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funds to deal with the human results of the "recession."

Meantime the popular clamor for a census of unemploy-
ment "Let's know exactly what we have to deal with,"
had an answer. The voluntary census through the post office
department, checked against a house-to-house sample, showed
in mid-November a minimum of 7,882,912 and a maximum
of 10,870,000 totally unemployed and 3,299,211 "partially
employed." The sharp slump in employment in December
made the census figures, by the time they were compiled in
early January, little more than an outdated estimate. Said



John D. Riggers, administrator of the census, "It has
proved the impracticability of obtaining a precise mathe-
matical measure of unemployment."

Early in January, with business slipping, employment
plummeting and relief demands skyrocketing, the Senate
Unemployment and Relief Committee, Senator James F.
Byrnes of South Carolina chairman, began its public hear-
ings. When this committee was authorized last June [see
Survey Midmonthly, July 1937, page 224] many people
saw it as more or less a political instrumentality for dis-
crediting the going federal relief program ; a means of fore-
stalling the proposal, urged by many social workers, for a
broad, long range study of unemployment and an appraisal
of relief methods by a non-political commission. The Byrnes
committee attached to itself as expert advisers Alan John-
stone, attorney, and Pierce Williams, economist, both
identified for varying periods with the WPA and, prior
to its liquidation, with the FERA.

BY the time the committee opened its public hearings the
scene had so changed that its program became more a
general forum on the business recession and the rise of
unemployment, than a fishing expedition into the adminis-
tration of relief. The committee gave the impression of
seeking light and understanding; its questioning of wit-
nesses was generally free of political motivation. The busi-
ness men who testified were serious and for the most part
candid. They were puzzled by the untoward course ot
events, hopeful that the recession had run its course, opti-
mistic, on the whole, for the future. Few of them had
immediate proposals more concrete than "Let the govern-
ment restore confidence."

The series of hearings which ended in late January were
more concerned with the causes of unemployment than with
its results. Such ear as the committee gave to the problems
of relief was more to proposals for long term federal-state
collaboration in program than to the immediate situation
of unemployed people and the need of a deficiency appro-
priation for WPA. At this writing the committee is in
recess, in process of digesting information accumulated at the
hearings and submitted in departmental reports and memo-
randa. It is probable that a second series of hearings will
be held this month or next on the subject of federal-state
relationships in the financing and administration of relief.



35



There can be no question of the fact that, as Aubrey
Williams, acting WPA director, says: "The relief loads
everywhere, locally, are increasing precipitately." Early in
December pressure on WPA showed itself greatly in excess
of seasonal expectations. The peak of pressure is expected
in late February. Between December 1 and January 20
upwards of 300,000 workers were added to WPA rolls,
bringing the total to about 1,800,000. This is close to the
maximum number which WPA can handle at this time and
hold to the budget limitation imposed by the Emergency
Appropriations Act of 1937. Under that limitation any
further stretching of its current rolls would mean drastic
curtailments and lay-offs in the spring. To maintain the
current program until the end of the fiscal year, June 30,
allowing for normal seasonal shrinkage, would require, it
is said, a deficiency appropriation of more than $200 mil-
lion. Pressure for a deficiency appropriation is increasing
but as yet no authoritative request for it has been put to
Congress by the administration.

BEYOND June 30 the future of WPA is clouded. In
his budget message to Congress President Roosevelt
proposed reduction of this year's $1,322,200,000 estimated
total of its spending to an even $1 billion, but added, "The
economic situation may not improve and if it does not, I
expect the approval of Congress and the public for addi-
tional appropriations if they become necessary to save thou-
sands of American families from dire need."

There has been no indication in the President's public
utterances of any change in policy which would have the
effect of "substituting a dole in place of useful work." In
his firm backing of work as "the American way" of relief
the President seems to be supported by public opinion. In
a poll made early in January the American Institute of
Public Opinion, by a sampling method for which it claims
demonstrated accuracy, put the question, "Do you think
relief should be given as work relief or as direct cash
relief ?" Ninety percent of the voters interviewed answered,
"Work relief." Voters on relief voted four to one for work
relief; voters in the middle and upper economic brackets,
nine to one.

