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four years of age, inclusive, ill enough to require medical attendance. And these years, it will be noted, are the most important working years. In furnishing this estimate to the present writers, Mr. Phelps calls attention to the fact that some seven years ago one of our very best statistical authorities tabulated the number and percentages of Odd Fellows reported as sick in twenty-nine different States, and found that of the total membership of that organization in those States an average of 7.85 per cent. were sick. One of the large health and accident insurance companies publishes a carefully tabulated statement which shows that on an average ten per cent. of its policy-holders between the ages of twenty and sixty-four years, inclusive, are sufficiently ill to warrant the payment of sickness claims. Dr. Farr's estimate that 2,000,000 in the United Kingdom are ill enough to require medical attention was equivalent to saying that that 6.3 per cent. of the total population was sick. The medical director of another large health and accident company estimated that in the United States, on an average, fully 5 per cent. of all persons in the age-group named are ill enough to need medical attention. If we average these several estimates and apply that average to the population in the age-group named, the result is almost startling:

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Total number of sick persons estimated according to the average of the four estimates..


It would seem, therefore, that, on an average, at least 3,000,000 persons between the ages of twenty and sixty-four are sick. Not all of these are of the working class, for the fires of fever burn in mansion and hovel. Many are wealthy, many are of the professional class. How many

are bread-winners with families dependent upon them we do not know. Probably not less than 1,500,000. We do know that diseases of all kinds, and especially the most dangerous, like tuberculosis and pneumonia, are more prevalent among the wage-earners than among any other class. It is perfectly obvious therefore, that disease greatly adds to the poverty of the masses. According to Mr. Hunter there were in 1904 at least 10,000,000 persons in poverty in the United States. There is no evidence that poverty is diminishing. All the organized charities are constantly enlarging their scope, and are pressed to the limit of their capacity in relieving misery. The cry of helplessness which ascends from our great organized agencies for philanthropic relief is appalling.

The pauper: The greater part of the families living in poverty do not become paupers. They strive to maintain their self-respect. They struggle bravely to increase their incomes, and by small economies manage to avoid applying for relief. Even the very poor will sacrifice part of their meagre incomes to help their neighbors and friends tide over a period of exceptional distress and to save them from becoming paupers

But the typical pauper has lost the self-respect of poverty. Take the pauperism of the tramp, for example. The tramp is not necessarily unhappy, nor does he suffer keenly. He cheerfully relies upon his stronger neighbors, or upon organized charities, to keep him from starvation. This form of chronic pauperism is a disease of character, more hopeless than crime itself. But it cannot be denied that capitalism puts a premium on this parasitic life. The tramp on the whole has an easier life and is often much better fed than the hard-working laborer. It is estimated by Mr. James Forbes, Director of the National Association for the Prevention of Mendicancy, that there are not less than 250,000 such tramps in the United States The tragedy of this aspect of the problem lies in the fact that, very often, the most promising and healthy boys of the working class find their way into the ranks of trampdom. The monotony of the average wageearner's life, and the periodic unemployment which destroys ambition and thrift, are perhaps mainly responsible for this. 1 Cf. Fisher, op. cit., p. 22.

Another form of chronic pauperism, closely allied to that of the tramp, but differing from it in important respects, is that of the shiftless and inefficient families who are always dependent upon public and private charity. If there is a man at the head of the family he is generally unemployed, even in times when there is relatively little unemployment. The truth is that he is unemployable. The cause may be nefficiency and inability to apply himself to any task, however simple, or it may be sickness, or drunkenness, which is itself a form of sickness. Or the cause of his failure may be the characteristic which we call laziness. But laziness is probably always a result of defective conditions closely allied to poverty, and rarely or never the primary cause of poverty. Back of the inertia, lack of ambition and staying power which manifest themselves in what we call laziness are the untoward conditions born of poverty, such as malnutrition, neglect of disease, lack of training, failure to discover in the formative years of life the natural aptitudes of the boy who thus develops into the pauper. How many families of this class there are we have no means of ascertaining in the present chaotic state of our statistics of relief. That the number is frightfully large is certain. They go from one charitable agency to another until they have gone the entire round, and then they begin the circuit anew.

