more marked deficiency is indicated when the comparison is made on the basis of the volume of service received per case of disabling illness (attended and not attended). In a surveyed population of over a quarter million persons in eight large cities, the average case of disabling illness in families with incomes of $3,000 and over received 5.7 calls from a physician, compared to only 3.9 calls per case among families on relief. This represents the upper income families as receiving 46 per cent more service per illness than the individuals in the lower economic brackets. It must be borne in mind when interpreting these figures that among the surveyed relief families a relatively large volume of medical care was provided with the aid of Federal relief funds in 1935. In the fall of that year Federal subsidies for medical relief were discontinued, so that, consequently, a resurvey of conditions among these individuals would in all probability show a marked increase of unattended cases. T h e very people who are most susceptible to illness, the poor, then, are those who obtain least medical care! Why? W h y this situation? I list some of the more important reasons: 1 . T h e income of great numbers of our people does not permit them to purchase the necessary medical care. 2. T h e frequency, severity, and duration of illness for any
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HEALTH
individual or family is unpredictable. The costs of keeping well, it follows, are likewise unpredictable. In any given year some families will have high medical bills, others low or none. 3. T h e provision of medical care is a business as well as a service. Fees are established which are expected to produce a profit. A t the set or profitable price (standard fee) the need for many medical services cannot be expressed in effective demand for these services. As is so often the case in our economic system, profit for some means scarcity for many. 4. Medical facilities are not equally available to all because of their uneven geographical distribution. 5. Because of ignorance, many laymen neglect all medical attention or resort to quack doctors or patent medicines. 6. The public and most of its official representatives are not fully aware of the benefits to be derived from preventive health measures. Y o u will remember the figures I gave you earlier on the distribution of wealth and income in the United States Even in 1 9 2 9 , that fabulous year, about half of the families had less than enough income to maintain a health and decency standard of living. These families could not afford adequate medical care then unless they sacrificed food, clothing, or other necessities. And if they sacrificed necessities they were all the more liable to need medical care. For that forty perccnt of our families who made less than $ 1 , 5 0 0 in 1 9 2 9 the situation was, of course, even worse. And still worse has been the situation for the low-income groups during the depression which started in 1929, seemed over in 1 9 3 6 and 1 9 3 7 , began anew in the fall of 1 9 3 7 , and is not over yet. It is a safe conclusion today that half of our families cannot really afford adequate medical care, and that probably a fifth of them can afford little or none. Y o u r Buchanans, Whitmans, Schultzes, and Harrys are not isolated cases of hard luck. As you imply, they are typical of most poor families.
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HEALTH
If a family had no or little illness during a year it, of course, would not need much medical attention. But illness and medical costs are unpredictable. Some families like the Whitmans suffer severe unexpected illness and therefore need much care. Each year, the Committee on Medical Care found, 2 to 4 percent of the families with incomes under $1,200 incur medical expenses of $400 and over, one to 1.5 percent of the families with incomes between $1,200 and $2,000 have medical bills of $500 and over, and .8 to 1.2 percent of the families with incomes of $2,000 to $3,000 have medical bills of $700 and over. Even in the same income groups the financial impact of illness falls unevenly. Of the families with incomes of under $1,200, 80 percent had medical charges of less than $60 a year, while one percent of these families incurred charges of $500 or more, and 2.5 percent of $250 to $500. Of the families with incomes between $1,200 and $2,000, 69 percent had charges below $60, while one percent saw their medical expenses mount to more than $500. From the following table (from Committee on Medical Care [Table 1 0 ] ) you can see for yourself just how sickness costs are distributed. Table 10. Total Annual Charges per Family Under $60 $60 — $ 1 0 0 $100—$250 $250—$500 $500 and over All charges
Distribution of Sickness Costs' Income under $1,200 Income Sr ,200 to }2,000 FAMILIES CHARGES FAMILIES; CHARGES 79-5 9-9 7-1 2-5 1.0
313 15-5 22.3 17.8 13.1
68.9 12.9 13.0 4.0 1.2
23.6 14-7 29.3 19 5 12.9
100.0
I OO.O
100.0
100.0
• Percentage of families with specified annual charges for medical care compared with percentage of total charges to families.
Obviously the families which incur the high medical bills either cannot pay them at all or pay only with great difficulty
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and hardship. In spite of the sliding scale of fees used by some doctors, it is impossible because of the unpredictability of illness f o r these families to budget or estimate their medical bills f o r any one year. Doctors do sometimes adjust their bills to the capacity of the patient to pay, but they are in their profession not only for service but to make a living.. W i t h some exceptions, their services are obtained in return f o r a pecuniary consideration. Medical care is not always given when need arises. If it were, Mrs. Buchanan would have had her operation long ago. Doctors, dentists, and hospital officials are not so calloused that they will give no attention to the impoverished sick or injured. Ever)' doctor has his o w n list of charity patients. But the fact remains that medical, dental, and hospital care is given primarily in return f o r fees, and given almost in proportion to the ability to pay. Except in big city or university free clinics the poor, of course, never receive the highly specialized and costly medical services. T h e low-income groups in the United States either go without health care or get much less of it than they should. Those in most desperate need often turn to relief agencies or to state hospitals, but the medical needs of the great majority of those families dependent on wages are far from adequately met. Even when an individual desires and can afford care, he does not always get it. Rural areas, especially in the South, have comparatively f e w doctors, dentists, and nurses. In 1 9 2 9 South Carolina had one physician to every 1 , 4 3 1 persons in contrast to the one to every 6 2 1 in N e w Y o r k state, and there has been little improvement since 1 9 2 9 . In cities, private hospitals are often half empty and private practitioners are often idle while in the rural communities the sick often have great difficulty in obtaining hospitalization or the attention of a physician. Without a redistribution of medical facilities, without even an increase in medical expenditures, the people could obtain
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more adequate medical care if they knew how to spend their money. I'll wager that the Szymowskis spent a considerable sum trying to avoid visiting a doctor. According to the Committee on Medical Care, nearly $500,000,000 is wasted annually on patent medicines, quack cures, and quack doctors. Doubtless the sum would be much greater if all the facts were known. When an individual is ill, he will often try anything. From the long-term point of view the greatest waste of life and money arises from ignorance of the benefits of preventive medicine. Over 100,000 infants under one year of age die every year. This number could be halved, as could the 74,000 annual deaths from tuberculosis. The more than 100,000 yearly cases of typhoid fever and diphtheria (the Schultzes) as well as the more than 500,000 new cases of syphilis every year (the Szymowskis) could be greatly reduced in number if not altogether prevented. Then, too, the billion dollars in wage losses occasioned by preventable illnesses could be largely saved. If? If now-known measures for the prevention and control of disease and illness were put into practice. Progressive communities have already reduced sickness and premature death by one-third; the whole country could do likewise—if! With you, one ought to ask, "Preventive medicine, when? Oh, when?" Fortunately public health services which are largely preventive in nature are expanding. Not so long ago public health departments were primarily concerned with sanitation, with hogs in the streets and privies in the back yards. Now leaders in the field, like Surgeon General Thomas Parran, are becoming concerned (as they ought to be) about nearly everything which makes for healthful living, with scientific studies of disease, public education on health, the control and prevention of contagious diseases, public health clinics, maternal and child health services, decent housing, healthful working conditions, recreational facilities, and standards of living. Public health departments are still handicapped by lack of funds and by local offi-
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cials too short-sighted to see the light. But progress is being made. With the aid of federal appropriations made under the Social Security Act, $ 1 1 , 0 0 0 , 0 0 0 for 1 9 3 9 - 4 0 , nearly all states have extended and improved their public health programs, have initiated or extended services to crippled children, and are giving increased attention to the care of child health and maternity. As Senator Wagner and the interdepartmental committee on health and welfare appointed by President Roosevelt have recommended, the grants-in-aid to states by the federal government for these purposes should be increased. Much remains to be done! W e are only started on what should become a vast national program for the prevention of illness and disease. Such a program will cost money, perhaps hundreds of millions. But it will save thousands of lives and billions of dollars. If we spend billions on war, on roads, on post offices, why shouldn't we spend millions to prevent disease? The first step in any plan to solve the health problem ought to be, prevent sickness before it occurs: an ounce of prevention is worth a pound of cure. Not all sickness, all injuries, can be prevented. Most of them will not be prevented for many years to come. What, then, can be done here and now to care for them when they occur? If medicine could be socialized as education is, the problem might be solved. But, as ycu say, the very mention of the phrase socialized medicine arouses belligerent opposition. The most practical solutions are two: a health insurance plan for the wage earners such as Great Britain and most so-called civilized countries have; and further government aid for the needy sick. It is as possible to insure wage earners for the costs of medical care and for wage losses arising out of sickness as it is to insure them against loss of income arising from unemployment or old age. W e can in America, then, evolve a plan which will take care of the medical emergencies of the Whitmans and Schultzes. The people of the United States spend almost enough now to
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provide adequate care for everyone. We have the knowledge and almost as many doctors and nurses as we need and in a few more years we could train enough dentists and build as many hospitals as we could use. Through the budgeting and planning of medical expenditures health insurance would make it possible to bring the doctors and the sick together. The average cost of medical care per family is predictable, though for any one family it is not. If the average cost is predictable, then it is insurable. If the workers share the risks and the total costs of medical care, all the workers can obtain medical, dental, and hospital care at but little more than the average person is spending today. Health insurance, then, will enable us to synchronize need with care. By what magic? you ask. N o magic at all, just intelligent planning and action. Here's a rough sketch of a possible plan: 1 . Insure every wage earner as well as his family for the costs of general medical, dental, and hospital care. The benefits arising from the insurance should last as long as the patient is ill and needs them. 2. Insure the wage earner partially against loss of earnings during sickness by establishing a system of weekly cash benefits to be paid in case of disability. Usually the worker has no income except that derived from wages and possesses small savings. He and his family must eat and live even though he is ill. The cash benefits might well be one-half the weekly wages up to a maximum of $ 1 5 a week, and should be paid as long as disability lasts, with at first a maximum time limit of four months. 3. The doctors, dentists, and hospitals should receive a flat rate of payment per client. The doctor, for example, might well be given a definite sum, say $7 a year, for each insured person who chooses him for his regular practitioner. 4. The cost of the insurance for the wage earner and family
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should be carried by the wage earner and the employer or by both with government assistance. An amount equal to six percent of the payroll should be laid aside. If a worker received $ 2 5 a week the insurance would cost $ 1 . 5 0 . This could be shared by the employer and employee or by the two and the government. Three-fourths of the insurance fund would be needed for medical care, one-fourth for the cash benefits. I know you will have a number of doubts about the scheme. May I try to forestall some of them? Won't the doctors object? Yes, many will (some already have), and strenuously, until, like many of the British doctors, they see that most of their objections have no foundation in fact. American doctors fear that health insurance will deprive them of control over their personal relationships with patients and will hamper them in their scientific research. Neither situation needs occur under a good system of health insurance. With a system such as Britain has, the patient retains free choice of doctor, and the doctor can accept or reject a patient as he desires. N o w if the doctor accepts the patient under an insurance plan the relationship between them will be closer than it is under the present system. When the doctor is freed from the thought of fees and is no longer concerned with the ability of the patient to pay, he can concentrate more on the actual needs of the patient, present and future, than he does now. The doctor-patient relationship will then approach the ideal of the medical profession. The doctor will not be tempted to pamper the hypochondriac as much, and he can feel freer to go the limit in skillful treatment for those who would never have been able to afford care for severe maladies. As the doctor will strive to prevent sickness in order to lessen the need of medical care, he will give his clients periodic examinations and watch over the little illnesses of his patients closely. As far as scientific research is concerned, the doctors will be as free under health insurance as they now are in private practice. Most research
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today is done in the clinics and laboratories of private foundations, of universities, and of private and public hospitals. This would go on as before. The individual doctor would be as free to conduct his limited experiments under health insurance as he now is in private practice. Doctors also often claim that health insurance would make them servants of the politicians, and that their incomes will be diminished. These objections can be ruled out too. The practice and administration of all medical care should remain in the hands of the doctors. On the other hand, the payment of the cash sickness benefits should be handled by laymen, and the doctors should not be bothered with them except to certify disability. The politicians would not need to interfere in any way, except to make the laws and see that they are enforced. Then, too, under the health insurance plan that I propose, doctors could still have private practice. As families not dependent on wages would not be insured some doctors might well devote all of their time to private practice, and any doctor might have some noninsured clients. The doctors would never be compelled to enter the health insurance plan. They would never be forced to treat anyone except their patients. The claim that health insurance would mean financial hardship for most doctors is equally groundless. The doctors should be paid according to the number of clients who choose them. Suppose 1,000 insured people choose a certain Doctor X . Doctor X will then receive, according to the plan sketched above, $7,000 a year to give them general medical attention. Even after Doctor X deducted his expenses his income would at least equal the median net income of doctors in 1929, which was $3,800. It should be borne in mind that one-third of the doctors receive less than $2,500 in 1929. Surely a competent doctor wouldn't get less under health insurance. "But if the doctors are well paid, won't the cost of the health insurance be overwhelming?" No, it will not. Remember, in-
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surance in itself will not make medical care cost more; it will simply spread the risks and equalize the costs. W e are spending almost enough now to obtain adequate care of health for everyone if the money were rightly apportioned. Insurance, by spreading the risks and equalizing the costs, will make it possible for every wage earner to get medical attention when and in the proportion it is needed. In the long run, medical costs may be lower under health insurance than they are now. Diseases would be treated earlier, and more preventive measures would be taken. Wouldn't medical bills rise, however, if the patients simulated illness in order to obtain more cash benefits and keep from working? This danger is a very real one. I suppose some malingering would be inevitable. But the tendency could be checked. Before cash benefits were paid the doctor would have to certify disability. Since the doctor would be paid a flat rate per patient and would not benefit financially by a false certification, he would not often be tempted to perjure himself. Possibly some supervision of insured medical care by a stateappointed board of physicians would be necessary, but that could easily be worked out by the physicians themselves. Patients suspected of malingering in order to obtain cash benefits could be inspected by state authorities just as suspected cases are now investigated in the unemployment compensation system. I imagine few such cases would arise, because the cash benefits would be only one-half the weekly wage and would last only four months. W i t h health insurance, one might add, the duration of illnesses might be decreased, since they would be treated earlier and possibly prevented by the doctors. Many people have asked me if we could not obtain adequate medical care
without
governmental
intervention.
