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The Submerged Seventh
353
LEADING ARTICLES
Between 1953 and
THE LANCET LONDON
The
12
FEBRUARY
Submerged
1966
Seventh
"
"
WHAT is poverty ? jesting Pilate might have asked with as much justice as he questioned the absolute nature of truth; for, like truth, it is a relative term. To the visitor from Europe in the lusher parts of California, a poor man has only one car. In their new study 1 of poverty in this country, ABEL-SMITH and TOWNSEND define it as the level of living of those whose household income is less than 40% above the National Assistance scale including rent. Those from the impoverished twothirds of the world might regard this definition a little wryly; and they would not accept the authors’ finding that 7-5 million people (14-2% of the population) were below this level in 1960 as an adequate reason for the dissolution of Oxfam. Nevertheless, by the standards of a country like Sweden, it is a poor record in what passes for an affluent society, and ABEL-SMITH and TOWNSEND are right to probe its nature and origins more deeply. The information comes from a resourceful use of data collected for the Ministry of Labour in its inquiry into incomes and expenditure in 1953-54 and again in 1960. A sample of 20,000 households was drawn in 1953 and 5000 in 1960; and the response-rates to the interview were 65% and 71% respectively. Comparison with other national data showedthat, among these respondents, children, the aged, and the chronically sick were underrepresented. There were also fewer heads of households receiving National Assistance than might have been expected-though this is hardly surprising. Whether because of low intelligence or the distraction of an overcrowded home, the poor usually have difficulty in keeping the kind of written records used in expenditure surveys. There is also a certain Micawberism about the outruns replies, for reported expenditure consistently " the estimates of income. Expenditure on luxuries," especially drink and cigarettes, was apparently underreported, while occasional extra sources of income were forgotten. For these reasons, generalisation from this particular sample should be circumspect; but the broad indications are probably not far astray. Of the 1 in 7 of the British population living below the chosen poverty line, 35% depended on pensions, 23% on other State benefits,and 41% primarily on the earning of the head of the household. Many of this last were members of larger families, and 5% of the children of this country live in these impoverished homes. 1. The Poor and the Poorest.
By BRIAN ABEL-SMITH, professor of social administration, London School of Economics, and PETER TOWNSEND, of professor sociology, University of Essex. Occasional Papers on Social Administration no. 7. London: G. Bell & Sons. 1965. Pp. 78. 15s.
1960, the number of people
below or near National Assistance level apparently increased from nearly 4 million to nearly 7-5 million. The estimate is subject to various qualifications. Nevertheless, the rise is real enough and flows from the relative increase in the number of old people in the population, a slight increase in the number of men in late middle life who are chronically sick, and a relative increase in the number of families with four or more children. Family allowances and the wage scales of the lowest-paid workers have not kept pace with the rising standards of the remainder of the population. Contrary to the prevailing impression, the gap between the old, the chronically sick, and the unskilled worker and the rest of the affluent society seems to have widened. As ABEL-SMITH and TOWNSEND point out, not only are the State grants often inadequate but also many who are entitled to such aid fail to apply for it. They emphasise the need to supplement inadequate incomes, especially for the larger families even when the breadwinner is working full time. They admit that this would be an expensive remedy; and others might question its efficacy. The school meal service, meals-on-wheels, and other direct social aids would ensure that the young, the old, and the infirm would indeed get the diet they should have. The increasing proportion of chronically sick men in middle life is of special significance; and the problem does not seem to be getting the medical attention it deserves. A recent study by NEILSON and CROFTON2 of the circumstances of men disabled by chronic bronchitis has underlined the economic as well as the human wastage caused by chronic diseases among men of working age and the inadequacy of present arrangements for its reduction. As they point out, much more could and should be done by the development of the occupational resettlement services, and the provision of sheltered employment and special transport facilities. Whatever the solutions to these problems may be, noone will quarrel with the emphasis that ABEL-SMITH and TOWNSEND put on the value of a continuous monitoring, not only of the trend in average household income, but also of the economic circumstances of those at the lower extreme of the frequency distribution of national income.
Polyoma Virus and Leucoencephalopathy PROGRESSIVE multifocal leucoencephalopathy is
a
yet have entered many standard medical textbooks. It promises, however, to become a condition of high significance in our understanding of certain virus diseases of man. This we may conclude from work by Zu RHEIN and CHOU3 and HOWATSON et a1.4which strongly suggests that the neuroglial cells in this disease may be parasitised by organised particles closely resembling polyoma virus. disease that may
not
Neilson, M. G. C., Crofton, E. The Social Effects ofChronic Bronchitis: a Scottish Study. Edinburgh, 1965. See Lancet, 1965, ii, 832. 3. Zu Rhein, G. M., Chou, S. Science, 1965, 148, 1477. 4. Howatson, A. F., Nagai, M., Zu Rhein, G. M. Can. med. Ass. J. 1965, 93, 379.
