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The years that the locusts have eaten
PUBLIC HEALTH
JUNE
a team of workers, and in " Political Arithmetic "* there are gathered together the fruits of such investigations undertaken by the Department of Social Biology of the London School of Economics. The book is divided into two parts, the first of which--" The Survival Minimum "--will be of especial interest to the statistician and the demographer, and the second--" The Recruitment of Social Personnel " - - t o the sociologist and the economist. Although this volume is expensive it can hardly be said that good value has not been given. In fact, those who would wish to buy this volume will find that they will be able to dig deep in the wealth of material which is contained in the twelve papers~ This is a work which must be read and re-read if the full significance of its thesis is to be appreciated. It is shown in the opening paper by Dr. Kuczynski that, although the decline of ferlility is universal in Western civilisation, this decline has been to some extent masked in the most highly developed countries by a reduction in mortality. It is obvious that this reduction must soon reach its lower limit, and that the decline in fertility which has long been a latent factor will soon produce evident effects. In certain countries in Central and Southern Europe, where the gross mortality rate still permits of considerable improvement, a further decline might apparently offset the results The Years that the Locusts have Eaten of failing fertility. It has been held in many quarters that a partial solution of the population A biblical title is perhaps not inappropriate problem might be provided by a marked increase of for a note dealing with a subject which was the number of marriages solemnized, but Dr. undoubtedly discussed at the early meetings of the Kuczynski argues with considerable reason that Royal Society, which became two centuries later the only solution is an increase of fertility within a matter merely of historical interest, and which the married state. In later papers it is shown that has again arisen as a grim spectre, as yet seen by the greatest decline in fertility has taken place in few but advancing yearly into greater prominence. industrialised districts in which the large family Since the war most of the great countries in Europe was formerly the rule, and evidence is adduced in have had prophets to warn them of the dangers of favour of the supposition that where these fertile depopulation, but it is only within recent years families migrate to other less fertile regions, they that attention has been focused on the possibility quickly adapt themselves to the fashion of the of cure rather than on the proof of the existence of sma2~r family. The not-unexpected correlation the disease. Fertility, which began to decrease in which is shown to exist between low fertility and France during the second half of the eighteenth a high percentage of employed women is further century, is now only too evident in most countries evidence that the small family is possibly dictated of the western world, and, as it is admitted by many by a fashion which is itself directed by social that an actual reduction of the size of the population conditions. of this country must occur within a decade or two, In further papers Mr. D. V. Glass and Miss the whole subject has evidently ceased to be a Enid Charles and their co-workers have made very scientist's leisurely considered trifle, and has careful investigations of the fertility in different become, as Shelbourne would say, " a matter of parts of the country, especially in relation to the government and the greatness of the people." time-factor and to various social conditions, such The study of population growth and decline and as marriage, the type of industry prevalent in the of its causes demands a rare combination of district, the employment of women, and the statistical, demographical, social, economic and historical faculties, and few individuals can com* " Political Arithmetic. A Symposium of Population bine in themselves the ability to touch more than Studies." Edited by Lancelot Hogben, F.R.S. London : the fringe of the problem. The natural solution is George Allen and Unwin, Ltd. 1938. Price 30s.
It is probable that much of the committee's work will have to be done by sub-committees on which persons not members of the main committee may be invited to serve, and it is certain that all medical officers of health will do everything in their power to facilitate work sponsored by such a representative body. Subjects which might call for attention include immunisation against whooping-cough, cross infection in isolation hospitals, the high mortality from enteritis in young children and the advisability of modifying existing practice in relation to terminal disinfection and the exclusion from school of contacts of cases of infectious disease. The amount of mass immunisation of children in this country against diphtheria compares very unfavourably with what has been accomplished in other parts of the world, and doubtless the committee will do all in its power to encourage an extension of this work. Readers will certainly have ideas of their own regarding lines of research appropriate to such a committee and the manner in which such research might best be undertaken. The committee will no doubt be glad to receive suggestions of this kind, and it is hoped that members of the public health service will communicate freely with the Secretary, Dr. Chalmers.