President
Roosevelt's interdepartmental committee did not believe we could and neither do I. Voluntary cooperative hospitalization plans are being established especially in large cities like New
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York and Washington. In a few industries the workers are insured for medical care under group plans. About 1,000,000 people are now participating in group medical plans. Voluntary health insurance, however, covers only a few now, and probably cannot be much extended. Government-sponsored compulsory health insurance seems the best and only practical way. There are weaknesses to such a plan. It is not foolproof. The unemployed or self-employed, such as farmers and small businessmen, cannot easily be covered. Some graft and malingering is inevitable. The taxation plan I suggested has its faults. The low-income workers would find it difficult to pay another 3 percent tax in addition to the taxes they are already paying. Of course if wages were generally raised the trouble could be avoided. Assuming that the wage increases will not come, I'd suggest the tax on the wage check be scaled from one percent to 4 percent according to the amount of wage. Health insurance will cost money. But it will assure a healthier population than we now have, and that is reason enough to try it; and it ought to be but a part of a nationwide health program. Health insurance would help families like the Whitmans and the Schultzes. Further government grants, especially for the building and maintenance of hospitals, will be necessary for the Buchanans and the Szymowskis. All of these people could be helped by further public preventive health measures. I hope I haven't exhausted your patience. Y o u asked for information and I have tried to provide it. Insure your own life and freedom from illness by eating dinner and avoiding giddiness. Self-sufficient person that you are, maybe you still need a husband to take care of you. But I'm not a dictator. Y o u are free to ruin your health if you wish. I shall, however, feel at liberty to persuade you peacefully. Ahem! Love, CARLISLE
SOCIAL W O R K
STATE COLLEGE LAKEVIEW, WISCONSIN
DEAR
CAROL:
My last letter was so full of statistics on illness that I was afraid it would make you sick. Apparently you have caught some kind of germ, a social-study bug! I wish more social workers would. You will see why when you have read my letter. For the first time I am going to turn the tables and ask you some questions. I believe in equality for women, you know, and equality carries with it responsibilities as well as privileges. Lately I have been forced to defend social work and social workers, and I wonder if I have been doing a good job of it. You have been asking me how dependent people can be made independent, how we can make possible not only the pursuit but the actual attainment of bread. Now I'm going to question you about social work. I want to know more than I do about what you social workers are doing to help people win their bread and happiness. I know you will be happy to answer. As far as I can tell, social workers seldom talk about anything but their jobs. Some of my students think a social worker is a queer combination of domineering woman in mannish clothes and smug ministering angel. (They don't know you and your office staff.) Social workers, they say, are interfering busybodies, just untrained women who have nothing to do but try to run other people's lives. "Anybody can do social work," said one well-
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fed youngster. "All you gotta do is hand out money and stick your nose in other people's business." These views are not mine, of course. I'm not that naive. I do admit some prejudices. Alas! I must confess, I have had a prejudice against any kind of charity and charity work, and a distaste for most of the old-type charity ladies. I remember those sweet ladies so well. They expressed their horror over the way the other half lived and they wrought mightily to change things by delivering baskets on Thanksgiving and asking fathers to sign the pledge. But a more fundamental reason for my prejudice is this: while I have realized that social work is necessary I have also believed that it attempts tasks impossible and hopeless in the present social and economic order. O f late I have been questioning the validity of my prejudices, my distaste, and my belief. Discussion, especially when one is defending something one doesn't quite believe in, often changes preconceptions. My change of attitude is the result, too, of having met the case workers in your office. They are intelligent and fairly well educated. They seem realistic and not too romantic, and their attitudes are more scientific than sentimental. I have been reading a little and trying to remember some of the interminable conversations between you and your co-workers that I couldn't avoid overhearing. Some of the books, Richmond, Robinson, and Kenworthy, for example, make sense, and now, as I recollect, the talking I heard was not all vague and vapid. Case work, I am beginning to perceive, would be needed even if most of our present economic problems were solved. Modern society could not dispense with your profession even in prosperous times, could it? I've sometimes thought of you as sops thrown out to the hungry masses to keep them from becoming dangerously dissatisfied, but this isn't at all just. What is the function of a case worker, anyhow? I'd like a scientific definition, a clear description that I can use.
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D o n ' t assume too much. I haven't been convinced that social workers are able to accomplish much socially valuable work except in isolated cases. In our complex, swiftly moving society many individuals do become maladjusted. T h a t these individuals receive assistance seems to me imperative as well as right. B u t can a social worker really do more than ameliorate bad conditions for a relatively few individuals and families? Can you do as much good as even the average family doctor does for his patients after they are sick? Y o u treat an individual isolated case for some social maladjustment and try to effect a social cure. Y o u do not prevent these maladjustments. Y o u are able to do little to stop general economic and social morbidity. Y o u step in only after the trouble has arisen and then I ' m not sure you can effect many cures. Y o u only ameliorate a bad situation for Mrs. Brown or Mrs. Jones. Y o u cannot, it seems, solve fundamental social and economic problems. After
all,
don't you often just putter around, patching up wornout social garments with cheap, weak thread? Y o u are seldom able to make the faulty social fabric into a new, durable garment. Sometimes you do not or cannot even do as good a job o f repairing as any master tailor would demand o f a journeyman. In the competitive society in which you are forced to work, isn't it true that you usually push one family down when you help one up? A n d the very families you help up often find the race too fast and fall again. A m I unjust? T e l l me if I am, I ' d really like to know. Far too often social workers do not realize the insurmountable odds against which they must work. Most case workers that I have known can become intensely excited about that widow Smith who has two, three, or four malnourished, underprivileged children who need milk, medical care, clothing, and a thousand other things. But wouldn't it be more important and vital if they tried to correct the conditions which cause the chil-
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dren to be malnourished and underprivileged? Many of the faults of your fine profession can be explained by its newness, I suppose. But is it wrong to say that far too often your energy and interests are exhausted by innumerable visits to, interviews with, and records on the Smith family and others like it. Don't you spend too much time on method and on discussing scientific aspects of treatment which ought to be taken for granted? And don't you often waste time drawing up nebulous and seldom-realized plans and writing long-winded case records? When there are a million fires breaking out, the social worker, it seems to me, tries to do something about a few hundred of them. My criticisms are probably unfair. Case workers, from my observation, are the most overworked group of people in America. But still, shouldn't case workers be active participants in the solution of general social and economic problems rather than the spectators they so often are? I look at social work from the outside and from a theoretical point of view. It might be wise to educate me by recounting your experiences on a routine day. When a client comes in you fill out a face sheet record of who he is and who his family are, what he has done, and why he came in. You then make a visit, write a family history, and set out to mend his affairs. All these mechanics I know. But I do not know precisely how you handle a case, how you actually treat a client. Case work is still an abstract matter of concepts and theories to me. Don't clients object to an investigation of their affairs? Don't they lie (as I probably would in similar straits)? And if they do, how do you find out the truth, or do you? What I would really like to know is, how do you justify your work? Just how much success do you have? Can you make a social diagnosis which diagnoses? And if you can make such a diagnosis, what can you do about it? I want to know what
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actually happens, and in concrete terms. I would really like to have more than a superficial acquaintance with what you are doing. I f you tell me you use psychiatry you'd better explain just what you mean. T o me psychiatry in its present state is sixtenths common sense, three-tenths nonsense, and one-tenth mind reading. It's the science which half the time misinterprets and overaccentuates dreams only to arrive at profound conclusions like, "Minds are divided into two kinds, the stable and the unstable," and "Women love men who are superior and women love men who are inferior." Frankly tell me, Carol, did you ever make a case diagnosis, construct a plan for the client, and actually see results? N o vagaries, no high-sounding platitudes, now! Leave these to the social scientists. Not long ago in one of those rare fits of inspiration I suddenly thought of a social worker as a social scavenger. Now I note that I was not original. But aren't you a cleaner-up of society's refuse, and not much more? Have you made it possible for many of your dependent people to make economic declarations of independence? If so, by what methods, procedures, philosophy, or incantations do you conjure your magic? Do a little social work on me. I am so baffled by the mysteries of your profession that I'm becoming frustrated! A little knowledge is dangerous. Enlighten me. CARLISLE
SOUTHTOWN, WISCONSIN WEDNESDAY EVENING
M Y DEAR CARLISLE:
Your last letter with an order for a short course in social work came as a real surprise. I chuckle at the thought of your
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defending social work to your students when you believe so little in its effectiveness. "Scavengers! Sops!" This is the exact point at which long-range discussion via U. S. mail is to your advantage. But, seriously, I am glad you have spoken your mind and I shall try to show you social work's job in this whole pursuit of essentials. When the city of Louisville was flooded some years ago and Jerry and Margaret were rescued from their floating roof would you say the rescue workers were scavengers? Would you call Jerry and Margaret refuse? Well, economic depressions and emotional crises threaten human lives and aspirations more than overflowing rivers. Social workers man the lifeboats in economic deluges. They steady and guide the emotionally submerged. They give first aid to those in need and help them to struggle back to dry land, to their own independence again. They are so busy pulling out drowning people that they have not concentrated upon flood control and conservation projects. They leave that to others. It may be true that plans for the prevention of further inundations are more important than the rescue work, but what about the already stranded victims? Their lives matter too, perhaps more than the lives of the unborn in a nebulous future of assured security. Their health must be preserved, their washed-out homes rebuilt, their gardens replanted. They must reestablish themselves as independent bread-earning citizens. In the struggle toward their rehabilitation the social worker finds her job. "Just what is the function of the social case worker?" you ask. " N o vagaries, no platitudes," you stipulate. You, a social scientist, a chronicler of social movements, a cataloguer of the great social forces, you want me, a social worker who specializes in ordinary observable facts about bread and coal, shoes and rickets, and who builds her hopes upon as common a thing as a young girl's apron, to speak in concrete terms. T h e nerve! Social work as a profession is comparatively new, but as a
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practice it is as old as man. I suppose God was a social worker when he gave Adam a mate to make him happy. You agree? Eve tried to do social work on her husband by feeding him fruit f r o m the tree of knowledge, and in turn Adam probably had to help Eve over the garden fence. Social work is an attempt by some people to help other people, other people who are unable to solve the problems of their lives. Its most important tasks are to reestablish these people, to return them to self-sufficiency if possible, and, when this cannot be done, to distribute essential goods and services to them. Great task, you remark. Yes, it is. Sometimes it means simply the granting of relief, sometimes it is child welfare and family case work; it may mean social legislation, probation and parole work, or recreation, or public health; even education performs certain tasks which might be termed social work. It is the art of helping people out of trouble. Social case work, which we are trying to practice here in our county welfare department, is distinguished from social work in the broad humanitarian sense in that it approaches its task through the individual, not the group, and is concerned chiefly with the individual and his particular social problems. The social case worker is the one whom the community, or a private organization within it, hires to take care of those of its members who are unable to meet their own problems. T h e social worker is the instrument through which the resources of the community are made available to those who want them but cannot get them unaided. Since society has assumed the obligation of providing minimum food and shelter, emergency medical care, and a few educational and recreational opportunities for all, the social worker has become the distributor of these as well as other services. But more than a simple social middleman, the social worker, if well qualified, is able to assist people with their personal difficulties. Problems of child care, of marital disagreement, of vocational guidance, or dilemmas growing out of
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personal fears and discouragements can often be solved with the assistance of someone with more insight, better perspective, and greater understanding than has the individual in trouble. In short, the social case worker helps the individual to eliminate or surmount all those economic, social, and emotional obstacles which prevent him from living as an independent member of society. In fact, the worker's chief effort is to afford the individual a chance to make a declaration of independence. Social work, philanthropy's child, has so outgrown its mother that the family resemblance can scarcely be detected. This child's precocity is largely the result of economic and social changes which have increased dependency in our country and enlarged our social responsibilities. A generation ago social work was charity with a sniff. It involved magnanimity or vanity on the part of the giver and weakness and failure on the part of the recipient. But today, with our giant industries growing more complex and impersonal, with our sprawling cities full of one-skill and no-skill people, with our mortgaged farms stripped of their independence and cultivated merely as backyard gardens to metropolises, and with little men cowed by big sticks, today social work can no longer be considered simply philanthropy. Modern social work fulfills a vital social need created principally by economic and social maladjustments of the present order. Thousands of destitute people are overcome by social forces which men may have instigated but which are now beyond a single man's control. So powerful are these forces in modern life that no man can be held entirely responsible for his own failure. So far we have not been able to eliminate or control economic catastrophes. Apparently we expect a suitable economic structure to build itself. But until we have worked out a method by which the basic resources will be available to everyone who will share the effort of producing and distributing them we shall probably have to be satisfied with emergency
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measures. However, emergency aid is only a temporary solution. It is all too true that the economic problem will be met only when everyone has a chance to take a real part in the production o f economic and social goods. There is no sense or logic to a system where many suffer from enforced idleness and want and where factories which could produce goods and employ men are likewise idle. There is no point to a system where some of us have to support all of us at a mediocre level. I f everyone were producing, we would have more goods, less unemployment, less need for relief, fewer social problems, and less need for social workers. ( Y o u see I've read your letters.) But—until we are wise enough to solve the problem of production and distribution we shall continue giving relief, supplying education and medical care albeit in a very pinch-penny manner, and supporting on our social capital a large group of people who should be a part of the economic machine but are not. Social work today is therefore a logical part of our illogical social order; it has become an assumed social responsibility. Its future depends upon the extent of future needs. If and when society provides ways for individuals to meet their own needs independently, social work will lose much of its reason for being. But economic need is only one of many needs. You were quite right when you thought social work would be needed even if most of our economic difficulties were solved. It is true that many maladjustments of human relationships would often dissolve if the affected individuals had economic competence. But the provision of bread will not alone solve all human troubles. An economic Utopia would not end domestic discord or juvenile delinquency or other personal maladjustments. As long as we or our children's children shall live there will be family, personality, vocational, and other problems requiring the advice and assistance of trained counselors. T h e purpose of social work, or that which it is attempting to
