Chapter 7: Social Aspects

One consequence was the establishment of our social security system with subsequent extension of coverage and benefits to most aged people and the recent addition of medical care. Numerous public monetary benefits have also gradually been extended to the aged, including special income tax deductions. Also, greater public resources have been devoted to research in the chronic diseases, which primarily afflict people in the older ages, and to extension of services for the chronically ill. Pension plans have become more common, and benefits for those reaching retirement age have been critical bargaining issues for labor unions.

There are compelling reasons for the continued preoccupation of society with the income, employment, and health problems of the aged. Poverty is more prevalent among the elderly—especially among the aged in minority groups—than any other age group.⁸ Not all of those now in the older population were covered by the federal Old Age Survivors, Disability, and Health Insurance program (OASDHI) when they were in the work force. Furthermore, the levels of payment under retirement programs have, in many cases, been low and not sufficient to raise recipients above the poverty level.

In the future, the income position of the aged will most likely be improved, because more will be receiving benefits from private retirement funds, will have larger accumulated personal resources, and will be covered by government insurance plans. Much depends, of course, on our ability to control inflation. Some might argue that improving the income position of the disadvantaged before they reach old age would reduce their income deficits in later years. Thus, it may be decided that national priorities should be focused on the disadvantaged; for them, income deficits among the elderly, as among all age groups, are greatest, and improvements have been slowest in coming.

Health needs will continue to figure high on the list of needs of the older population: Not only will standards of health care increase; there will also be a change in the age composition of the older population. While the entire population 65 years old and over will rise 43 percent between 1970 and the year 2000, persons 75 to 84 will increase by 65 percent, and those 85 years and over by 52 percent. It is among these old people that chronic conditions (including impairments and disease) increase, limitations of activity become more prevalent, and institutionalized care is more often required. Females predominate, for their expectation of life exceeds that of males. As with income, the risks of poor health, limitation of activity, and institutionalization are greater among the disadvantaged segment of the elderly.

The aged are, however, a varied group, and not all have, or perceive themselves as having, severe income or health problems.⁹ Although their incomes and total wealth are smaller on the average, the variation in income among the aged is considerable. The elderly probably require less income and most probably expect, and accommodate to, some decline in vigor and health without much difficulty. Even so, the combination of old age with very low income and poor health is devastating.

Two sets of issues are likely to arise with increasing frequency as the number of very elderly grows. First, there are the issues of ethics, personal preference, and allocation of public expenditures connected with the prolongation of life. This set of issues, which is just beginning to receive public attention, has not been addressed by this Commission.

The second issue, more widely discussed, is. far from resolution. It involves the type of institutional care necessary for the elderly who can no longer be cared for at home. Only a small proportion of the population 65 years and over—five percent in 1970—are institutionalized,’° but the percentage among those 85 years and over is much larger. This institutionalized population is relatively disadvantaged in terms of health, social ties, and economic resources. To date, the prevailing image of institutional life is largely negative, and older people generally express greater aversion to it than either their relatives or the public at large.

A continuing problem of the aged in our society is finding socially valued roles.¹⁰ What is desirable behavior is less clearly defined for older people than at any other stage in the life cycle. For men, the situation first becomes critical at retirement. Previously, their life courses were more clearly charted. After school came entrance into the labor force; their status in society depended largely on occupational position. After retirement, however, their status, and thus the means for earning social esteem, becomes indeterminate at best.

For women, the loss of status has traditionally appeared earlier in the life cycle, when children left home and family functions diminished. However, a woman’s status in society has depended largely on that of her husband, even though she may also have been in the work force for all or part of the time since marriage. Regardless of employment, she typically maintained household and family roles which forestalled her feeling of “uselessness.”

Opportunities for the employment of men after age 65 are more favorable for those with higher educational levels, and for those in a few selected occupations. It remains to be seen whether patterns of compulsory retirement would be noticeably altered with slower population growth and smaller numbers of new entrants into the labor market. If the opportunities for advancement diminish in a population with a stabilized age distribution, the bargaining position of the aged would not appear to be strong. Also, increased participation of women in the work force may present additional competition for older workers. Finally, society feels little obligation to provide employment for older people because of income and health supports now established in private retirement programs and in the national social security system.

It is possible, however, that noticeably higher levels of educational attainment, retraining at different stages of life, and a shortened work week (perhaps combined with educational programs) might alter the opportunities for employment—in the aggregate and for older workers as well.

Policies on age at retirement could certainly be made more flexible. Perhaps, however, retirement will be looked upon with more favor once the economic and social supports for the retirement years are more secure. Much depends on the extent to which society legitimates leisure-time activity in comparison with work. If a “leisure ethic” gains greater social acceptance, especially within the younger portion of the work force, people may come to look forward to retirement and the leisure it brings. A man of 65 has an average of 13 years of life remaining, and a woman 16 years,¹² and life expectancy may rise further with advances in medical science. With the increase in the number of older persons and the greater amount of their time available in the future, more consideration should be given to the effective use of volunteers in community agencies. This could contribute materially to both the individuals involved and the welfare of the community.

