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Organizing for community welfare
BOOK REVIEWS
294
the Irish, for example, are aware of many physical illness symptoms but tend to live with them rather than seek medical help. Thus, I suspect, they will go to a clinic when urged to do so by the Well Child Conference physician or the Visiting Nurse but are unlikely to go of their own volition. Illness orientation rather than institutional orientation may explain their behavior. Other things such as cost being equal, I suspect that they would go to a private dentist if they were referred to him. Unfortunately the clinic patient is not referred to a particular private dentist when he reaches the age limit of the clinics. Investigation of the interaction of social and personality factors and varieties of medical service organization may not only explain medically related behavior but may also contribute to general theories of behavior. The adoption of one “explanation” to the exclusion of alternative interpretations, however. tends to detract from the very interesting findings in The Clinic Habit. LEON S. ROBERTSON. Ph.D. Medical Care Research Unit, Harvard Medical School, Boston. Massachusetts, U.S.A.
ORGANIZING Books, Chicago.
FOR COMMUNITY 1967. 316 pp.
WELFARE
edited
by M. N. ZALD. Quadrangle
A FUNDAMENTAL assumption of the work is that social psychology and sociology can help to illuminate social welfare problems. Zald indicates that although comprehensive plans point to limitations, spell out are not offered, “our purpose is to highlight dilemmas, assumptions, examine variation, and even to account for the very definition of what becomes a welfare problem.” (p. 11). This objective is generally met. The work is composed of six essays under three major subheadings that are conceived as specific examples of applied or policy science. In the first section on Organizational Structure, “Sociology and community organization practice” by M. N. Zald is followed by “Public education and social welfare in the metropolis” by D. Street. The second section focuses on community process and welfare goals with the initial essay by E. Cumming on “Allocation of care to the mentally ill, American style” and the other, “The demonstration project as a strategy of change” by M. Rein and S. M. Miller. The final papers focus upon specialized social problems-“Sociai psychological factors in poverty” by E. J. Thomas and a “Policy paper for illegitimacy” by W. J. Goode. On the whole the volume is useful as a reference in social welfare and in public and mental health. It is also relevant to those interested in social policy analysis. Several focal points emerge from this review. First, our ‘system’ of health and welfare is in reality not a system but essentially a vast conglomerate of disparate and often opposing organizations, the majority of which grew under independent auspices with individual vested interests and objectives although engaged in similar functions of ministering to the needy and, the sick. As the authors note repeatedly, multiple power centers frequently overlap and even conflict with each other. Second, until recently there has been a relative void of planning in health and welfare at the local, policy and administrative levels which sharply limits the discretionary powers and authority of central agencies. Third, systematic
analyses of organizations are useful for management and administrative purposes. Fourth, while one may generalize about change, specific organizations and subsystems must be examined if innovative ventures in departing from the status quo are to be inaugurated. Fifth, networks of task-oriented organizations have evolved through attempts to meet special needs and demands rather than to meet specific program goals through the elaboration of uniform performance standards. Finally, there is a dearth of social welfare policy enunciation and follow through under-scored in the essay by William Goode in which he discusses strategies of alleviating poverty and indicates that “perhaps the pragmatists can lead the way-doing it while the social scientists ponder whether it can be done.” (p. 310). The work will prove to be more difficult to digest for those who attempt to translate policy into action. For example, while the essay on “Social and psychological factors in poverty” skilfully espouses the proposition that the poor are a distinct social category embedded in a more general social-structural context, there are few insights that can provide the administrator of a large welfare program with even partial solutions to the wholesale sit-ins, demonstrations and ultimatums. What is evident is that the theorist is too frequently far from the hectic scene of mass dissatisfaction and the administrator who attempts to develop practical measures on short notice is in a difficult predicament. There are, as Rein and Miller observe, too many demonstration projects which are readily employed to avoid action or to postpone major change. (p. 161). Jt is well known that the organization of public welfare services is as misunderstood as the population it serves. About 8 million persons are now receiving public assistance at approximate cost of 8 billion dollars. About 2 million are age 65 and over, 4 million children of parents who cannot support them and over 1 million mothers. Most of these persons are not self supporting. New approaches to the organization of public and voluntary welfare agencies are a first requisite in the reorientation of Society’s attitudes toward those on welfare rolls and Organizing,for Community Welfare provides significant reflective material both for the researcher and the policy analyst. SAMUELLEVEY,Ph.D. Department of Public Welfare, Commonwealth of Massachusetts, Boston, Massachusetts, U.S.A.
