Science in Christian Perspective

Poverty and the Adolescent Parent*
JAMES F. JEKEL
Assistant Professor of Public Health 
Yale Medical School 
New Haven, Connecticut

From: JASA 22 (June 1971): 59-65.

High teenage fertility, poverty, and illegitimacy are found together more often than would be expected by chance. Although a definite cause-and-effect relationship is difficult to prove, most students of the subject believe that poverty is an important underlying factor in high teenage fertility and illegitimacy. There are unfortunate consequences from school age pregnancy, whether it occurs in or out of wedlock. These include reduced health for the mothers and children, and lowered economic and social stability among their families.

Available statistical data are based to show a greater apparent than real difference between the rates of out-of-wedlock conceptions and births among the rich compared to the poor, and among nonwhites compared to whites. This bias gives false support to class pride and to punitive attitudes among many in our land.

Because of certain dominant values in our society, pregnant school girls are ostracized, reducing their chances of finishing high school or of obtaining needed health and social services. The end result is that many slide into a life pattern of high fertility, increasing social dependency, and personal degradation.

It is the responsibility of Christians to work for more and better services to pregnant school girls, and to work to modify society's punitive attitudes toward them. Following Christ's pattern, the emphasis in such cases should be to give real help rather than to ostracize and punish.

Poverty in the United States today is such a gigantic and complex phenomenon that, like the elephant being examined by the blind men, it cannot be fully apprehended from any one perspective. The majority of Americans, moreover, have an even greater sensory limitation with regard to poverty in this country than did the elephant-examiners with regard to their elephant! Most middle class Americans are sufficiently distant from the experience of poverty that they do not view the scenes of poverty, and cannot smell the smells of poverty, hear the sounds of poverty, or sense the pain of it, Michael Harrington was well aware of this when he wrote his classic book on poverty here entitled THE OTHER AMERICA, which is credited with a major role in sparking the War on Poverty.

We could study the problem of poverty by the examination of general statistics on the subject, and they are indeed sobering. For example, in 1966, 20% of our families earned only 5,4% of the national income, whereas another 20% of our families received 40.7% of the total, roughly eight times as much.¹ In 1966 almost one quarter (23.2%) of the families and unrelated individuals in this country had incomes of less than $3,000.² However, the statistics alone cannot show either the cause or the impact of poverty on human beings, and so I have chosen to focus upon one population group, whose problems are closely associated with poverty: adolescent parents.

CHARACTERISTICS OF TEENAGE PREGNANCY
The Magnitude of Teenage Pregnancy

Some persons fear that teenage pregnancy, particularly that which is illegitimate, is on the rise. Their fears are justified or not, depending upon the indicators which are chosen. Thus teenage pregnancy has shown a constant increase for decades in terms of actual numbers, but in recent years this has been due entirely to an increase in the number of women in the teenage category, and not to any increase in the birth rates for this age group. As a matter of fact, the birth rates per 1000 teenage women has actually fallen over the past decade. Between 1955 and 1966 the birth rates to mothers under 15 years of age was constant at 0.9 births per year per 1000 women in that age group, and during the same interval, the birth rate to women between the ages of 15 and 19 actually fell from 90.5 to 70.6 per 1000 women per year.³ In all, approximately 14% of all births in the United States are to teenage women.⁴ Therefore, although the absolute number of births to teenagers is increasing and will continue to do so as the population increases, the risk of pregnancy to a given teenage woman is actually decreasing slightly.

Illegitimacy Among Teenage Pregnancies 

Any discussion of teenage pregnancy must include a discussion of the role of illegitimacy in the problem, because of the relatively high proportion of teenage births which occur out-of-wedlock. The best overall classification of the population of unwed teenage mothers is that of Herzog, who divides the population into two subgroups." The first, or subgroup A, consists of the approximately one third of the mothers who come from the middle or upper socioeconomic classes, are predominantly white, and characteristically do not keep the child unless they marry. They resolve the pregnancy problem in one of three ways: abortion, marriage, or going to another city or a maternity home and putting the baby up for adoption. Approximately 70% of all illegitimate white babies are put up for adoption, and the proportion is even higher among the teenage group. Most of these mothers receive social services, and many receive psychiatric treatment as well. The remainder of the population, group B, consists of approximately twothirds of the unwed teenagers and comes from low income groups (although they are not necessarily on public assistance); they are largely nonwhite.