There are many other questions about the aged to consider—for example, where they will live, their position in the changing family structure, their influence on our political institutions, and so on. We can only speculate about such changes. All we know for certain is that, if the birthrate declines further, the proportion of bolder people will rise. However, as we have seen, total dependency—the proportion of aged and children together-will decline, because declines in the proportion of children will more than offset the rising proportion of aged. This change will take place gradually, permitting ample time for planning. We are not doing very well now in meeting the problems of the aged—we can certainly do better.

The Family

We recognize that in opening a discussion of the family we tread on sacred ground, for the family is our most revered institution. As the recognized unit of reproduction and child-rearing, as perhaps the most important socializing agent of oncoming generations, and for its importance in defining the social roles of both men and women in our society, it is central to most of our concerns.

The record attests to the enormous durability of the family as a valued institution, modified in response to changing conditions and to the choices available to different generations. In the United States, most people marry and they marry at an early age. Our population is unusual among industrialized nations in that the proportion ever marrying has always been high for both sexes.¹³

Our average age at first marriage is the lowest of any advanced country in the world. The great divide in the orientation to marriage seems to have come in the 1890’s, when age at marriage started a long downward movement that lasted, with only minor fluctuations, until the 1960’s. In 1959, the median age at first marriage was 22.5 for men and 20.2 for women; by 1970, these averages had reached 23.2 and 20.8 respectively.¹⁴ Thus, in our society, marriage has been almost universal and the age at entry into marriage has been low.

While marriage has been almost universal, divorce has become more frequent. The divorce rate in 1935 was more than twice that in 1900, and the rate in 1970 was more than twice that in 1935.¹⁵ It appears that perhaps as many as one-third of marriages now end in divorce. The increased divorce rate has often been interpreted as an indication that the institution of marriage is disintegrating. However, what appears to be happening is that unsatisfactory marriages are less often tolerated. Part of the increase in divorce is due to the fact that more couples now seek divorce when their marriages fail, instead of remaining separated. Marital dissolution does not mean rejection of the married state. The evidence for this is that, increasingly, the divorced marry again.¹⁶

Nearly universal marriage and early marriage in our society would possibly not be so prevalent had not circumstances made marriage less of an economic and social commitment and less of an irreversible step. some evidence supports such a view.¹⁷ Formerly it required that the man be able to provide adequate support for the family before marriage. Many men, therefore, had to delay marriage and some had to forego it altogether. Today, however, the proportion of women in the work force has increased markedly; and the willingness of women to work after marriage, with or without children, has encouraged many young people to decide that they could “afford” to marry. Another factor is that, while marriage once led automatically to children, it no longer needs to do so. The increased ease and respectability of divorce and remarriage has likewise reduced the obligation to remain in an unsatisfactory marriage. Finally, still other factors have encouraged earlier and more universal marriage—educational and housing benefits for veterans, federal subsidization of home ownership, college provision of housing services for married students, unemployment compensation, and last, but not least, parental willingness to continue supporting offspring after they are married.

It would appear that the result of these factors has been generally to provide a greater range of choice to men than to women. In quest of a stable relationship, the young woman often does more than perform her normal duties as wife. She often interrupts her own education and takes a dead-end job in order to support the young man while he pursues his education. Increasingly she works after marriage to improve the economic position of the family. It is the woman’s responsibilities, and not the man’s, which increase if the woman works, for she must carry family as well as job obligations. If divorce occurs, it is easier for the man to remarry, and the woman ordinarily is assigned responsibility for the continuous task of child-rearing, although she may receive financial assistance from the man. With contraception, the wife may have fewer children than before, and be fully occupied with their upbringing for a shorter time after marriage. Thereafter, however, she has the problem of coping with her time and “justifying” her relative inactivity if she does not work. Men, in general, do not face such major role conflicts until retirement.

While marriage is the common bond holding the family unit together, many families are maintained by one parent only, most often the mother. This may be the case for the woman who bears a child out of wedlock and does not put the child up for adoption, or for mothers whose marriages have been dissolved. In most such instances, however, being a single parent is a temporary state, for the person, especially if young, will usually marry or remarry.

Two developments are likely to have an impact on the family. One is the questioning of existing sex mores by young people and open violation of them by some. The other is the women’s liberation movement which aims to improve the status of women and to change role relationships within the family.

Changes in sex mores have not occurred all at once; they have been changing for a long time. In many cases, the sex mores were violated by the parental generation, but not so openly. And, overt compliance was achieved at considerable cost, especially in the case of marriages occurring as a result of premarital pregnancy. This is less necessary now with the greater availability of contraception and abortion. Also, many adults are aware that their own uncertainty and ambivalence has been a factor in the open repudiation of sexual standards by youth.

Some believe that the “sexual rebellion” may be moving in the direction taken in Sweden, where a permissive attitude towards premarital sexual activity is combined with a late age at marriage. However, both these traits are traditional in Sweden; they are not traditional in the United States. Today, many young people live together informally and are experimenting with a greater range of relationships. Whether or not these relationships are enriching depends on the personal responsibility of individuals involved and the attitudes of our society toward these individuals and their life styles. The effects on marriage and family patterns cannot yet be foreseen, and much depends on how the present confusion with respect to premarital relationships gets resolved.