To these classes of paupers who are the victims of moral deficiencies, diseases of character which flourish in capitalist society, must be added the large class whose pauperism is less directly the result of moral disease, but is the result of old age, physical infirmity due to disease and accident, the idiotic, the insane, the widowed and orphaned. There are more than a quarter of a million such men, women and children living in institutions at the public expense, in addition to the vast number supported outside by public and private philanthropy. Altogether, pauperism presents an appalling picture of human wreckage.

Poverty and the child: Nowhere are the ill effects of poverty more strikingly manifest than in the lives of the children of the poor. During the period of rapid growth in mind and body poverty creates an environment for the child which robs it of its chance of a full and healthy development, without which an efficient manhood or womanhood

will be impossible. Robbed of physical and intellectual opportunities in the most important years of all, the child of poverty is heavily burdened in the race of life.

It is a well-known fact that the death rate among the poor is very much higher than among the well-to-do. This is especially true of the infantile death rate. Dr. Charles R. Drysdale, an eminent authority, declared some years ago that the death rate of infants among the rich was not more than 8 per cent., while among the very poor it was often as high as 40 per cent. In aristocratic Brookline, Mass., the death rate of children under one year per 1,000 births in the year 1900 was 96.9, while in Fall River, an industrial town in the same State, it was 260.2. Yet the experts say that, upon the whole, the babies of the poor are just as strong and healthy at birth as those of the rich, and that postnatal, rather than pre-natal, conditions are responsible for the terrible difference in the death rate. Except for poverty and other evils resulting from capitalism, there is no apparent reason why the death rate of babies anywhere in the United States should be materially higher than in Brookline. This means that in the prosperous year of 1900 more than 200,000 babies under one year of age needlessly died in the United States. Not all were victims of poverty, of course, but a vast majority were victims of poverty, ignorance, lack of care and other evils which appear to be inseparable from capitalist society.

Terrible as these figures are, they by no means represent the worst evils of poverty as it affects the child. At least the suffering of those who die in infancy is of short duration. Death is all too often an escape from long continued privation and suffering. Recent investigations in this country and in Great Britain have revealed the fact that an alarming number of poor children of school age are chronically underfed and otherwise neglected. Victims of malnutrition and diseases incidental to malnutrition, an alarming percentage of the children in our public and parochial schools are not only backward in their studies, but as a result of the combination of their physical and mental disadvantages they are continually augmenting the ranks of the inefficient who fall into pauperism, the shiftless, the intemperate, the vicious, the lazy and unemployable.

Closely related to these conditions is the evil of child labor. Of the great army of children employed in mines, factories, workshops, street trades and farming occupations, the vast majority are victims of poverty. That a large number of such children come from families who manage to keep slightly above the line of poverty is indisputable, but it must be borne in mind that very often such families maintain that position only by adding the wages of the children to those of the adult bread-winners. Where a child earns two dollars a week, for instance, that sum may mean the difference between staying above the poverty line or falling below it. It may mean the difference between living in a hovel on a mean street where it is hard to be "respectable,' and living in a better neighborhood. One terrible fact is that the children who are forced thus early into the labor market are the children least fitted for it. Child labor is quite unnecessary in this age of marvellously productive machinery and unemployed adults. But if it were necessary for little children to labor at all, those chosen for labor should be the strongest and best fitted to bear the strain. But the strongest and best developed children are the sons and daughters of the rich and well-to-do classes, and these are never torn from the playgrounds to enter the factories and mines or to face the perils of the street trades. It is always the children of the poor who are forced into the labor market, and the poorer the family the more necessary becomes the income derivable from the labor of its children. Thus child labor is a link in a chain of vicious circumstance. The child whose infant years were spent in an environment which weakened it physically and so sapped the foundations of all strength, mental and moral as well as physical, and whose years of school life continued the cruel process, is subject to the further weakening of all that makes for strength of body, mind and character.

The prevention of child labor: It is manifestly impossible to end child labor by appealing to the parents of the children. The pressure of poverty forces them to send the boy or girl to work. Meagre though the wage of the child may be, it is often an important item in the family budget. It is vain to urge that the child becomes a competitor of his father, that child labor leads to low wages for adult workers. The

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