 Approximately 90% of these mothers keep their babies, in part because there is not a large demand for adoption of nonwhite babies. They seldom seek abortion, perhaps because legal abortions are seldom offered to them, and illegal abortions, if they know where to find them, are frequently too costly.⁶ Nevertheless, sometimes this group does seek illegal abortions, with unfortunate results in terms of maternal deaths (see below)⁷ Prenatal care, when sought, is obtained late and predominantly in public clinics.^8,9 Although their social problems are usually greater than those in the first population group, they are less likely to receive the needed social services, except for the minimal services which may be given to some in connection with their welfare.^10,11

The Magnitude of Teenage Illegitimacy

 It is difficult to discuss this with confidence because of deficiencies in the data. The definition of
an illegitimate birth is not always the same from state to state, and many states neither collect nor report  illegitimacy data. It is impossible, therefore, to obtain illegitimacy statistics for the United States as a whole. Moreover, the statistics from the states which do report illegitimacy show a systematic bias, because women
from the upper and middle income groups are better able to hide the fact of out-of-wedlock conception by abortion, by marriage, or by going to deliver in a state which does not report illegitimacy.

Because of the limitations of the data, all that can he reported are estimates of the illegitimacy problem. As in the case of all teenage births, we see a steady increase in numbers but a leveling off of the rates of illegitimate births. The estimated number of illegitimate births to teenagers has increased from 91,700 in 1960 to 129,200 in 1965.¹² There has, however, been no change in the rate of illegitimate births per 1000 nonwhite teenage women since 1957, and only a slow increase in the rate of illegitimate births to white teenage women during the same period of time. A third indicator, the proportion of all live births that are illegitimate, does show an increase during the past few years. This, however, results from the fact that the total birth rate for this age group has been falling, and the illegitimate birth rate, by remaining relatively constant, has increased proportionately.

Therefore, within the limitations of our data, there does not appear to be an increasing risk of out-ofwedlock births to teenagers. However, as the numbers of teenage births rise, there is a continuing increase in the need for services to these parents and their children.

Most middle class Americans are sufficiently distant from the experience of poverty that they do not view the scenes of poverty, and cannot smell the smells of poverty, hear the sounds of poverty, or sense the pain of it.
Relationship of Early Pregnancy to Income, Education, and Illegitimacy

As a generalization it may be stated that people from the lower income brackets tend to marry earlier, have children earlier, and have more children in all.12 For example, in a recent study in New Orleans, Beasley found that although only 26% of the female population of the city was classified as "poor" by his criteria, this group of women accounted for 56% of the live births, 88% of the "visible" illegitimate births, and 68% of the births to women under 19 years of age).¹³ As a matter of fact, 8 out of 10 of the "poor" women in the study had had their first child before the age of 18.

Another generalization which can be made on the basis of existing data is that the younger the mother, the greater is the risk that her child is born out-ofwedlock. (Table 1).

Table 1. Estimated Illegitimacy Ratios by Age of Mother. U.S., 1965.
        Mother's Age                                      Percent of births illegitimate
Below   15                                                              78.5
             16                                                              56.4
             16                                                              37.4
             17                                                              17.6
             18                                                               13.3

 Source: U.S. National Center for Health Illegitimacy United States, 1940-1965,
Statistics, Trends in Series 21, No. 15.

Race, Fertility, and Illegitimacy

Race is an independent variable associated with teenage fertility and illegitimacy, but it is a difficult variable to interpret meaningfully. Overall fertility rates for nonwhite women are higher in every age category than for whites, and the percent excess of nonwhite fertility over white fertility is highest in the teenage category, where nonwhites have a 69.3% higher fertility rate.

Overall reported rates of illegitimacy among women 15-19 years of age were roughly 9 times as high for nonwhites as for whites in 1965.14 This statistic does not, however, account for the considerable bias produced by the greater capacity of the white population to hide this condition. Therefore, the actual rates of out-of-wedlock conceptions between the racial groups may not be as different as this suggests. Moreover, the ratio of nonwhite to white illegitimate first births was only 5.8, whereas the ratio for second and subsequent illegitimate births was as high as 14.7.