254
1939 employment of children between the ages of 10 and 15 years. The results were mainly negative, apart from the important fact that in 1851 there was a considerable degree of correlation between fertility and the proportion of children employed, whereas by 1911, when this proportion had fallen considerably, no significant correlation was found to exist. The evidence suggests that the fall in fertility was due to the fact that married persons found the rearing of large families a drain on their resources with little hope of an early return. Unfortunately the English data are not sufficient to answer the question whether the decline of fertility was related to a reduction in the larger families, or whether there was an increasing proportion of sterile marriages. A study of the very complete data afforded by the birth registration system of Australia suggests that decreasing fertility has acted mainly in two directions--to increase the number of sterile marriages, and to reduce the number of large families of, say, four children or over. The papers in the second part of the volume, dealing as they do with social questions such as the relationship between fertility and educational opportunities, and with the methods whereby personnel is recruited for the skilled occupations, cannot be discussed here, but they naturally have a bearing on the subject, and the results, though somewhat inconclusive, are a stimulus to further research. What is to be done about this matter ? Correspondents to T h e T i m e s have suggested various remedies, ana it is interesting to note that many of these deal with the expense of education. Few modern sociologists or reformers would care to put forward the very complete series of rules and restrictions which were suggested by Sir William Petty over two centuries ago. Yet even at that date Petty recognised that fertility decreased because the stimulus to bear children was wanting, and it is to be expected that he, as an economist, should have suggested a system of rewards for service to the needs of population growth. Probably he was right. The results of subsidising marriages in Germany indicate to some extent that a longterm policy is required. Education has given the artisan and working classes the ability to think for the future, and it is unlikely that financial aid for those who marry will produce as satisfactory results as would some state guarantee to the potential parents that their children would indeed have opportunities of advancement during their childhood and adolescence. Professor Hogben says in his stimulating introduction that " close association of scientific theory and social practice is a feature of the ' adventurous hopefulness' of early English capitalism." One suspects that in recent years the cart has been
PUBLIC HEALTH pulling the horse, since the practice of birth control surely had its roots in social practice, and not .n any scientific results which postulated that birth control would be for the good of society rather than for the good of the individual. If population problems are thus bound to social practice, it would seem that the time has now arrived for scientific theory and sociology to combine in devising methods of changing the fashion which has evidently resulted in an almost world-wide decrease of fertility.
The Future of Health Education Members 6f the Society will welcome the report (included in the proceedings of the Council, page 277) of the round-table meeung held on April 19th between its representatives and those of the Central Council for Health Education. The report has now been adopted, with minor amendments, by the full councils of both bodies as a general basis for future co-operation. At the meeting of the Society's Council on May 19th, when the report was presented, the view was expressed that the Central Council had displayed an accommodating spirit in meeting the points put forward by the Society. It had become evident from recent expressions of opinion by members of the Society, notably at the ordinary meetings of October and December last, that some anxiety had arisen in the minds of medical officers of health about the future policy of the Central Council. The grounds for this anxiety have already been referred to in our editorial of February relating to the Health Education Conference and need not be further laboured, except to repeat that the Society may be pardoned its close interest in the affairs of an independent body when it is borne in mind that the whole initiative for the setting up of the Central Council in 1927 came from this Society, as did the main motive power for the period up to the Central Council's incorporation in 1936. The procedure by which the Society recently asked the Central Council for an informal discussion of the position was perhaps unusual, but we venture to think that it will prove to have been the best method for restoring the proper sense of co-operation between the two bodies. The points of special significance in the present report are the renewed recognition by the Central Council of the special position of the medical officer of health in regard to health education policy and methods in his own area, and the assurance that the medical element on the Central Council itself will remain strong. From the side of the Society, we hope that the response will be a continued active interest in the doings of the latter body and a closer liaison 255
JUNE