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accomplish, is vitally important. It permeates all the procedures we use. In fact, if you will allow me a breath of philosophy, the end in view determines the means, and the means in turn become a part of the end product. I am not talking about some final cosmic goal, a universal jigsaw pattern wherein we all have our assigned square. T o posit a distant goal of perfection for all life and then to fit us social workers into the scheme as agents in bringing about the millennium would be most egotistical fantasy. But it does seem reasonable to believe that an individual life can have meaning and purpose. A characteristic which seems to be most common to all life is the desire to grow. T h e development of an individual's capacities, bringing with it increased enjoyment in living, is sufficient reason for any life. T o facilitate this development is the primary aim of all social work. T h e individual does not develop in a vacuum, you remind me; he grows in a social medium under certain controls. I agree with you; and social work recognizes limitations to individual growth. Social work's aim is more than just the reckless sprouting of every capacity in every individual. T h e standards and patterns toward which this development is directed are as important as the actual stimulation of the growth process. But every time we social workers approach the subject of standards we shy away from the issue, realizing how difficult it is to talk of general norms and have them mean anything in a specific case. However, we do have some dreams for society. W e make them sound sensible and non-Utopian by calling them "limited goals." They represent workable "next steps" beyond which we cannot see, but which are sufficient for present action. Nothing we strive for is not in part here on this earth already. W e would set up the goal o f self-maintenance (in both its economic and emotional aspects) for any individual as the most important objective of social work. When self-maintenance is impossible we hold that certain basic requirements of life, food,
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clothing, and shelter must be provided by society. W e add to this aim, good health, a home of affection, at least a high-school education for those who have the ability, and some opportunities for development of the individual's capacities and talents. Nothing extravagant about these goals, is there? T h e only thing strange about them is the fact that in spite of their years o f verbal acceptance they are still far from being generally attained. On the other hand, we realize even more than we did ten or twenty years ago that the growth o f any particular life cannot fit into any preconceived pattern. Hence social case work has as many specific purposes as the number of individuals it serves. One might even say that social work has as many goals as there are capacities struggling for fulfillment in the lives of those it helps. W i t h such a forest of budding potentialities around us, social workers have reached the point where they feel that the stimulation o f the growth process is after all their primary purpose, while the direction taken by this growth is of secondary consideration. W h e n an individual really grows he progresses not only from infancy to maturity but also from dependence to independence and from limited self-centered behavior to broad social experiences. T h e possibilities of this development are already before us in the lives of those who have lived richly and fully; our chief aim, let me repeat, is to encourage this process of growth. There is no end to the ideas this discussion brings forth, but I have to stop sometime. In one sentence let me put down the kind of statement you might write on the board for your class: the purpose o f social work is to assist the socially inadequate individual toward an independent well-adjusted life, and as far as possible toward the creative fulfillment of his various capacities. W h e n your students ask you the meaning of "welladjusted," "fulfillment," "independent," you will have to make definitions with your uncommon sense. I trust it is as good as
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mine. A former teacher of mine said all this in a very simple way once: "Social work is helping someone to get going under his own steam. And," she would add after a pause, "to show him some place to go." Y o u certainly hit us in a weak spot when you criticize social workers for not participating more in the solution of general social and economic problems. But aren't your criticisms a bit far-fetched when you say, " Y o u do not prevent maladjustment, you are able to do little to stop social and economic morbidity. . . . You just patch up worn-out garments with cheap weak thread"? Just what part social workers should take in reform movements, in social legislation, and in other ways of effecting changes in our social order has been the subject of much heated discussion among us. Most of us recognize a definite obligation but experience difficulty in translating our obligations into social action. W e become excited about the widow Smith and her brood, you say, and do not try to correct the conditions causing her dependency. But, Carlisle, to establish a sane social order for children, should one begin with the children of the widow Smith or with a child labor law? How can one separate the individual from the society which molds him? Society is made up of men, women, old people, and children. They live together forming society and each also lives a life of his own. I f poverty is to be abolished and security established, the problem is not where
to begin but rather what to begin and when
to
begin it. T h e approach must be through both the individual and society. Social workers perhaps emphasize the care of the individual too much, but our leaders are realizing the absolute necessity of accompanying social action. It is tremendously important that we build a society where men can live without dependency. But we as social workers must first care for those living in society today in order to preserve and construct the world of tomorrow. The social worker's first responsibility is
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the individual dependent, after all. Who knows; maybe the widow Smith's twelve-year-old son Billy, whom we are educating at county expense, may be the senator who turns the vote for a child labor amendment! (Heavens, I hope we will not have to wait that long!) I often have spells of dejection in which I feel much as you seem to when you say you believe most social work vain and hopeless in the present social and economic order. At times I wonder if we would not do better to neglect those in need. If we neglected them, when conditions became insufferable they would revolt and build a brand-new order. But there is no guarantee that after the revolution we would have anything better than today. So I keep on, acting as a sop for society, patching up worn-out garments, holding up an oxygen tent, and hoping that through painstaking education and step-by-step plugging our world will become more livable for all. You are not, however, completely justified when you accuse us of doing no more preventive work than the family doctor who treats a person only after he is sick. The implication is wrong. The doctor does some preventive work. Like the doctor, we have to treat illness in separate individuals, not en masse. But treating patients already ill is a form of prevention. It reduces the sources of infection. Moreover, just as physicians would not treat a baby for typhoid and neglect a polluted water supply, social workers do not entirely neglect the sources of social and economic illnesses. Why do you suppose I have been asking you questions all summer about wages and unemployment if I were not interested in attacking some of the underlying causes of dependency? Social workers do sometimes assume leadership in social reform in spite of their absorption in the individual. They are the Jane Addams', the Edith Abbotts, the Harry Hopkins'. The influence of Miss Addams alone has been tremendous; the settlement movement, Chicago housing ordinances, pioneer
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juvenile court and mothers' pension laws, nationwide studies of industrial conditions, and worldwide peace activities were directly due to her efforts. Others, including Julia Lathrop, Mary Van Kleeck, and Paul Kellogg, have been responsible for agencies such as the National Children's Bureau and Child Labor Committees, for organizations of social research like the Russell Sage Foundation, and for magazines of social interpretation like the Survey Graphic. The federal relief program, the Works Progress Administration, and the new Social Security Act were undertaken with many social workers on advisory staffs. Even your most humble wife helped to prepare a study for a Wisconsin state committee which struggled with legislation for the reorganization of the state's welfare activities. Social workers may not run for Congress but they do participate in social action. I agree with you that they should do more. Because the social worker is so close to human needs, her situation is strategic if she will make use of it in her presentation of these needs to the public and to legislators. Here is her greatest opportunity to contribute toward the alleviation of social ills. And the social worker is on front-line duty also in the enforcement of social legislation. A social law will rot on the statute books unless it is enforced. After we have it in black and white it must be introduced to the public and used over and over until it becomes a part of our daily living. It is the social worker who can make effective realities out of vague legal sentences about child welfare. It is the social worker who can adapt social legislation to specific conditions and make it work. Your students who speak of us as untrained busybodies and who claim that anybody can do social work, no doubt express opinions quite typical of those held by the general public. True, almost anybody has tried to do social work, but not all really practice it. During and since the depression the demand for social workers has multiplied so rapidly that colleges have
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not been able to fill the need for trained personnel. In a rural relief office where I worked in 1 9 3 4 no one except myself had had an hour of direct social work training. They had been nurses, schoolteachers, and engineers. The sole credentials of one consisted of four well-reared youngsters of her own. Yet all these people were supposed to be social workers. It is estimated that there are about 40,000 social workers in the United States today. During 1 9 3 6 - 3 7 there were 1 0 , 1 7 4 students enrolled in the thirty-three recognized schools of social work in our country. Of these only half were new recruits, the others being part-time students or employed workers continuing their studies. It will be many years before the supply of skilled workers begins to meet the need for them. "Well, when is a social worker a social worker?" you are probably asking, just a wee bit exasperated. Since the ability to understand and help people is such an intangible thing, social work, like the medical and educational professions, has been forced to establish certain qualifications of training and experience as criteria. N o w you know as well as I do that a carefully trained worker may not be nearly as useful as some untrained person who is a "natural" in dealing with people. "Case work is just common sense anyway," I've heard you say. But common sense is rare. The risk one runs in asking help from an untrained worker is the same as the risk in going to a midwife instead of a graduate of Johns Hopkins. In this letter I have used "social worker" as a blanket term for all of us who are attempting social work, because I've been talking about us as we are. But when the name "trained case worker" is used as a title it generally means one who has graduated from a school of social work, which usually represents two years of study beyond a B . A . degree. And after that, two or three years of experience is considered a minimum training period. As an occupation social work is difficult to classify. At times I'm sure it is manual labor; then again, it is a profession of high
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abstraction. I don't know whether to call social work an art or a science; it has something of both. It calls for rigorous training, rare skill, and a keen imagination. I suppose that it really makes little difference whether we are artists or scientists; but artists we must be, for our chief compensation comes from our work and not our salary. Most of us work from eight to fourteen hours a day, fifty weeks a year, at $ 1 0 0 to $ 1 7 5 a month. If we have not finished our training we can expect to receive $80 to $100 a month, in some places even less. If we are promoted it often is to an administrative position for which we are not specifically prepared. Our tenure of office often depends upon the whim of a county board or the fad of an ambitious philanthropist. We are under constant public surveillance and are severely criticized when we do not accomplish that which the home, the church, the school, and industry have failed to effect in a family. There are social workers who find no challenge in their work; to them it is simply one of many ways of earning a living. To most the work affords more than a material income. The pay of a real social worker comes when she sees one of her families steam away on its own; her "raises" are the discoveries of new ways to help people; and her bonus checks are the acquisition of a few grains of social wisdom. You want to know how we actually go about our work, how we handle a ease. If you ask a doctor how he treats his patients he will no doubt say that it all depends upon the patient and what is wrong with him. The type of case work, too, depends upon the particular trouble of the one asking for aid. Does he need a job, advice about his children, or just a chance to let off pent-up emotions? No two want or need the same thing. What the social worker does depends also upon the function of the agency for which she works. For example, the mother's pension department offers services quite different from those of the probation department. The work differs also according to the needs and the resources of the community. The relief allow-
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ance f o r a family in N e w York City is considerably higher than the grant to a similar family in N e w Orleans. T h e presence or absence of hospitals, organizations like the Boy Scouts, swimming pools, night schools, and like community projects may make all the difference between success or failure in the treatment of cases. A rural area usually differs in resources from an urban district, and rural problems, although fundamentally the same as urban, have some complications relating definitely to the country. Communities differ too in standards of conduct: to drink a glass of beer is not the same in northwest Iowa as in northwest Wisconsin. W e may even go further and say that what social workers try to do depends upon the entire substructure of society, the socio-economic basis of the community where they work. Social work in Russia is quite different from that in Chicago. Social work twenty-five years ago hardly resembles that of today as much because of the economic and political changes that have occurred as of new methods in social work itself. Finally, I must mention that the process of case work varies with each social worker. Each worker has her own particular method, a characteristic brush stroke which is entirely individual. W h e n I was a beginner I would waylay my supervisor and try to get advice on a case by asking, " W h a t do we usually do about cases of drunkenness?" or " W h a t should wc do when a man beats his wife?" M y supervisor's first answer was always, " N o w , if you mean the family we talked about this morning we might suggest this . . ., but if not—Well, it all depends." If one could discover the cardinal principle of social work I am sure it would not be a reliable rock-solid command, but this aggravating phrase, "It all depends." In spite of all these buts, ifs, and howevers, there are a few characteristic ways of doing things in our work. After all, wc do have to dip our brushes into the paint and do have to put them on the canvas no matter what stroke we use or result we
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want. In social work, as in most fields, the first essential is to find out what is wrong. W e study the situation to discover where the difficulty lies and then we attempt to meet the problem. The whole process has been divided for convenient explanation into three types o f action, namely, social study, diagnosis, and treatment. These steps take place more or less at the same time, however—sort of a great triumvirate like the Father, Son, and Holy Ghost—three in one. I f I tell you the story of Sam Jacobson perhaps that will answer some of your questions about what we actually do and how we diagnose cases and construct plans. Remember, please, that I am no authority, merely a practitioner and a beginner at that. Sam Jacobson came to the welfare office over a year ago. ( I shall call him Sam hereafter although first names are seldom used in the office.) A small nervous man, smelling of cow barn, he asked in a businesslike way for financial aid for his family. The situation he presented was very similar to that of other young farmers, heavy land and chattel mortgages eating up his cash income from the sale of milk and leaving the family without money for necessary food and clothing. Sam showed me papers and milk receipts which gave evidence of the accuracy of his statements. As we talked along I was beginning to piece together Sam's situation; I was trying to get acquainted with Sam as a person and with his difficulty. I was even tentatively diagnosing his trouble as overindebtedness brought on by drought and by an attempt to buy a farm with insufficient capital. W e continued discussing his financial troubles. Sam was getting acquainted with me and with.the welfare department and its possibilities. I wondered why he seemed so tense. I felt that he wanted to have the interview over. There was a desperateness about him that seemed unrelated to the trouble he was presenting. When he talked about his family he avoided mention of his