This implies that either the whites are more likely to marry before the birth of the second child, or that they are more likely to use contraception, abortion, or to change their life style. This in turn may well he due to the fact that whites are far more likely to receive the needed services around the first pregnancy than are nonwhites. Herzog states: .

services are far from sufficient and those we do have are not distributed evenly or efficiently. A disproportionate amount of social services have gone to those unmarried mothers who are shove the poverty line, who are white, and who are likely to place their children in adoption.¹⁰

On the basis of these statistics, some believe that the nonwhite population must consider out-ofwedlock pregnancy acceptable behavior. Actually this is not so, and is contradicted to some extent by the fact that one reason many nonwhites seek out services late or not at all is their desire to conceal pregnancy as long as possible.8 There is evidence that out of wedlock pregnancy is not desired by the poor, but that it is tolerated to a greater extent because of its apparent inevitability.

CAUSATIVE FACTORS IN TEENAGE PREGNANCY

It should be emphasized that a statistical association between poverty and high fertility does not necessarily imply that one causes the other, or if one is causal, the association does not prove which one is cause and which result. One could argue that being poor causes one to marry early, or at least have coitus early. On the other hand, early and frequent children produce financial strains on a young marriage or on a young unwed mother. Moreover, both the poverty and the high fertility could result from other factors, such as discriminatory practices in education and hiring. If a man cannot maintain his self-image of manhood because he is unable to find a job and because he is subjected to discrimination over which he is powerless, siring children may be one of the few available avenues for demonstrating his manhood.

Vincent has reviewed the history of ideas about the causes of out-of-wedlock pregnancy, and he finds that one idea after another has had its period of being in "fashion"¹⁵ For example, prior to 1930, there was

The poor do tend to live with a deep sense of fatalism and hopelessness, live on a day-to-day basis without much planning for the future, and live with a general sense of alienation from society at large. There is a sense in which these attitudes are justified by the constant degradation, defeat and powerlessness experienced by the poor.

emphasis upon "theories pertaining to moral and inborn sources of behavior, and the emphasis on immorality, bad companions, and mental deficiency as causes of illegitimacy." During the 1930's there was greater emphasis on environmental sources of behavior, such as broken homes and poverty. During the late 1930's and 1940's there was "interest in the concept of 'culture'," and illegitimacy was considered to be a part of a way of life for certain population groups. Since that time there has been greater interest in psychological and psychiatric explanations of behavior, so that out of wedlock pregnancy has frequently been viewed as the result of emotional problems, or as a means to try to satisfy unmet emotional needs, such as a loving relationship. There is a common misconception that most illegitimate children are the result of "promiscuous" behavior, While it is true that the children are conceived out of wedlock, the relationship which resulted in a child was usually a very meaningful one to the mother, and one which had usually lasted for at least one to two years.° It would seem that many or all of these factors may be involved in the etiology of early pregnancies, whether in wedlock or out. Herzog states:

The factors that so far do not appear to stand up under analysis as the major cause include low intelligence, broken homes, geographical mobility, and phychological or interpersonal disturbances. Any of these factors may he involved in specific instances, but none can be held mainly accountable for the problem. ¹⁰

THE IMPACT OF TEENAGE PREGNANCY

The impact of early pregnancy is felt in many areas, some of which are discussed below:

1. Forcing early marriage. It must he emphasized that all school-age pregnancies are of concern, and not just those which result in out-of-wedlock births. Wallace reports studies which showed that approximately 50% of marriages between two high school students in California involved premarital pregnancy, as did a high proportion of marriages in which the woman was of high school age and the man was older.⁴ This and other factors lead to high rates of unstable marriages among teenagers.
2. Unstable marriages. Wallace states: "The highest divorce rate is in the age group married at 15 to 19 years. The divorce rate is 3 to 4 times higher among those married in their teens than among those married at later ages. It is apparent that a high proportion of teenage marriages are unstable and that there is great need for marriage counseling services in communities."⁴
3. High Neonatal Death Rates. Apart from theJAMES F.
question of illegitimacy, Stine et al. have shown that among Baltimore residents, the younger the mother, the higher the neonatal death rate. The same relationships are found in fetal death rates and prematurity rates.
4. Maternal mortality. Pakter found that in New York City unwed mothers had a higher mortality rate, clue primarily to puerperal infection from illegal abortions.7
5. Repeat pregnancies. The late teenage period is one of the most fecund periods in a woman's life. Beasley's study in New Orleans showed that the "poor" mothers had an average of nearly 5 children by the time they were 26 years old, despite the fact that 60% of them had not wanted more than three children."' More than 90% of the "poor" showed "marked ignorance" about reproductive physiology and family planning, and only 28% had used any form of conception control, compared to 85% of those in his study from the middle and upper income brackets. For the United States as a whole, there are estimated to be almost as many second or higher order repeat illegitimate pregnancies as there are first illegitimate pregnancies. Some studies have found even higher rates of recidivism. For example, in a follow-up study of a cohort of 100 unmarried pregnant teenagers, Sarrel found that over a period of 5 years following the initial out-of-wedlock delivery, they produced 240 more children, or an average of 3.4 children per mother in a space of about 6 years.'7 Some of these children were born in wedlock and some out.

6. Interruption or cessation of education. Stine et al. found that in Maryland

...pregnancy is the most frequent single physical condition causing an adolescent to leave school prior to graduation. More than twice as many adolescent females left school with pregnancy as the stated reason than left school for all other physical or medical reasons.¹⁶

In his New Orleans study Beasley found that those "poor" women who had their first child before the age of 18 "were five times as likely not to complete their high school education as those who delayed their first child until beyond the age of 18."¹³ For the most part, this interruption of education is forced upon the mothers by our society. In 1965 Sauber and Rubinstein reported that the requirement of the New York City Board of Education (which was typical of others around the country) was that pregnant girls must withdraw from regular school attendance until they have had their babies. After their infant's arrival, these women may return to school to continue their education. It is to New York City's credit that it changed these rules to permit pregnant teenagers to stay in regular school throughout pregnancy. Most school systems, however, have not changed their regulations in this manner.

One problem is that, after becoming a mother, it is more difficult to return to regular school. Fatigue, financial problems, fear of ridicule, and especially the difficulties in making adequate arrangements for the care of the infant prevents a large number from returning to school. Sauber and Rubenstein found that only about half of the unmarried school age girls returned to school after their babies were born, and of those who did return about one-third had dropped out again by 18 months without graduating. Until recently there had been almost no attempt in the 27.5 United States to provide a real school equivalent for 21.7 these mothers during pregnancy or to assist them in their return to regular school. One of the earliest attempts was the Webster school in Washington, D. C., described in a study by Floward.¹⁸

We are in a state of crisis regarding our current approaches to providing social, medical, and educational services to our society, particularly to those from minority groups and those who are poor.

7. Financial problems. No data could be found regarding the financial problems of all teenage parents taken together. It is known, however, that a majority of the younger mothers are unmarried, and some data is available for them. Pregnancies to teenage women from middle and upper income families usually end in abortion, giving the baby up for adoption, or marriage, which may be financially assisted by one or both families. Sauber and Rubenstein found that approximately 45% of the unmarried mothers who retained their babies were on welfare at some time during the 18 month period immediately following delivery.⁹ Sarrel found that 60% of his sample of 100 teenage unmarried mothers were on welfare at some time during a five year period following delivery of their first child. However, the belief that illegitimate children form the bulk of children on welfare does not appear to be substantiated, Pakter et al., found in 1961 that: 

contrary to popular opinion, the out-of-wedlock children did not constitute the majority of children on the welfare rolls. Of 193,376 children on the welfare rolls, as of August, 1959, 63 percent were born in wedlock.⁷

 Sauber and Rubenstein found that approximately one-third of the unmarried mothers were working 18 months after delivery, which raises questions concerning completion of schooling, and the quality of mothering. Suffice it to say that for the unmarried teenage mother, and probably for most teenage parents, life is economically difficult at an age when they are frequently ill-prepared to cope with these problems. Financial problems are undoubtedly one of the stresses which contribute to the instability of many teenage marriages.

