For the very reason that certain diseases—for example, certain affections of the stomach and intestines—will destroy even the strongest infant, the prevention of these diseases becomes a matter of the first importance. It is unquestionable that such diseases can be more effectively prevented in proportion as the circumstances are favourable in which the infant is reared.
It is certainly through an error of observation that some writers maintain that in the age-class of children who have survived their first year we find no weaklings. Even the strongest infant will not survive to enter this age-class if its environing conditions are too unfavourable. It often happens that an infant survives an illness, and yet survives in a damaged condition. A high death-rate is a consequence of a high disease-rate; but of the infants affected with disease, only a certain proportion succumbs, whilst the others survive with damaged constitutions, and constitute a favourable soil for fresh inroads of disease. In the twentieth century, in the civilised countries of Europe, of one hundred children dying during the first year of life, barely twenty die in consequence of inborn defects or congenital diseases (such as congenital debility, atrophy, congenital scrofula, tuberculosis, &c.).
If it were true that infant mortality exercised a selective function, we should find a high infantile death-rate associated with a low death-rate in the case of children past infancy, and conversely. But everywhere we find that the infantile death-rate and the death-rate amongst children at ages one to five vary directly, and not inversely. Moreover, the variations in the death-rates in children during different years of life are determined by the fact that the younger the child, the less are its powers of resistance; thus the danger to health resulting from unfavourable conditions of life varies inversely as the child’s age; and even within the limits of the first year of life, the infantile death-rate is higher in proportion as the time which has elapsed since birth is less. Among the lower classes of the population, the infantile death-rate is higher than it is among the upper classes. If a high infantile death-rate exercised a selective influence, we should find that among the lower classes the death-rate among children more than one year old would be less than the death-rate of upper-class children of corresponding ages. But this is nowhere the case.
The mortality of children between the ages of one and five years depends chiefly upon the incidence of the infectious diseases. It is well known that these diseases are much milder in civilised than in uncivilised countries. From this it follows that the death-rate among children between the ages of one and five years depends chiefly upon the level of civilisation; the death-rate being higher where the level of civilisation is low, and conversely; but the infantile death-rate is much less influenced by the standard of civilisation. Moreover, recent investigations have shown that (especially in large towns and in industrial regions) high infant mortality is closely associated with a low level of fitness for military service, and with a high death-rate from tuberculosis. It is true that the number of those who succumb to tuberculosis and the number of those who prove fit for military service are influenced by other causes in addition to the infantile death-rate—causes which have nothing to do with that death-rate. But the fact remains indisputable that the causes leading to a great mortality among infants tend to injure the constitution of those infants who succeed in surviving, and thus weaken the general health of the population.
Socialism versus Poor-Relief.—Many Socialists are opposed to the relief of destitution. Poverty existed prior to the rise of capitalism, and is found where the capitalist system has not as yet struck root. But the chief cause of poverty to-day is unquestionably capitalism. Capitalism is the creator of the proletariat, the type of the poor class; poverty and proletariat, poor man and proletarian, are almost equivalent terms. Capitalism is also the creator of pauperism (e.g. of the industrial reserve army), which must be regarded as an essential pre-condition of capitalist production. In the manufacturing districts, poverty is more extensive than it is in the agricultural districts. In the towns it is more extensive than in the country. Capitalism cannot exist without poor-relief. Unless the destitute are relieved out of the superfluity of capitalism, certain very undesirable consequences will ensue. For poverty is a chief cause at once of punishable offences and of all kinds of disease. The two main purposes of the relief of the destitute are, in fact, the protection of the rich against criminal outbreaks on the part of the poor, and the prevention of the epidemic diseases which would breed in the surroundings of neglected poverty, and spread thence to the homes of the rich.
The chief aim of poor-relief is to give help in cases of poverty arising from individual causes, to deal with poverty regarded as an individual concern. Poor-relief makes no attempt whatever to do away with the social causes of poverty—nor, indeed, could the methods of poor-relief effect this, even if the attempt were made. In a certain sense, socialism and poor-relief have a common character, inasmuch as both are opposed to free competition. It is the aim of poor-relief to relieve the disastrous consequences of free competition; the aim of socialism is to do away with class distinctions and existing contrasts between wealth and poverty—that is, to equalise and to democratise. But socialism does not favour the relief of destitution, and rather regards the need for such relief as a proof of the unrighteousness of the capitalist system. Socialism regards poor-relief as nothing more than a way of treating symptoms of social disorder, and as a method necessary only during the age of capitalism. Socialism is hostile to any social institution which serves to safeguard capitalism.
Socialism versus Child-Protection.—The considerations put forward regarding poor-relief bear to some extent on the relationships of child-protection to capitalism. Many departments of child-protection—foundling hospitals, for instance—are merely departments of poor-relief. Child-protection is chiefly concerned with the children of the poor, since these are far more in need of protection than the children of the rich.
Child-protection and socialism both existed, in a sense, prior to the development of capitalism. But in the nineteenth and twentieth centuries, child-protection has received much more attention than in former times. This extensive development of child-protection is one phase of that general development whose other phase is the development of capitalism. Modern child-protection and modern socialism are necessary consequences of capitalism, and the existence of the last in the absence of child-protection and of socialism is altogether unthinkable. Capitalism gives rise to numerous diseases in the social organism, and then endeavours to cure them, for the most part, by the methods of child-protection. The causal relationship between capitalism and child-protection is not direct or primary. Certain applications of child-protection are not the direct consequences of capitalism itself, but only consequences of the causes by which capitalism has been created and evolved. When we come to examine concrete conditions, such as those of some particular country, we invariably find that child-protection and capitalism are intimately connected with the general development of the country with which we are concerned. This fact may interpose modifying conditions in the causal chain connecting capitalism and child-protection.
(The origin of the Children’s Courts in the United States of America offers an instructive example of this. In this country, as in England, special causes led early in the last century to the establishment of reformatory schools. But whereas in England, until quite recently, boarding institutions were preferred for this purpose, from the first, in the United States the attempt was made to arrange for the upbringing of neglected and criminal youths under family auspices. The reasons for the adoption of this latter plan in America were the enormous possibilities of territorial expansion and the lively demand for new population. When juvenile offenders came before the courts, responsible individuals would offer to undertake the upbringing of these children, binding themselves over to report at regular intervals upon the behaviour of the children, and generally accepting all necessary responsibility. The judges ventured upon such experiments, and as the successful results multiplied, this method of procedure attained the force of a customary institution, and subsequently was formally embodied in legislation.)