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wife but said his three children were well and happy. Janie, the oldest, was seven and already a real help around the house. Finally he volunteered the information that Mrs. Jacobson was ill, had been sick since the baby, now a year old, was born. He relaxed a little and with an air of confession explained that he really did not need food, but he had schemed to ask for a couple of dollars worth of food a week so he could use the money he saved in order to hire a girl to keep house for the family. As it was, he found it almost impossible to do both farm work and house work himself. N o w the whole problem had changed. My first diagnosis was discarded. ( I n some cases this point is reached after two or three weeks or months of visiting and study of the facts. Sam's story condenses these processes.) W h a t was the real trouble? Did Sam want any help other than financial aid? After all, why delve any further if that is where he wants assistance? But what was the matter with his wife? Maybe it would be wiser to wait until we had visited in the home and had gained more o f Sam's confidence before trying to reach a better understanding. Sam might be lying. ( Y o u wondered about this matter in your letter.) I f he were, the fact that he lied was much more important than the facts he lied about. T h e event as seen by Sam, or as he wanted us to see it, is as revealing of the total situation as are the facts themselves. O f course we try to know the facts too for a working basis. Most deceptions of income and property are eventually brought to light anyhow. Subtle misrepresentation of oneself in one's social relationships is so common to all of us that we have learned to expect it in everyone. However, we do need to know the truth (relatively speaki n g ) and expend considerable effort in obtaining it because the individual who lies to us or to himself needs the truth in order to perceive exactly what he is facing. Like the doctor, we have to know whether the pain is in the head or in the foot. But to get back to Sam. It seemed as though he were mis-
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representing his case so I decided to make a fresh start. W e discussed the farm situation in the county, the soil in his township, the excellence of the Guernsey cow, and the health of Sam's children. In answer to a deliberate question about Mrs. Jacobson's doctor Sam said, "There's no doctor stepped in our house since the baby come, and I won't have you or anybody else buttin' in! See?" Suddenly Sam was mad, mad at me, at the relief department, and at himself for coming to the office. He made for the door, but couldn't quite leave and stood with his back to me looking out of the window. I asked him if he knew Reverend Norgaard, pastor in the village. He nodded. I told him that Mrs. Norgaard had been very ill for a long time after her last baby's arrival but that she had gone to a doctor in the city who had helped her. Now she is well again, and able to play the church organ every Sunday. Sam turned and sat down wearily on the window sill. He watched my face carefully as he said, "There ain't a doctor can help her. I might as well tell you first as last: she's nuts! Gone clean nuts since the last one come." "Well, you do have a problem! But what makes you think she is nuts?" "She won't talk; just sits there. She dresses herself and she eats when I give her somethin', but she won't do nothin'. Just sits over by the stove. I'm so scared she'll throw somethin' at the kids that I been tyin' her up to the rockin' chair lately when I go out to the barns. She don't seem to mind. She ain't never made no move toward em, but you can't never tell. God, she ought to be gettin' better soon! Don't you think?" Then Sam came back to his chair and talked. He told of his struggle to keep up the home and the appearance of a normal family life, of his mother who had disapproved of his marriage but who came to see them once a week to care for the baby, of his father who could not help Sam financially because
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o f the large family still at home, and o f M r s . Jacobson's parents who had died several years ago. H e didn't want the neighborhood to know he had come to the relief office; he was afraid they would learn the nature o f his wife's illness; he blamed the doctor loudly for her condition. " S o m e t h i n ' jest gotta be d o n e , " he stated determinedly. W e offered to try to help him. H e was introduced to the case worker in his district, who luckily was a graduate nurse. Sam gave her directions for reaching his home. As he left he admitted to us and to himself that he wanted to talk things over again as there might be something that could be done to help his wife after all. O f one thing he was certain: he could not go on all winter as he had been. I n this first interview we began to find out what was wrong. Sam too was beginning to see his problem in a new light. Y e t there was much more to be understood. W h e n the case worker visited the Jacobsons she found things worse than Sam had pictured them: the woman depressed and ill, almost oblivious of her surroundings; the children timid wild things with potato stomachs and queer clothing; the home a housekeeper's nightmare; the farm fertile but neglected; the family shunned and S a m considered a " q u e e r guy" by the neighbors. I have given you in detail the beginning o f the social study. Y o u spoke o f case histories. Y e s , these records are part of the social study. T h e y are essential because in the life story of a family lie the clues to the causes of its dependency. In the Jacobson case the little family history obtained in the office led us to Mrs. Jacobson's mental aberrations. Y o u are wrong, however, if you think we stop when we know the family story. T h a t is only part of the study. Much more than history is needed when, as in Mrs. Jacobson's case, the difficulty is not only economic but psychological and physiological. F o r such troubles we must consult experts in other fields, in medicine and psychiatry. W h e n the case worker came back from her first visit to
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Sam's home she listed the following as next steps in her study o f the family: See Dr. Farrel re Mrs. J. See Jim creamery re cream checks. Gill Mr. Davis at First National Bank. Check mortgages at Court House. See Mr. J.'s parents. Write Brownville, N. Dak., re family of Mrs. J. See County Nurse. In making a social study such as this we try to discover and define the trouble in several ways. In the first place we talk with the individual personally. Almost always the best source of information is the person himself. His troubles are not fully revealed until he has disclosed his attitudes toward them and the conflicts that may be taking place within himself. T o see where a man lives and with whom he lives is very important, but to know how he feels about his home and family is still more significant. N o visit to the home or talking with relatives, mortgage holders, or family doctor would help us understand Sam's problem as fully as an interview with Sam in which he expressed himself. Secondly, since the individual himself is not always aware o f the causes of his trouble, we must find out about him by seeing him through the eyes of others. Relatives or acquaintances who have known him longer than we often round out the picture of an individual in his social environment. By securing information from employers, banks, doctors, and lawyers, we obtain a more specialized knowledge o f his situation. As in Mrs. Jacobson's case, the opinion of experts, like doctors, is absolutely necessary before any decision for treatment can be made. However, only in extreme emergencies would we inquire about an individual without his permission to do so. T h e social worker finds herself using different approaches to different people and problems, basing each study upon that particular way which will give the best answer to, " W h a t is wrong in this case?" As the social study is being made it is intermittently being summarized in the mind o f the case worker. These little sum-
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marizing statements which are the answer to her question, " W h a t is wrong here?" are diagnoses, and represent one of the three steps in the case work process which I mentioned earlier. Whether it is formally written after long study and consultation or is merely a flash of insight in the case worker's mind, the diagnosis is the worker's decision regarding the cause of the trouble and her recommendations for solving it. The term "diagnosis" has been adopted f r o m medicine and psychiatry because it defines a similar process. Since any plan of treatment is determined by the diagnosis of what is wrong, the ability to make these decisions is the crux of social work. By now you are no doubt asking me, "But did you ever make a plan that worked?" Sometimes the plans made by the social worker and the individual in need actually do succeed. T h e cure may be the result of capricious fate, but more o f t e n the welfare agencies and their workers play a definite and planned part in the process. If I stand off far enough it seems to me that two general methods of treatment take place, one in which the case worker does things for and with people, and one in which the individual is enabled to do things for himself. But here again it is hard to point out a definite dividing line. Both methods are directed toward the same aim, a change in the life of the individual. Most of social work consists of doing things for and with people, though social workers would not wish it so. This is often called the "executive" type of treatment; sometimes the word "protective" is used. The social worker acts as a leader, a guide, an advisor, or a temporary substitute for a mother or a husband. She tries to help the individual return to self-sufficiency by providing financial aid, or perhaps by showing him community resources hitherto unknown, or by making certain definite changes in his social environment. The case worker who helped Sam Jacobson used this method when she explained to
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him the possibilities of cure for his wife at the state hospital and made the specialized treatment of Mrs. Jacobson financially available to the family. She also enlisted the help of Sam's older sister, who came to the home and restored it to domestic order. She sent Janie to school. She gave no relief (other than medical) but helped Sam arrange a reduction in his mortgage payments so that he could meet his immediate running expenses. The case worker opened up new resources to Sam, the medical care and debt reduction; she also rolled up her sleeves and accomplished a few definite changes in the household management and in new opportunities for the children which Sam had never had the vision or ability to obtain. By doing these things for the Jacobsons the worker manipulated the environment and created conditions which eventually led to a balanced family life and the solution of a once apparently insurmountable problem. (You may be interested to know that Mrs. Jacobson is recovering and may be home in a half-year.) There is danger in this way of trying to cure social ills. The case worker may be positive that she is right and force her plan upon the individual. Superimposed plans, though sometimes necessary, seldom effect lasting changes. The final change has to take place within the individual and grow out of his own desire. A plan for the solution of his problem should come from the adult individual when he really sees his own difficulty. If it does not, the social worker does not understand the problem fully (how few of us do!) and has failed to help the individual discern the root of his trouble. Still, in spite of these objections, much of social work is necessarily of this executive type; we secure a job for a man (although he himself has to take it), we find a home for an orphan, we grant a pension to a widow, we send a boy to a summer camp, or we obtain a scholarship for a young girl. I realize that many environmental changes cannot be effected without social reorganization on a
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mass scale (creation of employment, for instance), yet it is still possible to help many people toward a satisfactory life by bringing about certain changes in their own social setting. The other way case workers help is in providing a relationship which gives an individual strength and insight to solve his own problem. The social worker acts as an understanding confidant, a confidant who does not blame the one in trouble but helps him to define his own dilemma and stimulates him to find his own way out. T h e relationship becomes in itself the medicine which works the cure. This idea is one of the oldest in social work, but it differs now as to what we believe this relationship should be. In ye olden days the social worker was Lady Do-Good who was so superior that by mere contact with her the poor vice-ridden rabble would be uplifted. Experience began to indicate that there are other satisfying ways of living besides the social worker's way and that the poor are neither vice-ridden nor rabble, so we social workers assumed an attitude of tolerance. Today we try to attain an attitude of objective understanding, devoid of prejudice and criticism and conducive to the full airing of the problem at hand. This does not mean a relationship of mutual give and take, such as that between bosom friends. T h e social worker cannot add her troubles to those of the person who comes to her for help. No, it is a different relationship, a professional one more like that of a doctor and his patient or a lawyer and his client. Whenever a social worker and the one asking for help come together this type of treatment takes place. As a rule it takes place unconsciously, since most of us are not skilled enough to attempt a cure through this relationship alone. However, we are learning a few things about its use that we can practice. For instance, conditions are much more favorable to the solution of any problem when a person finds that the social worker is that singular individual who, surprisingly enough, does not spend time blaming him for his past or coercing him into the
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future, but who asks, " W h y did you do it? What can we do about it now?" In the first interview with Sam it was the relationship between the social worker and Sam that was already effecting a cure. Sam found someone who accepted him at face value and who cut through subterfuge and concentrated with him upon his own difficulties. It was easy for him to reveal his thoughts to a person like that. As he talked about his troubles he began to see them more objectively. His troubles were put into words now, and were no longer vague breath-snatching fears. He began to see what he was doing to his wife because of his own feeling of guilt and pride. Now that his problem was out where he could look at it Sam plucked up courage to tackle it. When Sam began to assume responsibility for a way out the most important step in treatment was accomplished. Now this doesn't sound vague and mystical to you, does it? After all, isn't a new determination to carry on one of the greatest things that can be given? W e cannot live another person's life for him; we cannot change him one iota unless he wants to change. The final cure has to take place within the individual himself when the base of the trouble is there. Some social workers, like Virginia Robinson, go further than I would and hold that the only distinguishing feature of our profession is the establishment of this relationship, which in itself provides a new environment wherein the individual finds an opportunity to work out his own problems. Most of the things we do as treatment, whether by stimulation through a new relationship or by direct manipulation of outside forces, are merely the motions we go through in the attempt to give the individual new strength and ability to meet life on his own. You asked me if we use psychiatry and, if so, what it means. Yes, we use psychiatry; we have gleaned much from this study of human motivations. Psychiatry, which seeks to understand and treat individuals with mental and emotional maladjustments, has not only offered us the specialized services of its
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experts but has made available a large body of knowledge which we can use in our study of why people behave the way they do. Largely f r o m this field has come the belief that all behavior is purposive, that it is symptomatic of deeper needs and urges. Hence the growing emphasis upon the treatment of causes rather than the more superficial aspects of behavior. Psychiatry has taught us the importance of emotions, and psychoanalysis has hinted of hidden powers in the unconscious realm. Of course case workers are not trained to treat conflicts in the unconscious, but at least they realize that such conflicts take place. This study has permitted our records to be more than a mechanistic rehearsal of the events in a life, and has enabled us to see people as thinking and feeling beings with reasons for behaving in the way they do. W h a t if some of us are lost in a maze of terminology or find meaning in our dreams! At least we are all searching for explanations of human conduct. Many of the findings have proven helpful. Psychiatry is by no means the only clue to behavior, but it is a veiy fruitful one. Oh, dear! It is one o'clock; to bed, now. I hope I'll dream of you!
THURSDAY NIGHT
D E A R CARLISLE:
All day I've been thinking about this letter and wondering if I had the nerve to assemble for you a few basic concepts of social work. W e have no ten commandments, maybe because our Moses, Mary Richmond, was a woman! But I have found some ideas that have remained solid and constant, supporting the whole structure of the daily practice of social work. Maybe ten years f r o m now my list would be different, but today the following concepts stand out: i . W e hold the belief that the great masses of mankind,
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when enlightened, are capable of self-rule and of bettering themselves. Whether civilization is advancing is not the question; the point rests upon faith in the possibility of advancement. There would be no social work, save the alleviation of suffering, if we did not believe that man is capable of building a more satisfactory world. 2. In order to grow, man must have the means of subsistence (his bread) and some opportunity to make choices (liberty). These are as essential to the development of man as are soil and water to the life of a plant. Social work provides bread to those without it and tries to enlarge the range of choice for those who have lost their freedom. 3. Man makes society and society builds the man. N o social problem or group action can be understood save in its effect upon the lives of individuals. N o individual can be understood unless he is seen in his social setting. Social changes involve changes in both man and the group which nourishes him. Hence both social case work and group action are necessary to attain the good society. 4. Each individual is unique as well as common. He is more than a farmer, a Chinese, a father, or an invalid; he is Sam Jacobson or John Kaczmarek. An increasing awareness of individual differences has resulted in a greater respect for the individual and his rights (both "natural" and legal) and has perceptibly influenced the methods of social work. Now, more than formerly, we expect people in trouble to seek out the social worker if they wish help; the worker and agency do not take the initiative. The individual is taken at his word; his attitudes become even more important than actual facts. We attack at first the problem as presented by the individual and avoid forcing plans upon anyone. The social worker has, however, a responsibility to help a person to see his full problem and to activate his desire to solve it. We realize that the potentialities within an individual can be developed only by his own effort.