In the face of the hard realities of mid-winter, discussion
of the virtues of work versus direct relief become somewhat
academic. WPA never has provided jobs for all the employ-
ables on relief. Its present limited funds and the rising pres-
sure of acute need removes its objective farther away than
it ever has been. Whether we Americans like the dole or
not there is no escaping the fact that we have it and that
as things stand it is the only alternative to acute suffering
on the part oif great masses of people.

Statistics on the rising need of relief are abundant, but
at this time, even more than usual, they are inadequate to
portray the critical human situations that lie behind them.
Statistics show the effect of the recession on the relief load.
They do not show the effect on family after family, just
finding a footing after depression unemployment, now cast
out again to the miseries of uncertain and inadequate relief.
Statistics we must have, but let no one forget that behind
them are desperate, frustrated men, women and children.

The division of public assistance of the Social Security
Board's bureau of research and statistics reports that from
November to January 7 and 8 the number of cases receiv-
ing general relief in fifty-eight cities of 100,000 or more
population increased 17 percent. Its tabulation includes all
relief by state and local public agencies except the three



forms of assistance to the aged, the blind and dependent
children in which the Social Security Board participates.
It also excludes WPA and all aid given by the Farm Se-
curity Administration. The "general relief" of these figures
is, in effect, the dole. Only twelve of the fifty-eight cities
reported a rise of less than 10 percent in relief cases;
twenty-four showed an increase of 20 percent or more ;
seven, all in the midwestern steel, rubber and automobile
belt, an increase as high as 75 percent.

A cross-country sampling of cities and their reported in-
creases in relief rolls gives an idea of the geographical
variation in the spread of trouble: Portland, Ore., 35 per-
cent; San Francisco, 14 percent; Salt Lake City, 19 percent;
Kansas City, Mo., 13 percent; Fort Worth, 35 percent;
Chicago, 9 percent; Detroit, 65 percent; St. Paul, 17 per-
cent; Indianapolis (county), 22 percent; Gary (county),
71 percent; Cincinnati, 28 percent; Toledo, 70 percent;
Philadelphia, 4 percent; Baltimore, 17 percent; Atlanta, 6
percent; Trenton, N. J., 24 percent; New York 5 percent;
Boston, 10 percent; Providence, 24 percent.

All these percentages, and the people behind them, would
be less disturbing if there were assurance that the need they
represent will be met. To be sure the Social Security Board's
figures show sharp increases in "obligations incurred for
relief extended" in all the fifty-eight cities listed, in most
instances an increase comparable with that of the case load.
But there are elements which the figures do not show.
Relief, even in those states which contribute funds to local
administration, was pared down close. Increased demands
may be met temporarily but, "It can't last. We are rob-
bing the future." In Chicago, for example, the relief admin-
istration in November and December dipped into the future
to the extent of $1,250,000 borrowed from future taxes at
the time not even assessed.

It is well known that in states where no support is given
to local finances relief has dropped to the level of the old
poor law days. While this condition is probably worst in
small communities and country districts plenty of cities are
in equally bad plight. In St. Louis, for example, relief is
barred to anyone able to work, whatever his need, with
certain exceptions when children are involved. In Cincin-
nati an inquiry into what had become of people turned
off relief brought the answer, "The burden of relief has
been shifted largely to friends and neighbors of the destitute
who themselves are usually poor and unable to bear it."

TO the U.S. Conference of Mayors have come echoes
of distress and alarm from mayors of small and middle
sized cities all over the country. "We are scraping the bot-
tom of the barrel." . . . "We can no longer cope with it." . . .
"We are spreading our funds as thin as we can, and already
there is suffering." . . . "We can squeeze through somehow
till the end of January. After that, God knows."

