tion with the health officer at its head, and one public health program under his control. If the health officer is wise he will encourage the co-operation of private agencies but he should not divide his responsibility for the public health with them. . . . . Bound by no limitation except as to funds, and responsible to no one but their supporters, the private health agencies have grown rapidly until, at the present time, the health officer is beginning to wonder whether he is the ring master or only the clown in the circus."

I hope that no one will misinterpret the remarks I have made, and feel that I underestimate the importance of unofficial health agencies. In fact, I have the highest admiration for the good work accomplished by unofficial agencies in the field of public health and particularly in that phase of public health having to do with venereal disease control measures.

DIVISION IV-THE FAMILY

THE SIGNIFICANCE OF THE RISE IN RELIEF-GIVING DURING THE PAST FIVE YEARS

ITS RELATION TO INCREASED COSTS AND THE ADEQUACY OF RELIEF BASED ON A STUDY OF RELIEF-GIVING IN FORTY-SEVEN AMERICAN CITIES WITH A POPULATION OF 100,000 AND OVER

John B. Dawson, Secretary, Organized Charities Association, New Haven

For the purposes of this study a questionnaire was addressed to the family social work agencies in seventy-five cities in the United States with a population of 100,000 or over. Forty-seven replies were received. On these replies the conclusions and suggestions contained in this paper are based. Whatever value they may have depends in large part on the generous co-operation of the executives of these forty-seven agencies to whom the writer wishes to acknowledge his indebtedness.

The questionnaire called for information regarding the amount disbursed in relief yearly during the five-year period 1916-17 to 1920-21. and at the same time covered other factors in the work of the Society to which this first might conceivably be related. The real purpose of this study is to reveal the main trend in relief giving in these fortyseven cities during the past five years, and further to determine how far if at all the changing cost of commodities and the workers' conceptions of adequate relief have been the controlling factors in this trend out of the many other possible factors of variation.

The increase in relief disbursements.-Thirty-six cities reported relief disbursements over the full five-year period. Taking the year 1916-17 as the base, every city reports increases in relief during one or more of the four succeeding years. In thirteen cities the relief increased progressively each year. Five cities report increases in all but one year, eight in all but two years, and in one instance in three out of the four remaining years the relief disbursements were lower than in 1916-17 (see Table I).

If we assume that the relief disbursements in 1916-17 are represented by the figure 100 and then draw comparisons with succeeding years, three results are discernible: first, where decreases occur as compared with the original year they occur most frequently in 1917-18, viz., in twelve out of twenty-one instances; second, the maximum appears most frequently in 1920-21 (thirty-one out of thirty-six times); third, there is a wide divergence in the maximum figure, varying from an increase of one to 3200 per cent (see Table II).

The variation in the maximum relief disbursements is shown most clearly in the following table where cities are grouped according to the percentage increase of their maximum relief disbursements compared with 1916–17.

We have seen roughly how great these increases in relief disbursements have been and how they have been distributed. A reference to Table IV will show them in relation to the increases in total disbursements for family work.

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I

Cost of living in relation to increase.-To what must this remarkable increase in relief disbursements be related? It seems apparent at the outset that the increased cost of commodities during the past five years has played a relatively small part in the change.

The period which most frequently shows a decrease in relief disbursements where such is evident at all, viz., 1917-18 as compared with 1916-17 also shows an increase

per cent the increase in retail food prices as between these two periods is 4 per cent. The conclusion seems inevitable that so far as this particular period is concerned though changing costs have been operative their effect in relation to the increase in relief disbursements as a whole is slight indeed.

TABLE II

RELIEF DISBURSEMENTS

Relative Numbers, Distribution and Amount ("r" indicates decreases, not minima)

Unemployment and the increase in relief.-Now although our enlarging conception of adequate relief may be expected to play a part, it can be taken for granted I think that the increase in relief disbursements which we have disclosed is so great and so widespread as to indicate the existence of some more potent cause to which the question of the adequacy of relief is more or less subsidiary. This leads us obviously to the nature of the work with which these agencies have had to deal during the five years in

question. At once the problem of unemployment comes to mind. Just prior to the commencement of the five-year period we are considering there had been eighteen months of continuous and marked improvement following the depression of 1914-15. The war boom, lasting from 1916-18, was followed by a relapse during the half-year