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T h e worker helps by arranging a more fertile environment and by stimulating the growth process. The individual himself must do the growing, and in his own way. 5. Social workers believe that the relationship between the worker and the individual has meaning in itself. The worker can be anything from a human signpost to a savior. At all times the ease worker must offer a relationship free from prejudice and anxiety, an open table cleared for cooperative action in solving a certain problem. Persons with severe inner conflicts require the assistance of experts in psychiatry and medicine, and ordinary case workers do not expect to treat them. However, the worker may collaborate with these experts and treat the environment that might have given rise to the inner conflict. A n d a case worker can help those with less devastating conflicts by acting as a friendly guide, perhaps as an educator pointing out shortcomings and new resources, or even as a mirror aiding in self-interpretation, for many people can correct their own troubles after they see them clearly. Social workers realize more and more that in order to keep clearheaded in the midst of the difficulties that overwhelm those who ask f o r assistance they themselves must be individuals of emotional maturity and broad experience. In the chemistry of the relationship between the case worker and the seeker of help, the resulting product depends upon the interaction of ingredients from both parties. The workers too find this relationship a stimulating growth experience. 6. The last belief which I shall mention is the concept of having no concepts that cannot be changed. I do not mean a state of flabby indecision, a lazy discarding of inconvenient principles, or a refusal to search for as broad a vision as is possible. I do not refer to the number or strength of our convictions but to the tolerant skeptical attitude with which we should hold them. W e cannot know anything to be certain. Our concepts, growing out of previous experience, give us direction and pro-
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vide a basis for further choices. But even they are never as sure as a compass. It is a philosophy that expects variations and insists upon differential treatment for different ills. It is a philosophy that recognizes limitations and is satisfied with tentative goals. If one has only one leg one does not plan a cross-country hike. One is willing to accept a turn around the garden for the afternoon. W e say, "Given these conditions we can expect to go about this far. Until we get there we may not see farther." T o me this affords a greater sense of reality and a firmer basis for planning than a more universal all-embracing philosophy. At last, I am at the end. Judging by the number of men and women in this world who are not yet self-maintaining and who lack even the basic essentials for development, the task of the social worker has just begun. T h e day will not come during my life when the social worker has worked herself out of a job. W e can give people bread and help them obtain their independence through earning their own. W e cannot give them happiness. But we can, you and I, help create a society in which more happiness is possible for more people. I have written myself out of two nights of sleep and now am worried about boring myself out of a husband. I find that this letter is sprinkled with words like "try," "attempt,"
"plan,"
but so also is any statement of purpose and philosophy. Such words give one courage in this pursuit of life, liberty, and bread. Lovingly, and with renewed hope, CAROL
BIBLIOGRAPHY
SOUTHTOWN, WISCONSIN
M Y DEAR CARLISLE:
Hurray! There is finally news about my vacation—the vacation that I thought I would never get. Well, it begins next week. I want two whole weeks at home with you. I want to rest and read most of the time, maybe skate and ski a little. I want books and books piled all around me so that when I'm not falling on ice or snow I can revel in a few new ideas. All of which brings me to the point of this letter. Suggest a few books. I'll get some from the state office and bring them north with me if you do not have them in the college library. Don't be stingy with your list; I won't read them all anyhow. I feel so illiterate, so socially incoherent and statistically antique. Could you make the list cover most of the questions we have been writing about? I'll tack your suggestions above my desk when I get back to spur me on to intellectual effort whenever I begin to grow stale. What books do you consider a minimum essential for a general social and economic background today? Maybe I have read some of them, but I want the list anyway. I am getting ready to dig in and work. I shall really put on some steam in my pursuit of knowledge. With love and an unexpected amount of pep in this grand weather. Vacation is coming! I shall see you soon! CAROL
184
BIBLIOGRAPHY LAKEVIEW,
DEAR
WISCONSIN
CAROL:
Out of the thousands of books and articles on the topics we've been corresponding about I'm going to pick out a few for your vacation and winter reading. Y o u will realize, of course, that in a letter I can't list all the good readings, that I am not able to mention even some of the classics. I am going to run the risk of mentioning some titles you already know. Just ignore those. A s a teacher I'm very much pleased that you wish to read. Where do you find time? Evidently I'm a better educator than I thought. The education of a wife and incidentally of a husband has progressed! W e l l , here are some readings and comments under the headings of social problems in general, unemployment, wages, old age, fatherless homes, and health. SOCIAL P R O B L E M S IN G E N E R A L
Armstrong, Barbara, Insuring
the Essentials
(New
York:
Macmillan, 1 9 3 2 ) . Eight years old but the best summary of social insurance legislation in foreign countries. Armstrong, Louise, We Too Are the People
( N e w York:
Little, Brown, 1 9 3 8 ) . Y o u undoubtedly know this vivid picture of people on relief written by a Michigan relief administrator. Beard, Charles and Mary, America
in Mid passage
(New
Y o r k : Macmillan, 1 9 3 9 ) . A brilliant and liberal interpretation of the ten years from 1928 to 1938 by two of the keenest minds of our times. Burns, Eveline, Toward Social Security ( N e w York: McGrawHill, 1 9 3 6 ) . A good book on social legislation. Commons, J., and J. Andrews, Principles of Labor Legislation
( N e w Y o r k : Harper, 1 9 3 6 ) . The fourth edition of a
standard text by the dean of students of labor and another wellknown authority.
BIBLIOGRAPHY
185
Daugherty, Carroll, Labor Problems in American Industry (Boston: Houghton Mifflin, 1 9 3 8 ) . An excellent text. I ordered twenty-five copies for one of my classes. Douglas, Paul, Social Security in America (rev. ed.; New York: McGraw-Hill, 1 9 3 9 ) . A solid volume on the history and nature of the Social Security Act. Elliot, Mabel, and Francis Merrill, Social Disorganization (New York: Harper, 1 9 3 4 ) . A good lucid text on social problems. Encyclopaedia of the Social Sciences. If you are not acquainted with this monumental reference work, you should be. Epstein, Abraham, Insecurity, a Challenge to America (New York: McGraw-Hill, 1 9 3 6 ) . Epstein is a staunch pioneer advocate of advanced social welfare measures. Ford, James and Katherine, The Abolition of Poverty (New York: Macmillan, 1 9 3 7 ) . A brief clear analysis of the problems which interest us. Frank, Jerome, Save America First (New York: Harper, 1 9 3 8 ) . A prominent New Dealer with ideas and a program for America first. Klein, Philip, A Social Study of Pittsburgh: Community Problems and Social Services of Allegheny County (New York: Columbia University Press, 1 9 3 8 ) . This is a sound factual as well as interpretative study of conditions in one large city. Lescohier, Don, and Elizabeth Brandeis, History of Labor, 1896—1932: Working Conditions and Labor Legislation (New York: Macmillan, 1 9 3 5 ) . This is one of the volumes of the best history of labor, that edited by Commons. Lynd, Robert and Helen, Middletown in Transition: a Study in Cultural Conflicts (New York: Harcourt, Brace, 1 9 3 7 ) . The Lynds' second great social study of the people of Muncie, Indiana. MacDonald, Lois, Labor Problems and the American Scene (New York: Harper, 1938). Another good text.
186
BIBLIOGRAPHY
Moulton, Harold, Income and Economic Progress (Washington: Brookings Institution, 1 9 3 5 ) . This summarizes the important findings of the Brookings Institution on income. Look at this, by all means. Ogburn, William, ed., Recent Social Trends (2 vols.; New York: McGraw-Hill, 1 9 3 3 ) . Without these two great volumes any student of the American social scene of the twenties would be lost. Social Security in America: the Factual Background of the Social Security Act as Summarized from Staff Reports to the Committee on Economic Security (Washington: Government Printing Office, 1 9 3 7 ) . Without this I couldn't have written the letters I did. Your office ought to get a copy if it hasn't one. Stewart, Maxwell, Social Security (New York: Norton, 1 9 3 7 ) . A provocative and critical study of our recent social legislation by an associate editor of The Nation. See also his little pamphlet, Readjustments Needed for Recovery. Thomas, Norman, Human Exploitation in United States (New York: Stokes, 1 9 3 4 ) . After the New Deal, What? (New York: Macmillan, 1 9 3 6 ) . Both of Thomas's volumes are worth your while. Norman Thomas, as you know, is the honest, courageous, and learned leader of the Socialists in the United States. Van Kleeck, Mary, Creative America, Its Resources for Social Security (New York: Covici, Friede, 1 9 3 6 ) . Since I gave you this volume for a birthday present you ought to know what I think of the book and its great author. Much of the information about social problems has, of course, never been put into books. I obtain much, especially current, material from a number of magazines and newspapers and from government and union publications. I couldn't get along without the New York Times, and I regularly read The Nation, The New Republic, The Survey Graphic, The Survey, and Family. The Bureau of Labor Statistics (Department of
BIBLIOGRAPHY
187
Labor) makes constant studies of labor problems, and publishes them in the Monthly Labor Review and in bulletins and news releases. The Social Security Board likewise publishes many bulletins and pamphlets, and its monthly Social Security Bulletin gives current information. You can obtain releases of both the bureau and the board for little or no cost if you will write to them. Nearly every union has its newspaper or magazine. The A. F. of L. publishes the American Federationist, a monthly magazine, besides a monthly survey of business and a weekly newspaper. The CIO News comes out weekly. Some of the scholarly journals often have good articles on current social questions. Look particularly at the American Economic Review, The American Journal of Sociology, The Political Science Review, and the Annals of the American Academy of Political and Social Science. UNEMPLOYMENT
A good many of the books and publications under "Social Problems in General" might be mentioned here, as well in the following sections, again. I shall note only the pertinent pages in some, and give a few additional titles. Douglas, Paul, and Aaron Director, The Problem of Unemployment ( N e w York: Macmillan, 1 9 3 1 ) . A good orthodox study by economists who are not so orthodox. The newspaper example I used is paraphrased from this book. Elderton, Marion, Case Studies of Unemployment (Philadelphia: University of Pennsylvania Press, 1 9 3 1 ) . A good collection. Ezekiel, Mordecai, Jobs for All (New York: Knopf, 1 9 3 9 ) . A constructive plan for industrial expansion of and by the key industries. Ford, James and Katherine, op. cit., pp. 206-33. Gill, Corrington, Wasted Manpower (New York: Norton, 1 9 3 9 ) . An excellent recent study.
188
BIBLIOGRAPHY
Hobson, John, Rationalization and Unemployment (London: Allen and Unwin, 1 9 3 0 ) . Hobson, the unorthodox English liberal, is one of the great economists of our times; his book's conclusions are pertinent for America. Magdoff, Harry, Irving Siegal, and Milton B. Davis, Production, Employment, and Productivity in Fifty-nine Manufacturing Industries 1919-36 (Philadelphia: Works Progress Administration, May, 1 9 3 9 ) . Predicts less employment in manufacturing, on the basis of statistical studies of the past. Nathan, Robert, "Estimates of Unemployment in United States," International Labor Review, January, 1936. Best estimates. Ogburn, William, You and Machines (American Council on Education, 1 9 3 4 ) . Simply written and brilliant, but the CCC boys weren't allowed to read it because it was thought too pessimistic. Shafer, Carol and Boyd, "Lay-offs with Pay," Survey Graphic, April, 1 9 3 7 , and " A Community Creates Real Jobs," ibid., September, 1939. Social Security in America, pp. 3 - 1 3 3 . Weintraub, David, "Unemployment and Increasing Productivity," Technological Trends and National Policy (Washington: Government Printing Office, 1 9 3 8 ) , pp. 6 7 - 9 1 . This is an important section of a report to the National Resources Committee. Y o u will find many of the publications of the Bureau of Labor Statistics and the Social Security Board of real value here. For example, Bulletin 6 1 0 of the bureau gives Revised Indexes of Employment and Payrolls, 1919-33.
LOW INCOMES
Brissenden, P. F., Earnings of Factory Workers, 1 8 9 9 - 1 9 2 7 , Census Monograph X , United States Department of Commerce, Bureau of the Census, 1929. Technical but sound.
BIBLIOGRAPHY
189
Bureau of Applied Economics, Standards of Living, a Compilation of Budgetary Studies, Bulletin No. i (rev. ed.; Washington: Government Printing Office, 1932). Chase, Stuart, The Economy of Abundance (New York: Macmillan, 1934). Journalistic but a good description of the possibilities. Gark, Harold, Life Earnings in Selected Occupations in the United States (New York: Harper, 1937). Earnings should be judged primarily on a lifetime instead of an hourly or yearly basis, and this book does pioneering in the field. Douglas, Paul, Real Wages in the United States, 1890-1926 (Boston: Houghton Mifflin, 1930). The book most used; an authoritative study. Leven, M., H. Moulton, and C. Warburton, America's Capacity to Consume (Washington: Brookings Institution, 1936). The Brookings studies of income and productivity are among our best recent estimates. They were summarized in pamphlet form. Loeb, Harold, and Associates, The Chart of Plenty (New York: Viking Press, 1935). A group of engineers and economists financed by the former Civil Works Administration chart their findings and find that plenty for all is possible. Moulton, H., The Formation of Capital (Washington: Brookings Institution, 1 9 3 5 ) . National Resources Committee, Consumer Incomes in the United States: Their Distribution in 1933-36 (Washington: Government Printing Office, 1938). These studies are the latest and best available on the subject. Nourse, E., and Associates, America's Capacity to Produce (Washington: Brookings Institution, 1934). Shafer, Carol, "These People on Relief," Survey Graphic, September, 1936. You can follow the trend of wages in the Monthly Labor Review, and before 1933 in Bulletin 610 of the Bureau of Labor Statistics.