Responsible public welfare officials and social workers
everywhere are of one mind that prompt federal assistance
is imperative if the pledge that "no one shall starve" is to
be honored. Local resources, inadequate to the need at any
time, simply cannot cope with the fresh influx. In small
communities there is a substantial opinion that an expanded
WPA program "might" meet the situation. In the large
cities however, informed opinion holds that such expansion,
while urgent and important, would not be enough; that
with it must come federal funds, grants-in-aid if you will,
for direct relief. As to how such grants would be adminis-
tered, by what implementation they would come down from



36



SURVEY MIDMONTHLY



the federal treasury to out-of-work John Smith in your
town and mine, there is definite difference of opinion. The
suggestion of a return to the centralized system of the
FERA is met by sharp, often cogent criticism. Equally
vulnerable, it seems, is the proposal that the federal govern-
ment turn over lump sums to the states on the basis of
population and estimated need.

A proposal frequently heard, though not from official
quarters, is of an amendment to the social security act cre-
ating a division of general assistance where relief would be
supported by federal participation in somewhat the same
manner as aid to the aged, the blind and dependent chil-
dren is now handled. The only suggested amendment to the
security act that bears on the present situation and that has
any official backing, is one that would permit states to begin
payment of unemployment compensation after reserves had
accumulated for one year instead of two as now specified.
To President Roosevelt's approval of this proposal Arthur
J. Altmeyer, chairman of the security board adds the cau-
tionary word: "If unemployment compensation is to suc-
ceed, it must be looked upon as a permanent insurance
system, rather than a temporary relief measure. It cannot
meet any considerable portion of the need during the early
months."

Most concrete and immediate of the proposals put before
the Senate committee was that of the National Citizens
Committee of the Mobilization for Human Needs, Charles
P. Taft of Cincinnati, chairman. This committee, it will
be recalled, has functioned for a number of years in con-
junction with Community Chests and Councils, Inc. It was
not the fault of Mr. Taft and his associates that in pre-
senting their program to the Senate committee they were
identified in the press as "spokesmen for 8500 private
philanthropic groups." They themselves made no such
claim. Their program was developed by a group of business
and community leaders and social workers, generally iden-
tified with community chests.

THE program calls for federal relief grants to the states
on a fixed percentage matching basis (not necessarily 50-
50; more probably 75-25). To what extent funds would be
used for work or direct relief would be for the states to
determine, as would standards of eligibility for relief. Funds
would be apportioned by the states to local communities
upon "any basis compatible with relief needs." Special
grants would be made for the care of interstate transients.
The federal government would set up "standards of ad-
ministration and of relief within general limits," and would
require in each state and city "a unified or at least co-
ordinated administration under an adequate and inclusive
merit system of appointment. . . ." Finally, the program
urges a national commission, appointed by the President,
to work in conjunction with existing congressional com-
mittees in making "a careful and unbiased investigation and
review" of the "human values and the expense involved in
relief, security and public welfare programs."

This program has drawn a variety of criticism : that it
lacks realism on federal-state relationships; that it destroys
the "bulwark" of WPA ; that it throws back on local units
responsibilities that many of them have shown themselves
unable to support; that it creates new confusions of admin-
istration at a critical time; that it fails to envisage the
whole welfare program, specifically the social security ser-
vices, and takes no account of the critical conditions of the
moment. On the other hand, run the claims: it would



rehabilitate state and local responsibility for their own peo-
ple, remove the possibility of a "relief bureaucracy," permit
of more flexible programs and stimulate greater local par-
ticipation in determining ways of meeting local needs.

Meantime a group of well known social workers indenti-
fied chiefly with social work publications and with national
agencies and organizations have sent "an affirmation of
principle" to the Senate committee. This group favors a
"long term federal program of public works on a non-relief
basis," but holds that the "pressing immediate need" is for
a substantial deficiency appropriation to extend the WPA
program "to provide employment for at least 300,000 wage
earners," and, in addition, for a "substantial appropriation"
from federal funds to be allocated to the states for direct
aid "under conditions laid down by the federal government."