A significant feature of the women’s liberation movement is that, although its demands have been made on the basis of equity for women, it has not usually been anti-marriage or anti-children. It has, however, been concerned with changing the role relationships within families and with extending services for children. Its most vocal demand, however, is for equality in the educational and occupational spheres outside the family.¹⁸

If the movement is successful, many of the role patterns will be dissolved or weakened. We can expect more conflict within marriage as to who will do what, but such conflict has already been apparent in many cases, and many believe that the quality of child-parent and of husband-wife relationships would be improved by more participation of the husband in family life. In those cases where the woman chooses or is required to work, the division of labor within the family will be based less on sex, for the husband also will be expected to assume responsibility for household chores, to share in the responsibility of caring for children, and to accommodate his occupational requirements to the family roles, much as women do.

None of these changes dictates the direction which reproduction within families will take, or whether the responsibility for childbearing and child-rearing will be enhanced, or what will happen to the quality of family life. As more satisfactory alternatives to childbearing and child-rearing become available, that in itself is likely to enhance rational and responsible decisions about reproduction and parenthood.

Population Density and Population Size

More and more Americans live in urbanized areas at densities far exceeding those in rural areas, but urban densities are not increasing. In fact, average density is actually declining, because urban territory is expanding faster than urban population. In 1960, about 96 million people lived in urbanized areas at an average density of 3,800 people per square mile. By 1970, 118 million people lived in urbanized areas, but the density of urban areas had dropped to 3,400.¹⁹

It is important to distinguish between density and agglomeration. Density, defined as the number of people per unit of area, does not specify the total numbers of people involved. Population agglomeration refers to large collections of people at an unspecified density. A small town may have a high density if the lots are small and the buildings tall. Many suburban areas have a low density but contain a large population distributed over extensive areas.

We need to understand the effects of urban density itself and the effects of having such large proportions of our people living in areas that include millions of people. What can be said about “crowding” and its effects? To what extent can social problems—high crime rates, mental illness, mass violence—be attributed to density and to the scale at which we live in metropolitan areas? What will be the social effects of near-total urbanization?

What is the meaning, in terms of daily life, of urban densities which can reach as high as 67,000 people per square mile on Manhattan Island in New York City?²⁰ Without knowing the context in which it is experienced, the fact of high density tells us little about its importance or impact on human behavior.

High density does not necessarily imply crowding, since the type of activity a person is engaged in, its duration, and the person’s attitude all shape perception of whether a particular situation is crowded. The high density at a movie theatre does not cause a crowded feeling as long as each person has a seat. The same density at an office where people are active would probably be unbearably crowded. And certainly where a family of eight lives in three or four rooms the situation is undesirably crowded. In this case, high density coupled with poor housing conditions and poor nutrition, can only aggravate an otherwise difficult situation and seriously hinder the development of children. We cannot, however, assume that all high density situations are either crowded or necessarily bad. Some are, some are not.

Other things being equal, we know that increases in density cause increases in air pollution as the natural recycling system is overloaded. Similarly, traffic and other forms of congestion grow with density, as growing numbers of people hinder each other’s movement. But, other factors, such as population size, the layout of the city, and its type of transportation system, are also important.

In general, the research on the effects of population density on human behavior is sparse and the findings either inconclusive or negative. Despite popular belief, the evidence is lacking to show that social pathology is associated with density itself. The most judicious conclusion we can reach is that little is known and that conventional measures of density are of little use as single indicators.²¹

Some intriguing research has been conducted on animals which indicates that certain kinds of anti-social behavior result from excessive crowding.²² Attempts at similar research on humans have only begun, and the results are inconclusive. One study, which placed groups of individuals in rooms of different sizes, showed no effects on the performance of tasks. Men in such groups evidently became more aggressive and competitive, but women became more pleasant and less competitive. With men and women together, all effects of density disappeared.²³

Urban areas and central cities do have higher rates of crime and mental illness than rural areas, but efforts to implicate population density have been inconclusive. Other factors, such as income and education appear to be more important than density itself.²⁴

It is just possible that we may come to look at the decline in urban densities as a mixed blessing. In suburban areas, one can identify undesirable consequences of haphazard development at densities which are low relative to central cities. If continued in the decades ahead, declining densities could produce a serious reduction of available open space where we can occasionally escape from the pace of urban life. While our nation is thinly populated relative to many other advanced countries—compare our average of 58 persons per square mile nationally with 590 persons per square mile in Great Britain—it does not follow from this that our population may keep on growing with impunity, or that continuing declines in urban density are beneficial. Such a conclusion fails to reckon with differences in the habitability of the land and differences in the degree to which dense population settlement is supported by international rather than domestic commerce. Furthermore, such a conclusion glosses over the question of whether we would be better off or worse off if our open spaces were filled up with people.

Figure 7.3: Population Density by Counties: 1970