190
BIBLIOGRAPHY OLD AGE
Douglas, Paul, Social Security in America, pp. 1 2 9 - 1 5 1 . Epstein, Abraham, op. cit. Ford, James and Katherine, op. cit., pp. 1 3 2 - 3 7 . International Labor Office, Report of the Office on the Question of Discrimination against Older Workers (Geneva, Switzerland, 1 9 3 8 ) . An international, sober survey. Palmer, Dwight, and John Brownell, "Influence of Age on Employment," Monthly Labor Review, April, 1939. Social Security in America, pp. 137—229. Stewart, Maxwell, op. cit., pp. 42-54, 1 8 6 - 1 9 7 . Some of the best discussions of the problem are in the periodicals I mentioned under "Social Problems in General," especially the Social Security Bulletin. F A T H E R L E S S HOMES
Abbott, Grace, "Mothers Aid," Social Work Year Book, 937 (New York: Russell Sage Foundation, 1 9 3 7 ) . Cavan, Ruth, and Katherine Ranck, The Family and the Depression (Chicago: University of Chicago Press, 1 9 3 8 ) . What actually happened to a hundred families. Colcord, Joanna, Broken Homes (New York: Russell Sage Foundation, 1 9 1 9 ) . A bit out of date but by a woman who knows the subject. See also her article on "Family Desertion" in the Encyclopaedia of the Social Sciences, Vol. VI. Elliot, Mabel, and Francis Merrill, op. cit.. pp. 4 1 1 - 5 6 6 . Flügel, J. C., The Psycho-analytic Study of the Family (London : Hogarth Press, 1 9 2 1 ) . Hankins, Frank, "Divorce," Encyclopaedia of the Social Sciences, Vol. V. and A. C. Jacobs, "Illegitimacy," ibid., Vol. VII. Hart, Hornell, "Changing Social Attitudes and Interests," Recent Social Trends, I, 382-442. Shows how changing attitudes are affecting the family. T
BIBLIOGRAPHY
191
Kammerer, Percy, The Unmarried Mother (Boston: Little, Brown, 1 9 1 8 ) . Still usable. The Modern American Family, Annals, March, 1932. Mower, E., Family Disorganization (Chicago: University of Chicago Press, 1 9 2 7 ) . About as scientific as any study of the family. Ogburn, William, "The Family and Its Functions," Recent Social Trends, I, 6 6 1 - 7 0 8 . You should not miss this article if you wish excellent information. Social Security in America, pp. 229-301. Spiegelman, Mortimer, "The Broken Family: Widowhood and Orphanhood," Annals of the American Academy of Political and Social Science, November, 1936. Stouffer, Samuel, and Lyle Spencer, "Marriage and Divorce Rates in Recent Years," Annals of the American Academy of Political and Social Science, November, 1936, pp. 56-69. There are many general texts on the family. You probably know, among others, those by Groves, Goodsell, Reuter and Runner, and Folsom. You undoubtedly know the publications of the Women's Bureau and Children's Bureau of the Department of Labor. Get their lists of publications. HEALTH
Altmeyer, A. J., I. Abell, and C. E. A. Winslow, "Public Health Aspects of Medical Care," American Journal of Public Health, January, 1939. Davis, Michael, "Public Medical Care, Pronouncements and Progress," The Survey, December, 1937. His articles in the Survey Graphic in 1 9 2 7 - 2 8 were among the first shots for public medical care. Epstein, Abraham, "Health Insurance, the Next Step," New Republic, February 1 7 , 1937. His plan is the best I know. He has given me many ideas. Falk, I., M. Klein, and N. Sinai, The Incidence of Illness
192
BIBLIOGRAPHY
and the Receipt and Costs of Medical Care among Representative Families (Chicago: University of Chicago Press, 1 9 3 3 ) . Publication 26 of the fine Committee on Medical Care study. Hall, H., and P. Kellogg, "Unserved Millions; Interpretation of the National Health Conference," Survey Graphic, September, 1938. Interdepartmental Committee to Coordinate Health and Welfare Activities. Report of the Technical Committee on Medical Care, The Need for a National Health Program (Washington: Government Printing Office, 1 9 3 8 ) . Representatives of three federal agencies report, advocating extension of governmental functions. Kingsbury, John, "Health Insurance in a National Health Program," National Conference of Social Work, 1937, and "Adequate Health Service for All the People," ibid., 1934. Kingsbury is a courageous pioneer and an intelligent one. Medical Care for the American People (Chicago: University of Chicago Press, 1 9 3 2 ) . This summarizes the exhaustive findings of the other twenty-seven volumes of the Committee on Medical Care. The committee members were not all in agreement, but the summary is excellent. National Health Survey, Bulletins 1 - 6 (Washington: Government Printing Office, 1 9 3 8 ) . The results of the vast survey undertaken by W P A under the direction of the United States Public Health Service. Read these by all means. Orr, Douglas and Jean, Health Insurance with Medical Care (New York: Macmillan, 1 9 3 8 ) . This is a provocative study of British health insurance and how it works, by a young American doctor and his wife. Reed, Louis, The Ability to Pay for Medical Care (Chicago: University of Chicago Press, 1 9 3 3 ) . Volume X X V of the Committee on Medical Care report. Health Insurance: the Next Step in Social Security (New York: Harper, 1 9 3 8 ) . This man knows whereof he speaks.
BIBLIOGRAPHY
193
Roche, Josephine, "Medical Care as a Public Health Function," American Journal of Public Health, December, 1937. Josephine Roche is one of America's great women, and she too knows this subject. Rorty, James, American Medicine Mobilizes (New York: Norton, 1939). Rorty, writing from the left-wing point of view, gives a vivid picture of the opposition of the American Medical Association to social medicine. Social Security in America, pp. 259-301, 315-45. Winslow, C. E. A., "Medical Care for the Nation," Yale Review, March, 1939. I see that I have listed more books and articles than I expected, and probably more than you will have the time or inclination to peruse. Now I am going to turn the tables again and ask a favor of you. Since you wrote me about the nature of social work, I have been wishing to read some of the best books on the subject. Can you list ten or twelve that I ought to know? I see now that social work, too, will lead toward life, liberty, and the pursuit of bread and happiness. During your vacation I would like the chocolate cake that you have been promising me. You can't spend all your time reading. Love, CARLISLE
SOUTHTOWN, WISCONSIN
DEAR CARLISLE:
If you really want to read a bit in the field of social work, I shall be more than glad to list some books and articles for you Much of the technique of social case work has not as yet been set down in books of instruction, but quite a little has been
BIBLIOGRAPHY
194
written about the history, principles, and general practice of social work. T h e following writings should give you a broad understanding of the how and why of social work: Bruno, Frank J., The Theory of Social Work
(New York:
Heath, 1 9 3 6 ) . A philosophical statement of the purpose and function of social work. Coyle, Grace L., ed., Studies in Group Behavior ( N e w Y o r k : Harper, 1 9 3 7 ) . Provides case material for analyzing group work. Day, Florence, "Changing Practices in Case Work Treatment," The Family, March, 1937. Her views are always helpful. De Schweinitz, Karl, The Art of Helping Trouble
People
Out of
(Boston: Houghton Mifflin, 1 9 2 4 ) . Valuable for per-
spective and inspiration. Hamilton, Gordon, Social Case Recording
( N e w York: Co-
lumbia University Press, 1 9 3 6 ) . A much-needed book analyzing case recording. "Basic Concepts upon Which Case W o r k Practice Is Formulated," Proceedings of the National Conference Work, 1937
of Social
(Chicago: University of Chicago Press, 1 9 3 7 ) . A
dear statement of the modern philosophy of case work. Healy, William, A . Bronner, and Others, Reconstructing havior in Youth
Be-
( N e w Y o r k : Knopf, 1929). Full of case stud-
ies and evidence of the interrelation of causal factors in behavior. Interviews, Interviewers, and Interviewing ( N e w Y o r k : Family Welfare Association of America, 1 9 3 1 ) . A handbook on every social worker's bookshelf. Lee, Porter R., Social Work as Cause and Function
(New
Y o r k : Columbia University Press, 1938). Selections from the writings of the former director of the N e w York School of Social Work, rewarding for perspective and philosophy of case work. Lenroot, Katharine, "Social W o r k and the Social Order,"
BIBLIOGRAPHY
195
Proceedings of the National Conference of Social Work, 1935 (Chicago: University of Chicago Press, 1 9 3 5 ) . One of many great presidential addresses. Lowry, Fern, "Objectives in Social Case Work," The Family, December, 1937. A brief but careful discussion of fundamental objectives. ed., Readings in Social Case Work, 1920-1938 (New York: Columbia University Press, 1 9 3 9 ) . A collection of more than seventy of the best papers of the period. Marcus, Grace, Some Aspects of Relief in Family Case Work (New York: New York Charity Organization Society, 1 9 2 9 ) . Miss Marcus gave new significance to the daily practice of granting relief. Milford Conference Report, Social Case Work, Generic and Specific (New York: American Association of Social Workers, 1 9 2 9 ) . A great summary and vision of social work, most clarifying to the social worker. Neustader, Eleanor, Relief: a Constructive Tool in Case Work Treatment (pamphlet from Proceedings of the National Conference of Social Work, 1930). A practical help when relief giving seems discouraging. Reynolds, Bertha C , "Can Social Work Be Interpreted to a Community as a Basic Approach to Human Problems," The Family, February, 1933. Defining our place in the community. "Re-thinking Social Case Work," Social Work Today, April, May, and June, 1938. Especially helpful for us who are rethinking. Richmond, Mary, Social Diagnosis (New York: Russell Sage Foundation, 1 9 1 7 ) . Our bible. The first orientation of case work, proving still useful in practice. What Is Social Case Work? (New York: Russell Sage Foundation, 1 9 2 2 ) . A basic interpretation of our work. Robinson, Virginia, A Changing Psychology in Social Case Work (Chapel Hill, N. C.: University of North Carolina Press,
196
BIBLIOGRAPHY
1 9 3 0 ) . This book did change the psychology of social case work. Miss Robinson's writings are on the "must" list. Springer, Gertrude, Miss Bailey Says (a series of pamphlets, Survey Associates, Inc., New Y o r k ) . These articles, published periodically in The Survey, deal with the everyday problems of the case worker and have been of great help to us in the field. With the periodicals The Family, The Survey, and The Survey Graphic, social workers keep in touch with each other and with current common problems. The Social Work Year Book and the Proceedings of the National Conference of Social Work are annual and biennial publications which contain most of the important speeches and writings by and for social workers each year. The Family Welfare Association of America puts out many pertinent pamphlets. I shall not mention any of the more technical social and psychological journals to which a social worker might refer for information or special study. Now if you read all the books I have listed and if I read all you have suggested, we ought to possess some of the equipment essential for understanding and attacking our social dilemmas. Americans should be able to guarantee each other the bread of life and that liberty so necessary for the pursuit of wisdom and happiness. So, on with the pursuit! Faithfully yours, CAROL
INDEX
Abbott, Edith, 164 Addams, Jane, 164 Administrations, fear repercussions of unemployment statistics, 7 Adult education, federal emergency programs, 23 Aged, set Old age Age groups, illness and disability, 137 Agricultural workers, excluded from social insurance, 8 ; , 88, 122 Agriculture, uses older workers, 72 Alaska, aids aged, 79 Amalgamated Clothing Workers, 20; policies which serve to raise wages, 54 American Federation of Labor, estimate of unemployment, 8 Arkansas, grants to aged, 78 Australia, gives invalidity and oldage pensions, 80 Automobile industry, annual earnings of workers in, 38; wages, 42 Beauty work, more workers employed in, 12 Benefits, see Insurance benefits; Oldage benefits Biggers, John D., 8 Birth rate, diminishing, 71, 76 Blood tests, premarital, 1 1 2 Broken homes, 9 0 - 1 2 2 ; see also Fatherless homes Brookings Institution, estimate of annual incomes of nation's families, 3 ; ff. ; estimate of possible increase in industrial production, 48 ; study of distribution in relation to economic progress, 1 ; ; suggests decreasing prices, 17
Budget, for dependent family, 46; for low-income family, 32 ; health and decency, 43 Business, chief problem, 1 5 ; cooperatives a check on, private, 20; organized into combinations of capital, 54 Businessmen, 1 7 ; self-employed, excluded from social insurance benefits, 85, 88, 122; should be persuaded that lower prices are necessary, 19 Buying power, created by public works programs, 19; effect upon production and employment, 13 ff. ; increasing, 25 ; see also Wages, real California, grants to aged, 78 Capital, too immobile, 22 Capitalism, business will continue to operate within limits of, 19; control and regulation by, 23; fluctuations in economic conditions inherent in, 24; incentive to obtain high profits, 18; may not be able to stand up under its contradictions, 50 Case studies of sickness and medical care, 1 2 3 - 3 2 ; articles and statistics humanized by, 133 Case workers, 1, 153, 154; as participants in solution of social and economic problems, 1 5 5 ; function, 157, 158; training vs. experience, 166; see also Social workers Casual workers excluded from social insurance benefits, 8} Census, decennial statistics of little value in intervening periods, 7
198
INDEX
Charity, public, 73 Charity vs. social work, 153, 159, 176 Charity workers excluded from social insurance benefits, 85 Chase, Stuart, estimate of possible family income, 49 Chicago Social Agencies, validity of their standard budget for dependent families, 46 Child Labor Committee, 165 Children, aid for dependent, 92, 1 0 1 , 1 0 6 ; aid should be adequate, 1 1 7 , 1x9, 120, 1 2 2 ; cost estimated, 1 2 0 ; "dependent child" defined, 1 1 8 ; diminishing birth and death rate, 7 1 , 76; extent of state aid now being given, 1 1 7 , 1 1 9 ; health, 126, 1 3 1 , 132; higher standard of living needed, 1 2 0 ; home or institutional care? 1 1 5 ; illegitimate, 100, 1 0 7 ; in families with female heads, statistics, 105 f . ; marriage, 113; Social Security Act provisions, 82, 1 1 8 ; survivors' pension benefits, 1 1 8 , 1 2 0 Children's Bureau, 47, 165 Chronic diseases, 135, 136, 138 Cigarette workers, average income, 39 Civil service for old-age assistance officials, 81 Clerical groups, study of expenditures of low-salaried, 44 Coal industry, earnings of workers, 38 Colorado, grants to aged, 78 Commissions, expert: control of profits through regulation by, 19 Committee on Medical Care, studies by, 136, 143. 145 Common Law practices, a barrier to effective government control, 20 Communists, 18 Community resources, social worker as distributor, 158 Company housing and stores, 52 Competition must be restored, 1 7
Confinement, medical expense, 126 f. Constitution, a barrier to effective government control, 20 Consumption, fundamental needs far from being filled, 1 3 ; see also Production Cooperation and cooperatives, importance, 20, 54 Cooperative hospitalization, 150 Corporations, earnings of, and price indexes ( 1 9 3 7 ) , 1 8 ; property and liberty of, 21 Cost of living, constantly changing, 43 ; lower prices decrease, 50 ; prices raised to off-set increase in wages, 54, 57; trend in, compared with wage trends, 41 Cotton textile mill, 9 County nurse, 1 3 1 Courts of domestic relations, 1 1 4 Craftsmen, skilled, 46 ; see also Workers C W A engineers' and economists' estimate of possible increase in industrial production, 49 Davis, Michael, 1 4 1 Death rate, 139, 140 Debt, public, 21 Denmark, cooperatives, 55 Dental care, 130, 1 3 2 Dependency, in old age, 64 (see also Old age) ; need to change to independence, 1 ; poor health or physical disability as cause, 125, 138 Depressions, 1 4 ; as typical as prosperous periods, 38; increased percentage of jobless old workers, 72 ; threaten human lives and aspirations, 1 5 7 ; trends in pay rolls and in individual earnings, 40 ; unemployment not peculiar to, 8 Deserted wives and children, case study, 96 ff. ; custody of children, x i 5 ; dependency, i n , 1 1 5 ; emotional difficulties, 102 ; increase in, 99; more adequate provision
INDEX needed, 117, 119, 122; mothers' pensions, aid to children, 101, 106, 117 ff. ; possible prevention, 1 1 1 - 1 5 ; statistics, 105, 107, 119 Disabling illnesses, case studies, 125®.; statistics, 134®.; see also Sickness Diseases, major, 139, 145 ; see also Sickness Distribution, Brookings Institution study of, in relation to economic progress, 15; duplication of effort increases expenses, 17; effect upon employment, 10 ff. District of Columbia, 79 Divorce, case study, 99; custody of children, 115; dependency, 111, 115; families broken by, 96; more adequate provision needed, 117, 119, 122; mothers' pensions, aid to children, 101, 106, 117 if. ; possible prevention, 111-15 ; social factors causing, 108 ff.; statistics, 105, 106, 1x9 Doctors, better geographical distribution needed, 132, 144; charity, 144; indebtedness to, 127, 128; median income, 149; pecuniary objectives, 128, 142, 144; position of, under health insurance, 147, 148 f. ; services to relief and low-income families, statistics on, 141 Douglas, Paul, u , 41 Dwelling units, see Housing Earnings, average annual, best guide to workers' welfare, 38 ff. ; see also Income; Standard of living; Wages Economic conditions, Brookings Institution study of distribution in relation to progress, 15 ; during late 1920s, 15; fluctuations in, inherent in capitalism, 24; relation of social work to, 154, 159, 163, 165 Economic need, social work's function in meeting, 158®.