8. Skills as parents. It is difficult to see how high school age mothers, particularly those who live alone, could become satisfactory mothers without considerable help and support. A high percentage of the younger (unmarried) mothers who kept their babies have come from broken homes.^7,9 These studies, however, do not establish that the percentage is greater than for those from similar socio-economic groups who do not have early pregnancies. Psychiatrists are in essential agreement that both parents are needed in the home for optimum psychosocial development of the children.³⁰ What is not clear is whether or not it is better to have the husband and father around if he is inadequate and is a burden on the family. In all, the research on the effects of fatherless homes is confused, and we cannot confidently assert that a child from a "broken home" is more likely to have problems than is someone from a two-parent home in otherwise similar circumstances. ²¹ As Dr. Rene Dubos has emphasized, man has an amazing capacity to adapt to a large number of different circumstances.

WHAT NEEDS TO BE DONE?

On the basis of the above data it seems desirable for teenagers to postpone childbearing until they are prepared to establish stable homes. Factors which would encourage this, preventing the occurrence of an undesirable condition, would be called "primary prevention" in Leavell's classification of levels of health services.²² The most basic approach to primary prevention is the suhclassificatinn of "health promotion". In the ease of teenage pregnancy, health promotion would involve improving the economic, social, emotional, and educational climate in which children are raised. In fact, Herzog cautions against expecting too much from service programs in the absence of this type of fundamental social change.¹⁰

Still under the category of primary prevention, efforts focused specifically at preventing a particular problem are termed "specific protection". Few programs for the primary prevention of teenage pregnancy have been reported in the recent literature. A few community programs are now offering contraceptive services to teenagers regardless of marital status.^23,24 Garland described an extensive, community wide educational effort in Harlem, which, however, lacked evaluation.²⁵

If primary prevention has failed because an unwanted conception has occurred, then the methods of secondary prevention may be applied. This category also has" two subclassifications, the first being "early diagnosis and prompt treatment". Abortion fits into this category, but as has been mentioned earlier, this is not greatly utilized by the poor. The ethical and religious questions raised by both contraception and abortion have been thoroughly discussed in a report of a symposium entitled BIRTH CONTROL AND THE CHRISTIAN, and will not be discussed here.²⁶

If for one reason or another a teenage mother does not interrupt her pregnancy, programs to meet her needs could be described as "disability limitation" in Leavell's classification. These programs seek to prevent the undesirable medical, social, psychological, and educational results of an existing pregnancy, and to assist the parent(s) to prevent unwanted children in the future. Most existing service programs fall into this category, but unfortunately, with rare exceptions, there has been little careful effort to evaluate their success.^18,19

In providing service programs for young teenage mothers, one must keep in mind that the problems of teenage parents, particularly those from poverty situation, are on at least two levels. The first is the level of circumstances, where one circumstance (i. e. pregnancy) itself creates other circumstantial problems (loss of education, financial problems, conflict with parents, etc.) Thus, effective service programs must provide coordinated assistance to the many problems such as giving medical, social, financial, and educational services.

There is also another level of problems for the school age parents from poverty areas: their life style.
Although these characteristics are sometimes overemphasized, the poor do tend to live with a deep sense of fatalism and hopelessness, bye on a day-to-day basis without much planning for the future, and live with a general sense of alienation from society at large.²⁷ There is a sense in which these attitudes are justified by the constant degradation, defeat, and powerlessness experienced by the poor. Nevertheless, services to parents from this segment of society must take account of these attitudes, and work to build self-respect and self-confidence, so that they can cope with their problems rather than accepting them with resignation. Moreover, the alienation of these people makes them value personal relationships highly, but fear and suspect large, impersonal medical and social institutions. And rightly so, as the sociologist Andrew Billingsley has emphasized, in commenting on the social services provided by welfare departments:

The most far-reaching and characteristic aspect of this service strategy has been the limited programs in seelcted communities, in which very young, upper middle class white female college graduates without any professional training have been hired by welfare departments because they scored high on examination. They have been given caseloads of sixty low income Negro families and told to visit then once a month to see that they were not cheating the government of money and to provide casework services. No one, with the possible exception of politicians and armchair reformers, could consider this a reasonable-to say nothing of maximum-effort to institute a service strategy.²⁸