a team of workers, and in " Political Arithmetic "* there are gathered together the fruits of such investigations undertaken by the Department of Social Biology of the London School of Economics. The book is divided into two parts, the first of which--" The Survival Minimum "--will be of especial interest to the statistician and the demographer, and the second--" The Recruitment of Social Personnel " - - t o the sociologist and the economist. Although this volume is expensive it can hardly be said that good value has not been given. In fact, those who would wish to buy this volume will find that they will be able to dig deep in the wealth of material which is contained in the twelve papers~ This is a work which must be read and re-read if the full significance of its thesis is to be appreciated. It is shown in the opening paper by Dr. Kuczynski that, although the decline of ferlility is universal in Western civilisation, this decline has been to some extent masked in the most highly developed countries by a reduction in mortality. It is obvious that this reduction must soon reach its lower limit, and that the decline in fertility which has long been a latent factor will soon produce evident effects. In certain countries in Central and Southern Europe, where the gross mortality rate still permits of considerable improvement, a further decline might apparently offset the results The Years that the Locusts have Eaten of failing fertility. It has been held in many quarters that a partial solution of the population A biblical title is perhaps not inappropriate problem might be provided by a marked increase of for a note dealing with a subject which was the number of marriages solemnized, but Dr. undoubtedly discussed at the early meetings of the Kuczynski argues with considerable reason that Royal Society, which became two centuries later the only solution is an increase of fertility within a matter merely of historical interest, and which the married state. In later papers it is shown that has again arisen as a grim spectre, as yet seen by the greatest decline in fertility has taken place in few but advancing yearly into greater prominence. industrialised districts in which the large family Since the war most of the great countries in Europe was formerly the rule, and evidence is adduced in have had prophets to warn them of the dangers of favour of the supposition that where these fertile depopulation, but it is only within recent years families migrate to other less fertile regions, they that attention has been focused on the possibility quickly adapt themselves to the fashion of the of cure rather than on the proof of the existence of sma2~r family. The not-unexpected correlation the disease. Fertility, which began to decrease in which is shown to exist between low fertility and France during the second half of the eighteenth a high percentage of employed women is further century, is now only too evident in most countries evidence that the small family is possibly dictated of the western world, and, as it is admitted by many by a fashion which is itself directed by social that an actual reduction of the size of the population conditions. of this country must occur within a decade or two, In further papers Mr. D. V. Glass and Miss the whole subject has evidently ceased to be a Enid Charles and their co-workers have made very scientist's leisurely considered trifle, and has careful investigations of the fertility in different become, as Shelbourne would say, " a matter of parts of the country, especially in relation to the government and the greatness of the people." time-factor and to various social conditions, such The study of population growth and decline and as marriage, the type of industry prevalent in the of its causes demands a rare combination of district, the employment of women, and the statistical, demographical, social, economic and historical faculties, and few individuals can com* " Political Arithmetic. A Symposium of Population bine in themselves the ability to touch more than Studies." Edited by Lancelot Hogben, F.R.S. London : the fringe of the problem. The natural solution is George Allen and Unwin, Ltd. 1938. Price 30s.
It is probable that much of the committee's work will have to be done by sub-committees on which persons not members of the main committee may be invited to serve, and it is certain that all medical officers of health will do everything in their power to facilitate work sponsored by such a representative body. Subjects which might call for attention include immunisation against whooping-cough, cross infection in isolation hospitals, the high mortality from enteritis in young children and the advisability of modifying existing practice in relation to terminal disinfection and the exclusion from school of contacts of cases of infectious disease. The amount of mass immunisation of children in this country against diphtheria compares very unfavourably with what has been accomplished in other parts of the world, and doubtless the committee will do all in its power to encourage an extension of this work. Readers will certainly have ideas of their own regarding lines of research appropriate to such a committee and the manner in which such research might best be undertaken. The committee will no doubt be glad to receive suggestions of this kind, and it is hoped that members of the public health service will communicate freely with the Secretary, Dr. Chalmers.