NOT to be overlooked in the present discussion is the
call for concerted action, public and private, made
by the governing body of the National Federation of Set-
tlements which, at its December meeting, heard reports
from twelve leading American cities which brought the
recession down to its consequences in wage earners house-
holds. The federation offered, not a program, but a chal-
lenge framed in the form of five questions:

Can Congress afford to consider any diminution of the WPA
at a time when it is a central bulwark of purchasing power?

Can the federal administration bring forward the beginning
of benefit payments under old age insurance and unemploy-
ment compensation to make them count in this emergency?

Can we speed minimum wage and maximum hours legisla-
tion as a practical measure not only to lift the level of employ-
ment, but to spread it out?

Can we step on the gas of public housing, augment the
funds of the new National Housing Administration and make
public housing no less than private construction a genuine force
for revival?

Can we, in meeting this new stress of unemployment, apply
principles of planning that will turn our emergency moves
into long run account?

In the teeth of a hard winter it may be invidious to sug-
gest that things might be worse. But let's take a look over
the shoulder, back to as few as five years ago. In February
1933, unemployment was abroad in the land to an extent
that disturbed even the hardiest observers. The soup kitchen,
the bread line and the street corner apple seller were much
in evidence. Federal participation in relief was confined to
limited and unrealistic "loans to the states" by the Recon-
struction Finance Corporation. Fewer than a dozen states
were putting up any money of their own. Machinery of
administration was sketchy. Meager local funds were
bolstered by benefit football games and similar enterprises.
Old age assistance was a reality in only two or three
states; assistance to dependent children in their own homes
was accepted in principle by most of the states, but in few
of them was it more than a gesture. Unemployment insur-
ance was a matter of debate; "social security" a term heard
most often in social workers' conferences.

At the National Conference of Social Work in May
1933, bigger and better emergency relief, cash instead of
grocery orders or food baskets, was at the forefront of
discussion. Work relief on a national scale was an idea as
yet unborn. A few hardy souls prophesied that this might
be the beginning of a new era in government responsibility,
but in general social workers, like the public, thought and
talked of "the emergency."

Now comes midwinter 1938, and unemployment, new



I KBRUARY 1938



37



and unpredicted, adds itself to the residue of the mass
unemployment of the depression. Figures for February of
course are not available, but take those of a few months
ago, of October 1937 they are higher today. In that month
about 1,400,000 persons received nearly $77 million
federal dollars as earnings under the WPA. Some 1,300,-
000 cases, estimated to include 3,700,000 persons, received
direct relief from public funds, state and local, aggregating
upwards of $32 million. About 71,000 farmers received
emergency subsistence payments amounting to nearly
$1,500,000.

In that same month more than 1,500,000 aged persons
the country over received assistance in varying amounts to
a total of nearly $29 million ; some 200,000 households with
dependent children were benefited to the extent of $6,200,-
000; 41,000 blind persons to the extent of more than $1
million. This aid was then, and is now, in the form of
cash, secure and regular.

In this February 1938, unemployment insurance, or com-



pensation as we now call it, is a reality with twenty-two
states beginning to pay benefits, the rest will follow by
July 1939. At least a million persons now losing their jobs
are assured of short term benefits. The term "social se-
curity" is no longer the exclusive possession of social work-
ers. It may mean different things to different people, but it
is written into the law of the land.

Most marked of the changes of these past five years is in
the attitude of the people of the country. Five years ago
relief was the concern of social workers, of a growing body
of socially minded citizens, of a few legislators, and, tragic-
ally, of the relatively inarticulate unemployed. Today it is
the concern of economists, of big business and industry,
of legislators everywhere, of the President of the United
States. Social workers still bear witness valiantly; the un-
employed are no longer inarticulate. Relief, even that over-
crowded catch-all, where fall all those who miss the pigeon-
holes of the WPA and of the social security classifications,
is the nation's business.



Women and Children Last



By BEULAH AMIDON



EACH year more than 14,000 women die from causes
connected with childbirth. Recent studies indicate
that, given our present medical knowledge, at least
half of these deaths are preventable. Even more shocking
is the annual toll of baby lives: 75,000 stillborn infants,
69,000 who do not survive the first month of life.