199
Economic strain on family relationships, 110, 114 Economic system, causes and remedies for unemployment rooted in, 7. 23 Education, adult, 23; for marriage and family relationships, 113; schools of social work, 166; workers should use resources for, 53 Emergency expenses, 33 Emotional difficulties, in fatherless homes, 102; social workers' aid in meeting, 157, 180 Employability, loss through illness, 138 Employees, see Workers Employer reserve system, 21 Employers, raise prices to off-set increase in wages, 54, 57; shift tax to consumer, 87 Employment, coordination of workers and, 2 5; increasing number of jobs, 25; percentage of older workers gainfully employed, 71; regularization of, 24 Employment offices, as clearing houses to coordinate jobs and the jobless, 22 Employment services, government, 22 Examinations, medical, 140 Eye care, 131, 132
Fair Labor Standards Act, 57 Family, factors causing disorganization, 108 ff.; health needs and expenditures of average, 128; lost functions, 76; measures for preventing disorganization, i i i f f . ; see also Fatherless homes; Marriage; Relief families Family incomes, see Incomes Farm associations, future possibilities, 20 Farmers, do not pay social security tax, 69; few able to save for old age, 74
200
INDEX
Farming, fewer workers employed in, 1 2 Farm laborers, excluded from social insurance benefits, 8 5 ; may be included later, 88 Fascism, 1 9 Fatherless homes, 9 0 - 1 2 2 ; case studies, 91 ff.; dependency, i n , 1 1 5 ; emotional difficulties, 1 0 2 ; factors causing family disorganization, 1 0 8 - 1 1 ; measures to prevent disorganization, i n ff.; public assistance for, an accepted policy, 1 1 5 , 1 1 7 , 1 1 8 ; Social Security Act's benefits, 82 f., 94, 1 1 8 ff.; statistics, 104 ff., 108, 119; see also Children; Deserted wives; Divorce; Widows and orphans Federal Emergency Relief Administration, 73 Female heads of families, statistics, 104 ff.; see also Fatherless homes Filling stations, 1 7 Financial conditions, effect of upturn and drop on unemployed, 4 Fishermen excluded from social insurance benefits, 85 Ford, Henry, 20 Foreign exchange, stabilization of, 50, 51 France, invalidity and old-age pensions, 80 Freedom, effect of desire for, upon family life, 76 Goods, cheaper, see Prices, lower Government, assumes responsibilities formerly carried by family, 7 7 ; can create work which will pay for itself, 1 9 ; grants-in-aid for public health programs, 1 4 6 ; logical agent to provide work if business cannot, 6, 25, 5 1 ; medical aid from relief funds, 1 4 1 ; pensions taken over by, 52; should protect labor in its right to organize, 20; wealth and income depend on policies of, 55
Government control and regulation, 18, 23 ; Constitution and Common Law practices a barrier to, 20 Government employees, do not pay social security tax, 69; nor receive its benefits, 85 Government housing program needed, 20 Government ownership, 18, 57 Government projects provide only construction jobs, 5 Government securities could be taxed, 88 Great Britain, cooperatives, 20, 55; health insurance, 146, 148 Growth, individual: facilitated by social work, 1 6 1 , 162, 177 Handicapped individuals, 1 3 5 Hawaii, 79 Health and sickness, 1 2 3 - 5 1 ; case studies, 123—32; child problems, 126, 1 3 1 , 1 3 2 ; facts, statistics, 1 3 4 ff.; National Health Inventory of Public Health Service, 134, 136, 138, 1 4 1 ; plan for solution of problem, 1 3 2 , 147 ff.; preventive measures, 130, 134, 140, 142, 145, 1 4 7 ; problems of relief families, 125, 129, 1 3 3 , 138, 1 4 1 ; of nonrelief families, 126; workers economize on health, 45 ; see also Insurance, health; Medical care; Sickness Health insurance, see Insurance, health Hillman, Sidney, 20 Home, better than institutional care for children ? 1 1 5 ; lost functions, l6 Homes, broken, 9 0 - 1 2 2 ; see also Fatherless homes Hopkins, Harry, 164 Hospitalization, cooperative, 150 Hospitals, 128, 1 3 2 , 140, 144 Hotel employees, 42 Houghteling, Leila, quoted, 47 Housing, chronic need for adequate,
INDEX 1 9 ; increased subsidies needed, 56; subsidization by governments, 5i Illegitimacy, case study, 1 0 0 ; rural and urban, 100, 1 0 7 ; statistics, 105, 107 Illinois, old-age assistance, 78 Illness, see Sickness Incapacitation as result of illnesses and injuries, case studies, 126 ff. ; statistics, 1 3 4 ff. Income, better distribution necessary, 23, 5 1 ; distribution in relation to economic progress, 1 5 ; extremes in, greater than in wages alone, 39; family incomes not restricted to one wage-earner, 42 ; from property, 39; increase in, to check unemployment, 1 3 ; low, 2 7 - 5 8 ; of nation's families, 35 ff. ; possible to increase, 48 ff. ; relation to health, 138, 1 4 1 ; to death rate, 1 3 9 ; see also Wages Income, national: amount each family would receive if equally divided, 48 ; rise in, should bring increased benefits, 88 Income taxes, progressive, 56, 88 Indebtedness of relief families, 128 Individuals, development of, the aim of social work, 157, 158, 1 6 1 , 164, 177, 1 7 9 ; "executive" and "protective" methods of treating, 1 7 4 ® . ; linked to social forces, 159, 163, 1 7 9 ; maladjusted, 154, 160 Industrial equipment, lag of wages behind increases in, 42 Industry, demands limit jobs open to workers over forty, 7 1 ff. ; estimates of possible increase in production, 48 ff. ; failure to pay health and decency wage, 48 ; lower wages paid in recovery years, 38 ; public subsidizes low-wage companies, 31 ; savings invested in new, increase employment, 1 3 , 1 5 ; to blame for unemployment, 5 ;
201
uses older workers, 7 2 ; see also under name of industry, e.g., Manufacturing; Steel Infant mortality, 7 1 , 139, 140, 145 Injuries and illnesses, incapacitation as result of, 1 3 4 ® . Insurance, group, 52 Insurance, health, 5 6, 128, 1 4 6 ; British system, 146, 1 4 8 ; effect upon medical profession, 148 f . ; plan for, 147 ff.; relief clients not covered by, 1 3 3 Insurance, private: by workers, 1 0 1 , 121 Insurance, unemployment, 4 ; a palliative, not a cure, 21 Insurance benefits under Social Security Act, 82 ff., 1 1 8 ff. Invalidity, 79, 80 Inventions, no cessation of social changes due to, expected, 1 0 ; see also Technological improvements Investments, foreign, 15, 1 6 ; limitation of profits to prevent too rapid expansion of market, 1 8 ; nonproductive, 1 5 ; savings employed in, 23 Jobless, see Unemployed Kellogg, Paul, 165 Kenworthy, Marion, 1 5 3 Labor, see Workers Labor costs, in production of a newspaper, 1 1 Labor Statistics, Bureau of: estimate of wages in motor-vehicle plants, 40; indices of pay rolls, 39 ff.; studies of expenditures of wage earners and low-salaried clerical groups, 44 Labor supply, restriction of, 25 Labor unions, future possibilities, 20; object to profit-sharing, 5 3 ; results of unionization, 54 Laissez faire, days of, ended in the depression, 55 Lathrop, Julia, 165
202
INDEX
Laundry workers, 42 Laws, marriage, 1 1 3 Life expectancy, 73 Literary work, persons engaged in, excluded from social insurance benefits, 85 Livelihood, effect of struggle for, upon family life, 76 Machines, see Technological improvements Maladjustments, individual, 154, 1 6 0 ; see also Individuals Management, good: employer's chief contribution to workers' welfare, 53
Manufacturing industries, average wage paid, 38; discrimination against older workers, 7 2 ; effects of technological change in, 9; real wages and productivity, 4 1 ; workers employed in, 1 2 Marriage, clinics, courts of domestic relations, 1 1 4 ; education for, 1 1 3 ; forced, 1 0 1 ; laws, 1 1 2 ; measures to prevent disorganization, 1 1 2 Maryland, old-age assistance, 78 Maternal mortality, 140 Means test for old-age pension or relief, 66 Medical care, a business as well as a service, 142, 1 4 4 ; average cost predictable and insurable, 1 4 7 ; costs, 45, 1 4 0 ; facilities not evenly distributed, 142, 1 4 4 ; handicapped persons, 1 3 5 ; indebtedness for, 1 2 8 ; need of, in divorce cases, 1 1 4 ; percent of cases without, 140, 1 4 2 ; plan for obtaining, 1 4 7 ; plant-sponsored, 52, 1 5 1 ; preventive measures, 130, 134, 140, 142, 145, 1 4 7 ; results of postponing, 124, 1 3 1 ; sample family bill, 1 2 7 ; scientifically and financially possible, 140, 145, 1 4 7 ; socialization, 56, 128, 1 3 2 , 1 4 6 ; study by Committee on Medical Care, 1 3 6 ; widespread lack of,
1 2 5 ; see also Doctors; Health; Insurance, health; Sickness Mental incapacity, 126 Merit system, 21, 81 Middle Ages, 14 Minimum wage, company not able to pay, a social parasite, 57 Minimum-wage law, 57 Minister as relief client, 124 Monopolies, control of, 5 1 ; increase prices to make maximum profits, 1 7 ; must be broken up, 1 7 Mothers' pensions, 96, 106, 1 1 8 Motor-vehicle industry, see Automobile industry Moulton, Harold, 1 5 Movie stars, incomes, 39 Mutual benefit associations, 52 National Children's Bureau, 165 National Health Inventory, 134, 1 3 6 ; excerpts, 138, 1 4 1 National Resources Board, estimate of distribution of national income, 37 National Unemployment Census, 7; unemployment figures according to, 8 Need the only reason for giving aid, 81 New Deal's aid to dependent children, 1 1 9 Newsboys excluded from social insurance benefits, 85 Newspaper, labor costs, 1 1 N e w York state, percentage of workers over thirty-five barred from jobs, 72 Norway, cooperatives, 5 5 ; see also Scandinavian countries Occupational guidance, 23 Occupations, skilled: difficult to enter after twenty-five, 73 Ogburn, William, 1 0 5 ; quoted, 10, 106 Oklahoma, old-age assistance, 78 Old age, 59-89; function for the unproductive should be found,
INDEX 69, 89; indifference of children toward aged, 65, 75 ; infirmities, 7 3 ; need of public assistance, 7 5 ; number of dependent aged, 70, 77 ; percentage gainfully employed, 7 1 ; percentage receiving relief or charity or supported by relatives, 73 ; progress in care of aged, 79; proportion of aged in population increasing, 7 1 , 73, 75 ; Wisconsin law re responsibility of children, 64 Old-Age and Survivors Insurance Trust Fund, 82 ff., 120 Old-age assistance, 62 ; age requirements should be lowered or abolished, 79, 80; danger of political influences in administration of, 67, 78, 79, 81 ; grants too small, 66; increase in grants for, 64 ; means test, 66 ; plans, 77 ff. ; set up by state laws, 77 ; state laws and practices should be uniform, 78, 79; increase of uniformity in laws and practices needed, 78, 79, 81 Old-age benefits, 82 ff. ; calculations for, 67 ff. ; for widows and children, 82 ff., 1 2 0 ; handled by federal government, 82 ; increase in benefits, 79, 80; table of benefits, 84 Old-age pensions, see Old-age assistance Organize, labor's right to, 20 Orphans, see Children; Widows and orphans Parents, dependent, see Old age Parran, Thomas, 145 Patent medicines, 142, 145 Paternalism, 52 Pay rolls, period 1 9 2 3 - 2 5 compared with later years, 39 ff. ; trend in, not always the same as trend in individual wages, 40 Pensions, mothers', 96, 106, 1 1 8 ; survivors' benefits under Social Security Act, 82 ff., 1 1 8 ff. ; various
203
