The Relation of Wealth to Welfare

William Robson, William A. Robson

• Publisher: Routledge
• Year: 2021
• Print ISBN: 9781032184470
• eBook ISBN: 9781000527995
• Edition: 1
• Topic: Business
• Subtopic: Economic Theory
• Index: Business

First Published in 1924, The Relation of Wealth to Welfare examines certain definite and fundamental elements of human welfare and their relation to private income on the one hand and various kinds of collective action on the other. The four elements discussed in the book are health, art, work, and education. The author argues that the power of private income to increase the welfare of its possessor in regard to the various elements under examination is as a matter of fact frequently or even always comparatively small; whereas the power of collective action and public expenditure to do so is often comparatively great. This book is an essential read for students and researchers of political economy, political studies, and economics in general.

VARIATIONS ON THE THEME

CHAPTER TWO

HEALTH

It will be generally admitted that physical health is for every man and woman an essential condition of well-being, and it is for this reason that it will receive our first consideration as an element of welfare.

The relation between private wealth and personal health is by no means a simple one, once we get above the line of extreme poverty. When we leave out the classes which live no considerable distance above the level of mere subsistence, and whose deaths from an insufficiency of food, clothing, warmth and house accommodation swell the death-rate and the infant mortality rate, there is but little evidence to show that increased income leads to better personal health. Even in the case of the diseases which are definitely attributable to a pecuniary inability to purchase the commodities necessary for the preservation of health, it would appear that immunity is reached by the addition of a very small increase of income. Rickets is a typical example of a disease due in many cases to poverty, and is largely caused by a lack of the vitamins contained in milk.¹ But the following table, which is an analysis of the weekly income of the families of two hundred children, shows that a difference of only a few shillings a week in the family income may be sufficient to avert the disease.

Condition.	Weekly Income.
	No. 1-100.	No. 101-200.	Average of 200.
	s. d.	s. d.	s. d.
Markedly rachitic ..	28 $3\frac{1}{2}$	32 $7\frac{1}{2}$	30 $5\frac{1}{2}$
Slightly rachitic ..	31 1	33 0	32 $0\frac{1}{2}$
Non-rachitic .. ..	31 1	38 $10\frac{1}{4}$	35 0

Thus it may be observed that “ although there was a difference of about 15 per cent, in the average family income between the markedly rachitic and the non-rachitic groups, they belonged to the same social class.”² It appears from this and other evidence that there is no relationship at all between rickets and income when the latter exceeds about forty shillings a week. This is only another way of saying that the marginal utility of income falls rapidly so far as rickets is concerned.¹ This may be true of health in all its phases; and if we classified the whole nation into definite categories of physical health on a scientific quantitative basis, instead of merely distinguishing the living, the sick and the dead, it is easily conceivable that an actual falling off of health might be shown to exist among certain classes after a fairly high point on the ascending scale of incomes had been reached. For many of the habits of life customary among persons with large incomes, such as the eating of excessive quantities of highly-seasoned food,² late hours, the living in an atmosphere of continuous excitement, and a general irregularity of existence, are as destructive of health at one end of the scale as, at the other end, are the lack of proper nourishment, overwork, monotony, and the insanitary overcrowding which victimize the poorer and more helpless members of the community.

“In England, owing to prosperity, over-eating has become habitual with many.” writes Mr. Leonard Hill, F.R.S., in one of the most interesting of the official reports of the Medical Research Council.¹’ “ A young man, poor, keen, active and frugal, when he gets prosperous will overload his stomach three or four times a day. . . . The natural inclination of man, when well-to-do and engaged in sedentary occupation, is to raise his metabolism rate by increasing the protein value of the diet. He takes also alcohol, or hot stimulating drinks, and thus replaces the natural increase of metabolism and warmth of skin which is produced by open-air exercise. . . . The overfed man of means takes rides in fast motor-cars and thus secures a high cooling power to relieve him of the heat generated by his meat and drink. Thus uselessly and most uneconomically is the energy of food and petrol wasted on the self-indulgent.”

In a later passage Mr. Hill points out that “ children of the well-to-do are kept indoors for fear of catching cold . . . and are often wrongly fed or over-indulged. They may suffer from the conditions of environment ... no less, and perhaps even more, than children of the poor who play in the streets.”²

During the war of 1914-1918 an elaborate survey was actually made of a large section of the adult male population of Great Britain, the health and physique of which were determined on a quantitative basis by the Ministry of National Service acting through its Medical Boards. The results of this remarkable investigation, unique in the history of the nation, are of the greatest interest to our discussion.