These figures are the measure of the problem defined and
considered by the Conference on Better Care for Mothers
and Babies which met in Washington at the call of the
Children's Bureau, January 17 and 18, with the collabora-
tion of a number of national agencies having a stake in the
field.

The conference brought together some 500 experts in
public health from forty-four states and from Hawaii and
Alaska. In the five conference sessions the delegates con-
sidered facts and figures on mortality rates, medical and
nursing service, numbers of births in relation to adult pop-
ulation in various areas and income groups. They also
heard a pint-size public health nurse tell how she fought
her way on foot through the mud of a steep Vermont cart
track one stormy spring night to reach a woman in labor;
how she taught the French-Canadian father of a relief
family to boil nursing bottles and mix a food formula. It
heard a young doctor from Alabama tell how the gospel of
maternal and child care is being preached in sharecropper
cabins in areas where maternal and infant deathrates run
far above the national levels. It heard the forthright woman
doctor who heads the Child Welfare Division of Mon-
tana's Board of Health report that with the federal-state
system of highways, many women in that vast state regu-
larly drive 100 miles for the ante-partum care which means
so much, statistics show, to the safety and health of both
mother and child.

Out of the conference emerges a disquieting sense of the
inhuman waste of our most precious national resource.
There emerge, too, clear lines of effort which are no longer
experimental but proved means of reducing the annual



total of unnecessary maternal and infant deaths in this
country.

The material brought together by the Children's Bu-
reau as the basis for the conference discussions showed that
there has been little reduction in the maternal mortality
rate during the twenty-two years for which records are
available. Puerperal infection accounted for 41.3 percent of
the maternal mortality in 1935. And, as Dr. Jennings Lit-
zenberg of the University of Minnesota Medical School
pointed out, deaths due to infection are the result of "dirty
care," of ignorance or carelessness on the part of a neigh-
bor, midwife, nurse or doctor. The deathrate for infants
in the first year of life has steadily declined for the same
twenty-two year period. But in this time there has been
little decline in the deathrate for the first month of life,
which accounts for almost half the total mortality in the
first year.

Studies and demonstrations prove that from 50 to 68
percent of these deaths of mothers and babies are preventa-
ble. Thus, in summarizing its work in 1937, the Chicago
Maternity Center is able to report: "Working under ad-
verse conditions, with a group of patients physically below
par and on a minimum budget, a gross maternal mortality
rate of 14.2 per 10,000 live births was maintained over a
four-year period." This is less than one fourth the rate for
the United States as a whole. In Cattaraugus County,
N. Y., the maternal mortality rate for prenatal cases super-
vised by the Health Department, 1932-1936, was 12 per
10,000 live births as compared with 56 for the county as
a whole. The Cleveland Child Health Association in 1936
reported 2595 women who attended special classes for pre-
natal care, including both private and clinic patients. The
maternal mortality rate of this group was 7.7 per 10,000
births as compared with 38 per 10,000 for the city of
Cleveland.

Two government economists, one from the Department
of Agriculture, 'one from the Bureau of Labor Statistics.



38



SURVEY MIDMONTHLY




Maps from U.S. Children's Bureau

MATERNAL MORTALITY IN THE UNITED STATES, 1935

showed some of the relationships between problems of pub-
lic health and the problem of poverty. In all sections of
the country, it was brought out, incomes are higher in the
cities, birthrates higher outside the cities. In the cities there
are 26 infants per 1000 adults in the population; in the
country, 45. Rural areas cannot adequately support their-
population today, and the industrial areas no longer absorb
the excess. Even in urban areas, one third of all children
are born to families with an annual income under $1000;
one half, into families with less than $1500. Given an in-
come of $1500, the recent nation-wide health study shows,
a family manages to devote only $26 a year to medical
care. A national health program which will cut the num-
ber of preventable deaths must obviously become either a
program for more adequate family income, or a program



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