THE EFFECTIVENESS OF CURRENT EFFORTS

We are in a state of crisis regarding our current approaches to providing social, medical, and educational services to our society, particulary to those from minority groups and those who are poor. There i widespread doubt in government and other circles as to whether we have a clear idea of how to program our efforts to help the disadvantaged. Despite this there has been little effort-at least until recentlyto build careful evaluation into our service programs. Dr. Jack Elinson of Columbia has pointed out the dearth of careful, controlled, prospective studies of the effectivenes of "social action programs on health and welfare."²⁹ He could only find ten studies which met his rather straightforward critera for an adequate evaluative study during roughly a ten year period from the mid 1QSO's to the mid 1960's. And regarding these ten carefully performed evaluations, he comes to the disturbing conclusion that "I think it is not an unduly harsh judgment to make when I say that none of the ten programs of social intervention achieved striking positive results." (Italics his)
It is perhaps not surprising that our current services are less effective than we would desire. Helping people with multiple problems is at best an immensely difficult and sensitive task. Add to this the subtle problems
in communication and understanding which occur between those of different social, cultural, and economic backgrounds, and the opportunities for failure are apparent. Again Billingsley has put his finger on the heart of the problem:

And even in . . pilot projects and intensive service programs, the conception of service has been restricted by the middle class, professional, psychological perspective. The fact is however, we do not know in a professional way what services are required, We have not made sufficient efforts to find not from the people involved.²⁸

It takes more humility than the average middle class professional is able to muster to admit that lie needs help from those he serves in order to be an effective servant. The servant must truly be a servant if he is to be truly effective.³⁰

THE ROLE OF SOCIETY'S VALUES

Proverbs 19:4 tells us that "Wealth maketh many friends, but the poor is separated from his neighbor." This, I would hold, is not a statement of a desirable condition, but rather an astute observation of fact. The poor in our society are, in fact, isolated and alienated, and few more so than the young pregnant teenager.

The poor are isolated because the rich and the middle class have isolated them, by fleeing to suburbs, and by a thousand other more subtle (and often unrecognized) techniques that are lumped together by many under the term "racism". Few feel this isolation more than the pregnant teenager, married or unmarried, who is forced to leave her school as though she had some dread disease. In fact, teenage pregnancy (especially that which is out-of-wedlock) is such a threat to middle class values, that the educational system has sought to get rid of it by ostracism. Pregnant teenage girls are quite literally "outcasts" in our society. One early school for pregnant teenage girls had to be established in an administration building, because the educational authorities didn't even want it in the same building with the rest of the students. They did not want the other children "contaminated". I cannot find justification for this response in the New Testament, In fact, Christ became involved in disputes with the Pharisees over this very point when they condemned Him for associating with "sinners", some of whom were adulterers.³¹ Christ's response speaks clearly to our situation: It is the sick who need the physician, not the well; they need help that they may go and sin no more. But our wealthy society is more concerned to take care of its own, as we have seen above, than to help those in most desperate need. It was clear that the Pharisees were not interested in helping the poor, other than by a certain amount of ostentatious giving (cf. the parable of the good Samaritan). The parallels to our wealthy society seem clear: we will help by paying a certain amount of taxes and by giving to the United Fund, but please stay away from us.

The hypocrisy of the educational expulsion is clear, since only the female suffers this. She is unfortunate enough to show physical evidence of her behavior, but the male, who is often the aggressor in producing the child, is not kept out of school since he shows no evidence. The message to the other students is clear: "It is OK as long as you don't get caught".

Vincent has pointed out the larger hypocrisy of our society in which we "inadvertently encourage, if not explicitly condone, the cause (illicit coition), and explicitly censure and condemn the result (illicit pregnancy) Our society uses sex as a means to profit in all of the mass media, and yet is upset when this stimulation has the probable effect of increasing sexual awareness and activity. The Hebrew-Christian tradition firmly condemns fornication and adultery and I suspect it also condemns the modern use of sex as a tool for profit. Are not our youth being led into temptation?

Not only has our society encouraged youthful sexual behavior through the mass media, while condemning the result, it has also encouraged teenage pregnancy by permitting the problems of poverty in our society to grow to their current magnitude.

