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portions of common foods, will be found to be of great advantage in teaching food values in an attractive and easy way to both children and parents. These models may be purchased from the Plastic Art Company, 1495 Third Avenue, New York.
FEEDING THE FAMILY: A PROBLEM AND A METHOD FOR SOCIAL WORKERS IN WAR TIME
Michael M. Davis, Jr., Ph. D., Director of the Boston Dispensary
What are social workers doing to see that the families with which they deal are adequately nourished during these days of war prices and difficult food conditions?
Perhaps some will answer this by declaring the question to be unnecessary. Perhaps there are some who believe that with rising wages and steady employment every one today is prosperous enough to be well fed. Are there any here who cling to this fallacy? Let them examine the facts for themselves.
Since the opening of the European war, the cost of food has increased fully fifty per cent. Wages in some trades have increased in a very much higher ratio than this, yet as shown by the reports of the Federal Bureau of Labor Statistics, the average increase in wages among a number of representative groups has been less than half of the increase in food cost.
We are always in danger of being misled by the easy use of the word average. An average rise of wages is made up of a few cases in which there has been a very large rise, plus a smaller number of cases in which there has been some considerable rise, but it also includes a large number in which the rise in wages has been small and many in which there has been no change in wages at all. If a law were proposed, that every man under five feet four inches should have his right hand cut off, proponents for such a bill might argue that since the average height of Americans is considerably more than five feet four inches the law would be reasonable, since democracy must adapt its legislation to average conditions. The objectors to the measure, however, would answer with the effective retort, that while, of course, the tall men could take care of themselves, there were a large number of short men who would lose their right hands if the law were passed, and that it must be somebody's business to stand up for those little fellows.
Now that is exactly the responsibility which falls on social workers, these days, above all days, to stand up for the little fellows, for the wageearners whose incomes have gone up hardly at all, for the families who were just keeping their heads above water a while ago, and who are now in danger of being submerged, for the families who had to be helped previous to war prices and who need now more help than before. How far have standards of relief, as administered by social agencies, been revised upward to square with the rise in the cost of food? How far have case-working agencies informed themselves of the food supply of their families, and of its adequacy or inadequacy under present conditions? How far, in other words, have social agencies actually armed themselves with knowledge, and, therefore, with power, to stand up for the "little fellows"?
The figures quoted concerning the rise in food and in wages must not lead us to forget the fact that food is only one element in the cost of living, and that other elements, notably rent, have not risen nearly so much as food. Yet on the whole, the important point to us is, there are large numbers of families in every community whose income has increased very little, sometimes not at all, while the cost of living has risen all along the line. Food, the most vital element in the cost of living, has risen most of all. What most matters to us is not an average rise in family income, but the fact that there are thousands of families whose incomes are still only $12 or $15 a week, on which parents and three or four children are expected to subsist. The conditions of such families are vividly illustrated in the pamphlet just published by the Committee on Home Economics of the New York Charity Organization Society, My Money Wont Reach. That pamphlet is worth placing in the hands of every employer who has to double the wages of a certain number of skilled workers, and who has, therefore, become convinced that all wage-earning families today are prosperous, if not obese.
The effect of conditions of prices and wages upon the food supply of families is not a question of theory, but a matter of demonstrable fact. The New York Association for Improving the Condition of the Poor, in its pamphlet on A Study of the Adequacy and Economy of Some City Dietaries, gave an account of a careful investigation of the food supply of ninety-two families, mostly in New York City, during 1914 and 1915. This study showed that 59 per cent of these families were receiving less than 3,000 calorie standard of food energy per man per day, and that 36 per cent of the families were under a 2,500 calorie standard. This means a serious lack of adequate food supply.
The diminished use of milk, as shown by certain investigations in New York City, and the studies in New York indicating that one-third of the school children are decidedly under-nourished, will probably be referred to by other speakers at this session. In Boston the League for Preventive Work conducted a study last summer of over 200 families. Twenty-eight and one-half per cent of these families were found to be receiving an adequate food supply, measured in terms of the energy supplied. These families were selected from those known to six of the social case-work agencies of Boston. The majority of these families (three-quarters, in fact) were above the poverty line and not in receipt of material aid. Of the 198 families to whom the preceding figures relate there were 50 who were receiving material aid from charitable societies in Boston. Among these fifty families 42 per cent were found to be receiving inadequate nourishment. Were the social agencies looking after these families adequately? I would ask a more important
Motes Concerning Individual Patient: Weight lbs.