2.
LEADING ARTICLES
Between 1953 and
THE LANCET LONDON
The
12
FEBRUARY
Submerged
1966
Seventh
"
"
WHAT is poverty ? jesting Pilate might have asked with as much justice as he questioned the absolute nature of truth; for, like truth, it is a relative term. To the visitor from Europe in the lusher parts of California, a poor man has only one car. In their new study 1 of poverty in this country, ABEL-SMITH and TOWNSEND define it as the level of living of those whose household income is less than 40% above the National Assistance scale including rent. Those from the impoverished twothirds of the world might regard this definition a little wryly; and they would not accept the authors’ finding that 7-5 million people (14-2% of the population) were below this level in 1960 as an adequate reason for the dissolution of Oxfam. Nevertheless, by the standards of a country like Sweden, it is a poor record in what passes for an affluent society, and ABEL-SMITH and TOWNSEND are right to probe its nature and origins more deeply. The information comes from a resourceful use of data collected for the Ministry of Labour in its inquiry into incomes and expenditure in 1953-54 and again in 1960. A sample of 20,000 households was drawn in 1953 and 5000 in 1960; and the response-rates to the interview were 65% and 71% respectively. Comparison with other national data showedthat, among these respondents, children, the aged, and the chronically sick were underrepresented. There were also fewer heads of households receiving National Assistance than might have been expected-though this is hardly surprising. Whether because of low intelligence or the distraction of an overcrowded home, the poor usually have difficulty in keeping the kind of written records used in expenditure surveys. There is also a certain Micawberism about the outruns replies, for reported expenditure consistently " the estimates of income. Expenditure on luxuries," especially drink and cigarettes, was apparently underreported, while occasional extra sources of income were forgotten. For these reasons, generalisation from this particular sample should be circumspect; but the broad indications are probably not far astray. Of the 1 in 7 of the British population living below the chosen poverty line, 35% depended on pensions, 23% on other State benefits,and 41% primarily on the earning of the head of the household. Many of this last were members of larger families, and 5% of the children of this country live in these impoverished homes. 1. The Poor and the Poorest.
By BRIAN ABEL-SMITH, professor of social administration, London School of Economics, and PETER TOWNSEND, of professor sociology, University of Essex. Occasional Papers on Social Administration no. 7. London: G. Bell & Sons. 1965. Pp. 78. 15s.
1960, the number of people
below or near National Assistance level apparently increased from nearly 4 million to nearly 7-5 million. The estimate is subject to various qualifications. Nevertheless, the rise is real enough and flows from the relative increase in the number of old people in the population, a slight increase in the number of men in late middle life who are chronically sick, and a relative increase in the number of families with four or more children. Family allowances and the wage scales of the lowest-paid workers have not kept pace with the rising standards of the remainder of the population. Contrary to the prevailing impression, the gap between the old, the chronically sick, and the unskilled worker and the rest of the affluent society seems to have widened. As ABEL-SMITH and TOWNSEND point out, not only are the State grants often inadequate but also many who are entitled to such aid fail to apply for it. They emphasise the need to supplement inadequate incomes, especially for the larger families even when the breadwinner is working full time. They admit that this would be an expensive remedy; and others might question its efficacy. The school meal service, meals-on-wheels, and other direct social aids would ensure that the young, the old, and the infirm would indeed get the diet they should have. The increasing proportion of chronically sick men in middle life is of special significance; and the problem does not seem to be getting the medical attention it deserves. A recent study by NEILSON and CROFTON2 of the circumstances of men disabled by chronic bronchitis has underlined the economic as well as the human wastage caused by chronic diseases among men of working age and the inadequacy of present arrangements for its reduction. As they point out, much more could and should be done by the development of the occupational resettlement services, and the provision of sheltered employment and special transport facilities. Whatever the solutions to these problems may be, noone will quarrel with the emphasis that ABEL-SMITH and TOWNSEND put on the value of a continuous monitoring, not only of the trend in average household income, but also of the economic circumstances of those at the lower extreme of the frequency distribution of national income.
Polyoma Virus and Leucoencephalopathy PROGRESSIVE multifocal leucoencephalopathy is
a
yet have entered many standard medical textbooks. It promises, however, to become a condition of high significance in our understanding of certain virus diseases of man. This we may conclude from work by Zu RHEIN and CHOU3 and HOWATSON et a1.4which strongly suggests that the neuroglial cells in this disease may be parasitised by organised particles closely resembling polyoma virus. disease that may
not
Neilson, M. G. C., Crofton, E. The Social Effects ofChronic Bronchitis: a Scottish Study. Edinburgh, 1965. See Lancet, 1965, ii, 832. 3. Zu Rhein, G. M., Chou, S. Science, 1965, 148, 1477. 4. Howatson, A. F., Nagai, M., Zu Rhein, G. M. Can. med. Ass. J. 1965, 93, 379.
2.