But not only has our society encouraged youthful sexual behavior through the mass media, while condemning the result, it has also encouraged teenage pregnancy by permitting the problems of poverty in our society to grow to their current magnitude. This has been allowed to proceed so far because the wealthier groups have caused themselves to be "separated from the poor". Many distorted ideas about the poor have developed within the suburban middle class ghettos, and many have punitive overtones. For example, it is common to believe that the predominant cause of poverty is laziness. Because of this, the government has established a system of welfare based on a fear of rewarding the lazy. The result is levels of public assistance so low as to rob the recipients of any prospect of decent living conditions. The end result is degradation, loss of selfrespect, and hopelessness, which to outward appearances may appear as laziness, but which could more accurately he termed "defeat". These attitudes, of course, mitigate against the poor coping with their current problems, and they are easily passed on to the next generation.

Society fears visible immorality as well as laziness, so that there has been strong pressure upon legislators to reduce the AFDC payments to mothers, particularly the increment for subsequent children, so that the AFDC will not be found to be "rewarding immorality". But in fact, many, if not most, welfare mothers are married, and subsequent children will be the husband's. The net effect of this attitude of middle class society is well summarized by Herzog:

And the few relevant studies available show that giving services and support does not increase them (out of wedlock births). Births out of wedlock do appear to be increased, however, by programs that pot a premium on fatherless homes by refusing aid to families containing an ablebodied man, regardless of his ability to sopport.¹⁰

Billingsley believes that the welfare system, by requiring a recipient family to be without a male head, was more the cause than the result oP the black family disintegration emphasized by Moynihan:

Using 1960 census, Moynihan concluded that nearly 1/4 of Negro families were headed by females. The large proportion of fatherless families led him to conclude that the Negro family was disintegrating and failing to prepare the Negro child to make his way in the world. To fact just the reverse was happening.²⁸

Billingsley discusses the difficulties in removing the punitive attitudes from the welfare legislation in our "Christian" nation:

Even after the focus on services and the interest in family stability entered the national thinking around 1962, and the Congress was persuaded to abandon the custom of requiring unemployed men to desert or divorce their wives in order for their families to be supported, only eighteen of the fifty states have adopted this provision and made it possible for such families to stay together and he supported . . . . Not a single Southern state, for example, has taken advantage of the federally supported option to support dependent children while their father, though unemployed, remained in the home with his family. In many states, the husband and father must not only abandon his family, hot must he gone for a period of time (up to nine t, days in California) before the family can he considered eligible for this federal support. Thus it is clearly not the absence of an income strategy, but the presence of a wholly inadequate kind dysfunctional income strategy, which has failed to stabilize Negro family life.²⁸

Parker's studies in New York City did not support the idea that welfare encourages having more children:

The belief that unmarried women on welfare rolls repeat the pregnancy in order to obtain additional grants is erroneous. Our study indicated that parity for the unmarried Negro and Puerto Rican women was essentially the same whether she was a recipient of welfare assistance or not.⁷

The way out of the present dilemma is likely to he in the direction of providing more, not fewer, services to teenagers.

The solutions to the social problems of today will be no easier than were the solutions to the health problems of a century ago; in fact, they may be considerably more difficult and costly.

CONCLUSIONS

It is my thesis that neither social nor scriptural data support the punitive attitudes discussed above. Rather the scriptural message and the social need would seem to require special efforts to help this group out of the vicious cycles of the problems they face. Before this will really be possible, however, society must change its attitudes, so that fear of rewarding the lazy and immoral does not undermine the efforts to help those in need. Society must also readjust its financial priorities to provide a realistic attack on the conditions which contribute to poverty and family breakdown. These changes are dictated by biblical concern for social justice. The solutions to the social problems of today will he no easier than were the solutions to the health problems of a century ago; in fact, they may be considerably more difficult and costly. But as a society-and as individuals-who claim to hold to the Hebrew-Christian system of values, we cannot do otherwise.