254
1939 employment of children between the ages of 10 and 15 years. The results were mainly negative, apart from the important fact that in 1851 there was a considerable degree of correlation between fertility and the proportion of children employed, whereas by 1911, when this proportion had fallen considerably, no significant correlation was found to exist. The evidence suggests that the fall in fertility was due to the fact that married persons found the rearing of large families a drain on their resources with little hope of an early return. Unfortunately the English data are not sufficient to answer the question whether the decline of fertility was related to a reduction in the larger families, or whether there was an increasing proportion of sterile marriages. A study of the very complete data afforded by the birth registration system of Australia suggests that decreasing fertility has acted mainly in two directions--to increase the number of sterile marriages, and to reduce the number of large families of, say, four children or over. The papers in the second part of the volume, dealing as they do with social questions such as the relationship between fertility and educational opportunities, and with the methods whereby personnel is recruited for the skilled occupations, cannot be discussed here, but they naturally have a bearing on the subject, and the results, though somewhat inconclusive, are a stimulus to further research. What is to be done about this matter ? Correspondents to T h e T i m e s have suggested various remedies, ana it is interesting to note that many of these deal with the expense of education. Few modern sociologists or reformers would care to put forward the very complete series of rules and restrictions which were suggested by Sir William Petty over two centuries ago. Yet even at that date Petty recognised that fertility decreased because the stimulus to bear children was wanting, and it is to be expected that he, as an economist, should have suggested a system of rewards for service to the needs of population growth. Probably he was right. The results of subsidising marriages in Germany indicate to some extent that a longterm policy is required. Education has given the artisan and working classes the ability to think for the future, and it is unlikely that financial aid for those who marry will produce as satisfactory results as would some state guarantee to the potential parents that their children would indeed have opportunities of advancement during their childhood and adolescence. Professor Hogben says in his stimulating introduction that " close association of scientific theory and social practice is a feature of the ' adventurous hopefulness' of early English capitalism." One suspects that in recent years the cart has been
PUBLIC HEALTH pulling the horse, since the practice of birth control surely had its roots in social practice, and not .n any scientific results which postulated that birth control would be for the good of society rather than for the good of the individual. If population problems are thus bound to social practice, it would seem that the time has now arrived for scientific theory and sociology to combine in devising methods of changing the fashion which has evidently resulted in an almost world-wide decrease of fertility.
The Future of Health Education Members 6f the Society will welcome the report (included in the proceedings of the Council, page 277) of the round-table meeung held on April 19th between its representatives and those of the Central Council for Health Education. The report has now been adopted, with minor amendments, by the full councils of both bodies as a general basis for future co-operation. At the meeting of the Society's Council on May 19th, when the report was presented, the view was expressed that the Central Council had displayed an accommodating spirit in meeting the points put forward by the Society. It had become evident from recent expressions of opinion by members of the Society, notably at the ordinary meetings of October and December last, that some anxiety had arisen in the minds of medical officers of health about the future policy of the Central Council. The grounds for this anxiety have already been referred to in our editorial of February relating to the Health Education Conference and need not be further laboured, except to repeat that the Society may be pardoned its close interest in the affairs of an independent body when it is borne in mind that the whole initiative for the setting up of the Central Council in 1927 came from this Society, as did the main motive power for the period up to the Central Council's incorporation in 1936. The procedure by which the Society recently asked the Central Council for an informal discussion of the position was perhaps unusual, but we venture to think that it will prove to have been the best method for restoring the proper sense of co-operation between the two bodies. The points of special significance in the present report are the renewed recognition by the Central Council of the special position of the medical officer of health in regard to health education policy and methods in his own area, and the assurance that the medical element on the Central Council itself will remain strong. From the side of the Society, we hope that the response will be a continued active interest in the doings of the latter body and a closer liaison 255