Meals (regular or irregular? If latter, when and how?)
Bathing (how much and how often ?)
Sleeping (how long?) hours. (Alone or with whom?) Window*
Working Conditions (hours, overtime, lunch arrangements )
Form Number I and form Number II are brought to the Food Clinic at the time the patient arrives. They are filled out by the social worker to whom the case is referred.
Form Number I is a food record of the family containing certain facts regarding the particular member of the family who is the patient.
This^form is filled out by the social worker in conference with the mother, either in the home or elsewhere.
question: Did the social agencies know whether they were looking after these families adequately? No, we did not know, not until we made this investigation and found the food facts of the families.
The Opportunity and Responsibility of Social Agencies
I mention this Boston study, particularly, because it was made according to a method which I believe is generally applicable among social agencies. The study of the food purchased by the families was not made by trained dietitians from these agencies, but by the regular staff of social workers. Each worker selected one or several families whom she
Form 131-500-5-19 No. II
BOSTON DISPENSARY FOOD CLINICNAME
S. S. NO.
No. Of RoomsRELIEF RECO
Estimated Total Of Usual Weekly Incomi f
Type Of StoveT
Hot Water SoprLY t-PREPARATION OF MEALS
Double Boiler »
Sauce Pans r Dinner— Man At Homet Take Lunch t
Who Cooks Food T
REASON FOR REFERRING FAMILY TO FOOD CLINIC
r S. S. Record With Particular Reference To Present Needs.
(made By S. S. Worker
Form Number II is part of a general case work sheet for family investigation. This, like Number I, is filled out by the social worker. The general investigation of the family made by the social worker supplies most of the information needed for this form. In fact, the general case-work record card could be used instead of this form, adding the special items concerniny: the ©reparation of meals.
knew, so as to have a reasonably easy approach to the mother. Only families in which there were children were taken. Provided with a list of the common foods, she went to the mother and secured a list of the purchases made during the preceding week.* I do not consider that such a method yields as complete and accurate a figure of the food supply of a family as if we could get that faimly to weigh portions served and food wasted, each meal of each day for a week. But the latter method is hardly practicable in one family in a thousand. The former method, the one which was used in our Boston study, is practicable in a great many families, and if carried out by social workers, under careful supervision, is capable of yielding facts of great practical importance to
Form Number III is used in the Food Clinic itself. It is designed to furnish a running history of the case after the facts have been covered and the dietitian has begun a series of conferences with the mother of the family. The Clinic is equipped with stove and utensils for cooking so that demonstrations can be held for individuals or for very small groups.
the welfare of the families, and to the standards of the relief and other case-work conducted by the agencies: facts which are likely to be eyeopeners, even pocket-openers, if they are brought into appropriate relations with a check-book.
The responsibility of social workers, as a class, for dealing with the food problems of their families today, rests particularly upon three types of social agencies:
1. Relief agencies, which must administer material aid for the actual maintenance of needy families. Do relief agencies know the local food facts in their communities, and the present food facts and budgets of their families, so as to know whether their financial standards of relief need revision, and where and how much they need to be revised?
2. Child-caring societies, particularly those placing out children. These societies must pay for the support and board of children in foster homes. They must pay adequately or the children will be underfed in many instances. Have they studied the food facts of their children and their foster homes, so as to be able wisely to revise their standards of payment, and to guide the food purchases for their children in the foster homes under present abnormal food conditions?
3. Medical agencies: hospitals, dispensaries, and particularly the social service departments. These medical agencies must diagnose and care for illness, including malnutrition, and mut seek to prevent these evils. How far have these medical agencies, particularly the dispensaries, social service departments, and visiting nurses' associations, conducted studies and surveys concerning under-nutrition among their patients, particularly among the children?
How shall these social agencies deal with the present food problems of their families? The first step is to adopt as a principle of case work the following rule: Under present conditions no investigation of a family
* The data were analyzed under the supervision of dietitians, so as to be able to determine the chief errors in diet and the extent of malnutrition. The methods and results of this study were described in detail in a pamphlet issued by the League for Preventive Work, 46 Cornhill, Boston, at ten cents a copy.