REFERENCES

¹U. S. Bureau of the Census, Current Population Reports, Series P 60, No. 53, Dec. 28, 1967.
²C. S. Bureau of the Census, Current Population Reports, Series P 60 No. 53, Dec. 28, 1967.
³U. S. Bureau of the Census, Statistical Abstract of the United States: 1968, 89th ed., Washington, D. C., 1968. Table No. 58,
⁴Wallace, Helen M., "Teenage Pregnancy," Am.J. Obst. & Gynec. 92(8), 1125-1131, Aug. 16, 1965.
⁵Elirabeth Herzog, About the Poor, Washington, D.C.: Children Bureau Publication No. 451, 1967, pp. 73-75.
⁶Hall, B. E., "Therapeutic Abortion, Sterilization, and Contraception," Am J. Obst, & Gynec. 91, p. 518, 1965.
⁷Pakter. Jean, et al., "Out-of-wedlock Births in New York City," Am. I. Public health 51(6), 846-865, June 1961.
⁸Herzog, E., and Bernstein, B., Health Services for Unmarried Mothers, Washington, D. C.: Children's Bureau, 1964.
⁹Saober, M., and Bubinstein, E., Experiences of the Unwed Mother As a Parent, Community Council of Greater New York, 1965.
¹⁰Herzog, B., "Unmarried Mothers-the Service Gap Revisited," Children 14(3), 105-110, May-June 1967.
¹¹'Teele, J. E., et al., "Factors Related to Social Work Services for Mothers of Babies Born Out of Wedlock," Am. J. Pub. Health 57(8), 1300, August 1967.
¹²Kiser, Clyde V., et al., Trends and Variations in Fertility in the United States, Cambridge: Harvard University Press, 1968.
¹³Beasey, Joseph D., "View from Louisiana," Family Planning Perspectives 1, 1-17. Spring 1969.
¹⁴U. S. National Center for Health Statistics, Trends in Illegitimacy, U.S., 1940-1965, Series 21, No. 15, Fob. 1968, p. 36.
¹⁵Vioccnt, Clarke B., Unmarried Mothers, New York: The Free Press of Gloncoe, 1961.
¹⁶Stine, Oscar C., at al., "School Leaving Doe to Pregnancy in an Urban Adolescent Population," Am. I. Pub. Health 54(1), 1-6, January 1964.
¹⁷Sarrel, P. M.. and Davis, D. C., "The Young Unwed Primipara," Asn. J. Obset. & Gyoec. 95(5), 722-725, July 1, 1966.
¹⁸Howard, Marion, The Webster School, Children's Bureau Research Report No. 2, 1968.
¹⁹Howard, Marion, Multiservice Programs for Pregnant School Girls, Washington, D. C.: Children's Bureau, 1968,
²⁰Lidz, Theodore, The Person. New York: Basic Books, 1968.
²¹Hcrzog, B., and Sudia, C. B., "Fatherless Homes," Children 15(5), 177-182, Sept.-Oct. 1968.
²²Leavell, H. B., and Clark, B. C., Preventive Medicine, New York: McGraw-Hill Book Company, 1958.
²³Gordis, Leon, et al., "Adolescent Pregnancy: a Hospital Based Program for Primary Prevention," Am. I. Pub. Health 58(5), 849, May 1968.
²⁴Siegal, E.. et al, "A Longitudinal Assessment of the Characteristics of New Admissions to a Family Planning Program;' Am. J. Pub. Health 58(10), 1864, Oct. 1968.
²⁵Garland. P., "The Community's Part in Preventing Illegitimacy," Children 10(2), 71 March-April, 1963.
²⁶Spitzer, W. 0., and Saylor, C. L. (editors), Birth Control and the Christian, Wheaton: Tyndale House Publishers,
1969.
²⁷Trlan, L. M. (editor), Low-income Life Styles, Washington, D. C.: U. S. Department of Welfare, no date (circa 1965).
²⁸Bilhingslcy, Andrew, Block Families in White America, Englewood Cliffs, N. J.: Prentice-Hall, Inc., 1968.
²⁹Ehinson, Jack. "Effectiveness of Social Action Programs in Health and Welfare," Report of 56th Ross Conference on Pediatric Research, Columbus, Ohio: Ross Laboratories, 1967, pp. 77-81.
³⁰John 13:16.
^3lLuke 5:29-32, Luke 7:36-50.