types being taken over by governments, 52; see also Old-age assistance Pension systems, governmental contributions to, 56 Physicians, see Doctors Political influence in administration of old-age assistance, 67, 78, 79, 81 Poor, criticized by the privileged, 3 i . 43 Population, proportion of aged increasing, 7 1 , 73, 75 Poverty, as cause of family disruption, n o ; relation between sickness and, 125, 129, 1 3 7 ff. President of the U. S., salary, 39 President's Committee on Economic Security, quoted, 1 1 7 Preventive health measures, 130, 1 4 0 ; amounts spent on, 140; facts and planning necessary, 1 3 4 ; ignorance about, 1 4 2 ; ignorance causes waste of life and money, 1 4 5 ; plan for, 1 4 7 ; public health services, 145 f . ; scientifically and financially possible, results attainable, 140, 145, 147 Price-fixing associations, control of, 5i Prices, lower: advocated by Brookings Institution, 1 7 ; effect upon employment, 1 3 , 16, 18, 1 9 ; may bring increased profits, 1 7 ; mean higher real wages, 50; technological changes coming more rapidly than, 20 Prices, rise in' employers pass on tax and wage increases to consumer, 54, 57, 68; may cause unemployment, 54 Printing industry, effect of technological changes, 1 1 ; pays more than living wage, 46 Privileged classes, criticism of the poor, 3 1 , 4 3 ; extravagance of, 46 Production, resources for greater, 4, 48 ff.; for use instead of for profit, 57; government control of
204
INDEX
Production (Continued) associations which restrict, 51; increase in, and workers' income, 1 0 ff., 1 6 , 20, 4 1 , 48, 5 1 ; masses not able to buy what industry can produce, 2 1 , 2 3 ; social work necessary until problem solved, 160 Professions, increase of employment in, 1 2 Profits, control through taxation, 18, 1 9 ; lower prices may increase, 1 7 ; unemployment increased by idle, 12 Profit sharing, 52, 53 Progressive income and taxes, 56, 57 Property, most large incomes derived from ownership of, 39 Property-owning classes, 1 8 Psychiatry, in divorce cases, 1 1 4 ; in social work, 156, 1 7 7 , 1 8 0 Public Health Service, survey, 1 3 4 Public health services, expanding, 1 4 ; ; limitations of officials, 1 3 2 , 140 Public works, create buying power, 1 9 ; governmentally financed, 1 6 ; housing program, 56 (see also H o u s i n g ) ; needed to solve immediate problem of jobless, 1 9 Purchasing power, increased: a check to unemployment, 1 3 , 20 Quack doctors, 1 4 2 , 1 4 5 Railroad engineers, 46 Railroad workers, excluded from social insurance benefits, 85 Real Wages in United States (Douglas), 41 Recession, 1 8 Recreational programs, plant-sponsored, 52 Rehabilitation of individual the aim of social work, 1 5 7 , 1 5 8 , 1 6 1 , 164, 174 ff., 1 7 9 Relief and social work, 5, 7, 1 5 8 ; advisors on federal relief program staff, 1 6 5
Relief families, average income, 3 7 ; health problems, 1 2 5 , 1 2 9 , 1 3 3 , 1 3 8 , 1 4 1 ; indebtedness, 1 2 8 ; not covered by health insurance, 1 3 3 ; number headed by a woman, 91 (see also Fatherless homes) ; sickness and disability, statistics, 1 3 8 , 1 4 1 ; standard budget, 46 Relief funds, medical aid from, 1 2 5 , 1 2 7 , 128, 1 4 1 Relief office, packed, 1 ; a garbage disposal plant for industry, 5 Religious workers excluded from social insurance, 85 Rents, effect upon workers' standards of living, 56 Reserve fund, for insurance benefits, 8 8 ; re elimination of storage of idle cash, 69 Retail clerks, 42 Revolution in U. S. would probably be won by conservative groups, 18 Richmond, Mary, 1 5 3 , 178 Robinson, Virginia, 1 5 3 , 1 7 7 Roosevelt, Franklin Delano, 146, 150 Rural areas, lack of medical facilities, 1 4 4 Rural community becomes an urban industrial nation, 73 Russell Sage Foundation, 165 Sales, increased through lower prices, 50 Sales taxc-s, 56 Savings, amount necessary for security, 7 5 ; investment in new industries a preventive of unemployment, 1 3 ; too much money put into idle, 1 5 Scandinavian countries, cooperatives, 20, 5 5 ; illegitimacy, 1 0 1 Scientific workers excluded from social insurance, 85 Section hands, study of annual earnings of, 47 Self-employed, 85, 1 2 2 Self-maintenance as social work objective, 1 6 1
INDEX Selling, see Distribution Deserted Separated families, see families Servants, domestic, 8 ) , 1 2 2 Service trades, 1 2 Sex, and disability, 1 3 7 ; education, " 3 Sickness and health, 1 2 3 - 5 1 ; age, sex, economic status, as factors, 1 3 6 ff.; burden unevenly distributed, 1 3 6 ; cases without medical care, 1 4 0 ; distribution of costs, 1 4 3 ; effect upon workers, 1 2 6 , 1 2 7 , 1 3 4 , 1 3 8 , 1 4 6 ; health insurance and government aid, 1 4 6 f f . ; major diseases, 1 3 9 , 1 4 5 ; number of persons incapacitated, 1 3 4 ; other facts, statistics, 1 3 4 f f . ; relation to poverty, 1 2 5 , 129, 1 3 7 f f . ; results of putting nowknown preventive measures into practice, 1 4 ; ; sample family bill f o r illness, 1 2 7 ; wage losses, 1 2 7 ; see also Health and sickness; Medical care Social action, relation of social work to, 1 5 4 , 1 5 9 , 1 6 3 , 1 6 5 Social insurance benefits, 82 ff., 94, 1 0 1 , 1 1 8 ff. Socialists, 18 Socialized medicine, 1 2 8 , 1 3 2 , 1 4 6 Social ownership, 18 Social reforms, danger that aged will be helped at expense of, 6 7 ; leaders in, 164 Social scientists, view humanity in the abstract, 1 3 3 Social security, health measures a necessity, 1 3 4 Social Security Act, 67, 1 0 6 , 1 1 1 , 146, 1 6 5 ; excluded persons, 85, 1 0 1 , 1 2 2 ; extension of coverage needed, 86, 88; Old-Age and Survivors Insurance Trust Fund, 82 ff., 1 2 0 ; old-age grants suspended or reduced since inception of, 7 8 ; operation of annuity plan, 8 0 ; provisions for old age, 77, 82 ff., 1 2 0 ; provisions for wives
205
and dependent children, 82 ff., 94, 1 0 1 , 1 1 8 ff. Social Security Board, child aid given under plans approved by, 1 1 7 , 1 1 8 , 1 1 9 ; could demand more uniform state laws and practices, 8 1 Social security tax, 68, 69, 86 ff. Social work, 152—81; as an occupation, 1 6 6 ; basic concepts, 1 7 8 ff.; concern with individual maladjustments, 1 5 4 , 1 6 0 ; concern with method and detail, 1 5 5 ; distribution of community resources to the needy, 1 5 8 ff.; "executive" and "protective" methods of treatment, 1 7 4 ff.; function of case work, 1 5 7 ff.; prejudices and misunderstandings about, 1 5 2 ; primary aim, other goals, 1 6 1 ; procedure in handling of cases, 1 6 7 ff.; purpose defined, 1 6 2 ; relation to social and economic order, 1 5 4 , 1 5 9 . 1 6 3 , 1 6 5 ; three types of action, 1 6 9 ; typical case, 1 6 9 - 7 3 , 1 7 5 . 1 7 7 ; use of psychiatry, 1 5 6 , 1 7 7 , 1 8 0 ; work rather than relief advocated, 5 Social workers, case workers, 1 5 3 58 passim, 1 6 6 ; compensation and working conditions, 1 6 7 ; demand and supply, 1 6 5 ; education, 1 6 6 ; leadership in social reform, 1 6 4 f . ; should devote more time to causes and cures, 8 2 ; view humanity in the personal, 1 3 4 Society, social worker as distributor for, 1 5 8 , 1 6 4 Soft-coal workers, earnings, 38 South, child aid payments inadequate, 1 1 9 ; grants to aged, 7 8 ; lack of medical facilities, 1 4 4 ; lower cost of living in, 43 South Dakota, old-age assistance, 78 Standard of living, child welfare demands higher, 1 2 0 ; effect of rents upon, 5 6 ; health and decency standard for all, 35, 43, 47, 4 8 ; in U. S. ( 1 9 2 9 ) , 1 5 ; lower prices
206
INDEX
Standard of living (Continued) bring rise in, 1 3 ; raised by public works programs, 1 9 States, child aid, 1 1 7 , 1 1 8 , 1 1 9 ; public health grants-in-aid, 1 4 6 Steel industry, barometer of economic conditions, 3 8 ; huge combination of capital, 5 4 ; wages, 37 Steel workers, f e w obtain full-time employment, 37 Stenographers, 42 Sterilization laws, 1 1 3 Stock ownership, employee, 52, 53 Sunday Gazette and technological unemployment, 1 1 Survey Graphic, 165 Survivors' benefits, Social Security Act, 82 if., 1 1 8 if. Sweden, cooperatives, 5 4 ; see also Scandinavian countries Syphilis, see Venereal disease
Tariffs, lowering of, 50, 5 1 ; prevent foreign purchase of American products, 1 6 Taxation, burden should be shifted to rich 5 6 ; control of profits through, 1 8 , 1 9 ; progressive, 56, 5 7 ; social security tax, 68, 69, 86 i f . ; to increase employment, 1 6 ; see also Income taxes Teachers, increase in, 1 2 ; rural, 42 Technological improvements, effects upon employment, 39 ff., 2 7 ; increasing rate of, 2 0 ; not a cause of permanent unemployment, 9, 1 2 ; without planned provisions for displaced workers, 23 Technological unemployment, see Unemployment Tobacco workers, average income, 39 Townsend Plan, 62, 67, 7 7 Trade associations, advocate increased prices and maximum profits, 1 7 ; must be restricted, 1 7 Trade quotas, abolition of, 50 Trades, see Occupations Tuberculosis, 1 2 6 , 1 3 6 , 1 3 9 , 1 4 5
Unemployed, excluded from Social Security Act, 8 6 ; need of extensive public works to solve immediate problem, 1 9 ; pack relief office, 1 Unemployment, 1 - 2 5 ; among nonagricultural workers, 8 ; causes and remedies rooted in economic system, 7, 2 3 ; effect of distribution upon, 1 0 ff.; effect of new industries and lower prices, 1 3 ; high-wage purchasing power as a preventive of, 1 3 , 2 0 ; in the forties, 6 2 ; lack of reliable statistics, 7 ; little necessity for in America, 2 5 ; need of monthly check upon extent of, 8 ; of the aged (see Old age) ; palliatives for, 24 Unionization, see Labor unions United Mine Workers, 54 United States, can produce enough to permit families to earn a health and decency wage, 4 8 ; changed from agricultural to industrial nation, 7 3 ; see also Government V a n Kleeck, Mary, 1 6 5 Venereal disease, 1 x 2 , 1 3 6 , 140, 145 Vocational school movement, 22 Wages, and productivity, 4 1 ; Brookings Institution's estimate of, 35 ff.; extremes in income greater than those in wages alone, 3 9 ; health and decency, 35, 43, 47, 4 8 ; illness losses, 1 2 7 ; insurance against such losses, 1 4 6 ff.; insurance tax, 1 5 1 ; of low-income workers, 27—58; raised by distributing income differently, 5 1 ; trends, 39, 4 0 ; unskilled labor, 42 ; see also Earnings; Income; Minimum wage Wages, real: activities f o r workers which add to, 5 2 ; and money wages, 4 1 ; lower prices mean higher, 50
INDEX Wagner, Senator, 146 War, destruction and economic maladjustment caused by, 50, 55 Wealth, different division of, 5 1 , 56; distribution of, 1 5 Welfare work, resented by employees, 52; see also Social work Widows and orphans, amendments of Social Security Act as applied to, 83, 94, 1 1 8 ff.; case studies, 90 ff.; dependency, i n , 115; emotional difficulties, 1 0 2 ; more adequate provision for, needed, 1 1 7 , X19, 1 2 2 ; mothers' pensions, aid to children, 95, i o i , 106, 1 1 7 ff.; need for insurance, 1 0 1 , i n ; social insurance or public care the only real remedies, 1 1 5 ; statistics, 105 f., 1 1 9 ; survivors' benefits to begin in 1940, 120 Wisconsin, children held responsible for care of parents, 64; committee aiding welfare activities, 1 6 5 ; employer reserve system, 21 Women, independence, 1 0 9 ; relief families headed by, 90 if.; status of female heads of families, statistics, 104 ff.; see also Fatherless homes
207
Workers, coordination of jobs and, 2 5 ; emergency expenses, 3 3 ; existing on minimum standard, 3 2 ; few able to save for old age, 74; group medical plans, 1 5 1 ; incapacitated, work lost, 126, 134, 1 3 8 ; jobs open to men over forty limited, 7 1 , 72; low-income, 2 7 58; management of own incomes desirable, 5 3 ; must become more versatile, 1 7 , 2 2 ; need of adequate medical care, 4 5 ; not extravagant, 45; resent paternalism, 52; right to organize, 20; services and stock which add to real wages, 52; should have higher wages instead of services and stock, 53; should use every available educational resource, 53; stock ownership, 52, 53; study of expenditures of, 44; stunting privations of low incomes, 3 3 ; too immobile, 2 2; transfer from one industry to another, 1 2 ; see also Steel workers Works Progress Administration, social workers on advisory staff, 165 W P A jobs, 4, 19, 1 3 4