Between ist November, 1917, and 31st October, 1918, no less than 2,425,184 medical examinations were made of men of military age. Every man who was thus examined was placed in one or another of four distinct medical categories. Grade I consisted of those who had attained the full normal standard of health and strength, and who were capable of enduring physical exertion suitable to their age.¹ Such men must not have been suffering from progressive organic disease, nor have any serious disability or deformity. Minor defects capable of being remedied or adequately compensated by artificial means were not regarded as disqualifications. Grade II took in all those who for various causes, such as partial disability, could not reach the standard of Grade I, but whose physical condition was too high for Grades III or IV. Men in Grade II were not to suffer from progressive organic disease; must have fair hearing and vision; be of moderate muscular development, and be able to undergo a considerable degree of physical exertion of a nature not involving severe strain. Grade III consisted of all men who presented marked physical disabilities, or who gave such evidence of past disease as not to be considered fit to undergo the degree of physical exertion required for the higher grades. This third Grade included those who were fit only for clerical or other sedentary occupations, such as tailoring and boot-making. The lowest Grade, No. IV, comprised all men who were totally and permanently unfit for any form of military service.¹

Something will be said later regarding the general results arrived at from this great survey of the physical condition of the nation. What we are immediately concerned with here are certain data obtained from specific portions of the survey. In the London Region, for example, the health grading of 160,545 men was tabulated, according to their occupation group, as shown on pp. 32-3.²

In the following Table the groups have been arranged in a descending scale according to the percentages in Grade I. Grade I, it will be recalled, consists of thoroughly healthy and physically perfect men; and men in Grade II may also be regarded as being healthy and fit rather than the contrary. The final column on the right-hand side (Column A) consists of the percentages in Grades I and II added together ; and represents therefore approximately the percentage of the men in each occupation group who are not definitely unhealthy or suffering from physical disability or under-development. The addition of the first two grades results, as shown in this column, in a slight shifting of the physical ‘ order of merit’ of the occupation groups, but there is no fundamental change to be observed save that Group 5 (Labour) drops down two places to seventh in the list.

OCCUPATION.	GRADES. (Per cent, of men in each.)				Column A. I and II added together.
	I.	II.	III.	IV.
1. AGRICULTURE .. .. .. .. .. .. including farmer servants, gardeners, foresters, gamekeepers, golf professionals, caddies, etc.	38	21	30	11	59
2. SKILLED ARTISANS .. .. .. .. .. including munition workers, of all kinds, aeroplane constructors, plumbers, gas fitters, carpenters, engi-neers, painters, blacksmiths, etc.	37	25	29	9	62
3. SEAMEN .. .. .. .. .. .. .. including fishermen, lightermen, etc	36	14	41	9	50
4. TRANSPORT .. .. .. .. .. .. including outdoor porters, messengers, taxi-drivers, bus drivers, conductors, tram drivers, carters, dray-men, postmen, railway servants and porters (other than clerks), etc.	31	21	36	12	52
5. LABOUR .. .. .. .. .. .. .. including unskilled labourers, scavengers, dockers, etc.	26	21	39	14	47
6. INDOOR (SEDENTARY) .. .. .. .. .. including clerks, piece-workers (cloth trade), tailors, bootmakers, printers and compositors, etc.	26	23	39	12	49
7. INDOOR (ACTIVE).. .. .. .. .. .. including hotel servants and porters, indoor servants (except waiters and chefs), shop-keepers and assistants (except those concerned with food), teachers, legal profession, dental profession and dental mechanics, chemists, etc.	23	26	38	13	49
8. TRADESMEN .. .. .. .. .. .. including shopkeepers and assistants concerned with food, milkmen, waiters, chefs, etc.	18	23	46	13	41
9. BARBERS .. .. .. .. .. .. .. including complexion specialists, chiropodists, bone- setters, manicurists, masseurs, Turkish bath attendants.	16	17	46	21	33

The significance of the statistics which we have reproduced lies in the fact that they demonstrate conclusively the absence of a direct relationship between private income and personal health, even when large groups are examined. Agriculture is one of the worst paid occupations in England, yet those who work at it form the healthiest (or second healthiest, if Column A be taken) section in the nation. The average income of the members of the Indoor (Active) Group is almost certainly higher than that of any other in the list, including as it does the highly paid legal and dental professions, the teachers and the chemists; yet the relatively great personal wealth of these men does not secure for them a passable standard of health and fitness, and the group ranks seventh in the list as regards Grade I and sixth if Grades I and II are taken together. The earnings of seamen are considerably lower than those of the tradesmen in Group 8, but the seamen are far healthier than the waiters and chefs and shopkeepers.

It may be remarked that the expert Committee which drafted the report took into consideration the possibility of each occupation acting as a kind of selective agent on a physical basis upon those who were attracted to it. But after careful investigation this simple explanation was rejected. “ It can hardly be doubted.” the Committee observe, “ that the gradual fall in the index of fitness ... is a true criterion of the various occupations upon the physical welfare of the workers. They correspond to what we know of the conditions of life in several trades and their accepted effect upon health too closely to be explained by the hypothesis that the agriculturist is an agriculturist because he is healthy, and the tailor a tailor because he is unhealthy.” ¹

Even more striking is a table giving the incidence of tuberculosis of the lungs according to occupation among 895 recruits examined at Liverpool, representing a characteristic cross-section of the male inhabitants of that city. There, among nearly 150 specified occupations, we find seriatim clerks 109, managers 51, carters 38. . . . Yet the income of “ managers” must obviously be enormously greater than that of carters. Again, there were five more cases of consumption among “ salesmen ” than among “ dock labourers.” though the earnings of salesmen are considerably larger than those of dockers. Porters and engineers, dentists and packers, shipowner and newsvendor jostle one another in the list giving the incidence of the drea...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Original Title Page
• Original Copyright Page
• Preface
• Table of Contents
• I. The Theme Stated
• Variations on the Theme
• Index