CULTURE,HEALTH AND DISEASE: SOCIAL AND CULTURAL INFLUENCES ON HEALTH PROGRAMS IN DEVELOPING COUNTRIES by MARGARETREAD. Tavistock Publications, Philadelphia. $5.00. gap between members of the industrialized and those of the still predominantly traditional societies has grown to tremendous proportions, and as a result of the consequent divergence of world views, many well intentioned programs initiated by colonial powers, missionaries, New Nations, and charitable organizations, have failed. A principal cause of such failures has been the lack of understanding of the dynamics of cultures and societies. Well intentioned, but ethnocentric attempts to force isolated piecemeal solutions (such as hygienic programs) into complex networks of social relations and customs, have been tragically frequent. This book is a response to a real need for a different kind of approach on the part of health workers in rural areas of developing countries. Dr. Margaret Read, an anthropologist with extensive research experience in East Africa, formany years has
THE COMMUNICATIONS
294
the Irish, for example, are aware of many physical illness symptoms but tend to live with them rather than seek medical help. Thus, I suspect, they will go to a clinic when urged to do so by the Well Child Conference physician or the Visiting Nurse but are unlikely to go of their own volition. Illness orientation rather than institutional orientation may explain their behavior. Other things such as cost being equal, I suspect that they would go to a private dentist if they were referred to him. Unfortunately the clinic patient is not referred to a particular private dentist when he reaches the age limit of the clinics. Investigation of the interaction of social and personality factors and varieties of medical service organization may not only explain medically related behavior but may also contribute to general theories of behavior. The adoption of one “explanation” to the exclusion of alternative interpretations, however. tends to detract from the very interesting findings in The Clinic Habit. LEON S. ROBERTSON. Ph.D. Medical Care Research Unit, Harvard Medical School, Boston. Massachusetts, U.S.A.
ORGANIZING Books, Chicago.
FOR COMMUNITY 1967. 316 pp.
WELFARE
edited
by M. N. ZALD. Quadrangle
A FUNDAMENTAL assumption of the work is that social psychology and sociology can help to illuminate social welfare problems. Zald indicates that although comprehensive plans point to limitations, spell out are not offered, “our purpose is to highlight dilemmas, assumptions, examine variation, and even to account for the very definition of what becomes a welfare problem.” (p. 11). This objective is generally met. The work is composed of six essays under three major subheadings that are conceived as specific examples of applied or policy science. In the first section on Organizational Structure, “Sociology and community organization practice” by M. N. Zald is followed by “Public education and social welfare in the metropolis” by D. Street. The second section focuses on community process and welfare goals with the initial essay by E. Cumming on “Allocation of care to the mentally ill, American style” and the other, “The demonstration project as a strategy of change” by M. Rein and S. M. Miller. The final papers focus upon specialized social problems-“Sociai psychological factors in poverty” by E. J. Thomas and a “Policy paper for illegitimacy” by W. J. Goode. On the whole the volume is useful as a reference in social welfare and in public and mental health. It is also relevant to those interested in social policy analysis. Several focal points emerge from this review. First, our ‘system’ of health and welfare is in reality not a system but essentially a vast conglomerate of disparate and often opposing organizations, the majority of which grew under independent auspices with individual vested interests and objectives although engaged in similar functions of ministering to the needy and, the sick. As the authors note repeatedly, multiple power centers frequently overlap and even conflict with each other. Second, until recently there has been a relative void of planning in health and welfare at the local, policy and administrative levels which sharply limits the discretionary powers and authority of central agencies. Third, systematic
analyses of organizations are useful for management and administrative purposes. Fourth, while one may generalize about change, specific organizations and subsystems must be examined if innovative ventures in departing from the status quo are to be inaugurated. Fifth, networks of task-oriented organizations have evolved through attempts to meet special needs and demands rather than to meet specific program goals through the elaboration of uniform performance standards. Finally, there is a dearth of social welfare policy enunciation and follow through under-scored in the essay by William Goode in which he discusses strategies of alleviating poverty and indicates that “perhaps the pragmatists can lead the way-doing it while the social scientists ponder whether it can be done.” (p. 310). The work will prove to be more difficult to digest for those who attempt to translate policy into action. For example, while the essay on “Social and psychological factors in poverty” skilfully espouses the proposition that the poor are a distinct social category embedded in a more general social-structural context, there are few insights that can provide the administrator of a large welfare program with even partial solutions to the wholesale sit-ins, demonstrations and ultimatums. What is evident is that the theorist is too frequently far from the hectic scene of mass dissatisfaction and the administrator who attempts to develop practical measures on short notice is in a difficult predicament. There are, as Rein and Miller observe, too many demonstration projects which are readily employed to avoid action or to postpone major change. (p. 161). Jt is well known that the organization of public welfare services is as misunderstood as the population it serves. About 8 million persons are now receiving public assistance at approximate cost of 8 billion dollars. About 2 million are age 65 and over, 4 million children of parents who cannot support them and over 1 million mothers. Most of these persons are not self supporting. New approaches to the organization of public and voluntary welfare agencies are a first requisite in the reorientation of Society’s attitudes toward those on welfare rolls and Organizing,for Community Welfare provides significant reflective material both for the researcher and the policy analyst. SAMUELLEVEY,Ph.D. Department of Public Welfare, Commonwealth of Massachusetts, Boston, Massachusetts, U.S.A.
CULTURE,HEALTH AND DISEASE: SOCIAL AND CULTURAL INFLUENCES ON HEALTH PROGRAMS IN DEVELOPING COUNTRIES by MARGARETREAD. Tavistock Publications, Philadelphia. $5.00. gap between members of the industrialized and those of the still predominantly traditional societies has grown to tremendous proportions, and as a result of the consequent divergence of world views, many well intentioned programs initiated by colonial powers, missionaries, New Nations, and charitable organizations, have failed. A principal cause of such failures has been the lack of understanding of the dynamics of cultures and societies. Well intentioned, but ethnocentric attempts to force isolated piecemeal solutions (such as hygienic programs) into complex networks of social relations and customs, have been tragically frequent. This book is a response to a real need for a different kind of approach on the part of health workers in rural areas of developing countries. Dr. Margaret Read, an anthropologist with extensive research experience in East Africa, formany years has
THE COMMUNICATIONS