Senescence, the Last Half of Life

Before discussing the nature and functions of old age, which chiefly concern us in this volume, we must in a brief, summary way answer two preliminary questions: (1) how many old people are there in the registration areas of the world to-day as compared to earlier times and to the total population; and (2) what is done for them publicly and privately. Each of these topics has a copious literature and experts of its own. On the first or statistical problem there is still great diversity of methods and results, which I simply present and make no attempt to harmonize, for this would be premature. As to the second point, of care, I have also attempted only a bird’s-eye view and avoided details.

I

The population between the ages of 65 and 74 in various countries (1900)114 is as follows: United Kingdom—1,418,000 (including England, Ireland, Scotland, Wales, of which England and Wales have 1,076,000; Scotland, 151,000; Ireland, 191,000); Germany—2,003,000; Prussia—1,185,000; France—2,246,000; Italy—1,435,000; United States—2,186,000.

The percentage of the population 65 and upwards in various countries is: United Kingdom—5 per cent (in England, Wales, and Scotland the percentage is 5 per cent, and in Ireland 6 per cent); Germany—5 per cent; France—8 per cent; Italy—6 per cent; United States—4 per cent.

Allyn A. Young115 gives a table bringing out the following facts, taking the population of continental United States in 1900 as 75,994,575 as a basis:

Solomon S. Huebner116 says a mortality table is a picture of a generation of individuals passing through time. He takes a group of them and traces their history year by year until all have died. The American Experience tables, almost exclusively used for computation by the old insurance companies, contain the following and are based on 100,000 individuals:

American Experience Table of Mortality

In a table headed “Actuaries’ or Combined Experience Table of Mortality”117 we have the following, taking 100,000 persons of ten years of age as the basis:

In a very valuable state report118 collating data from many sources for convenient use by the legislature it appears that the total number of persons 65 or over in Massachusetts by the census of April 1, 1915, was 189,047. It is generally supposed that during recent years the ratio of the aged to the total population has increased, but the tables show that in Massachusetts this did not hold true for the forty years ending in 1915. Mortality rates in most localities have fallen, but improved conditions of life have not affected the ratio of the aged to the total. Still, the duration of life has continuously increased, owing to medical and sanitary science and improved standards of living; and while the younger element of the population has been chiefly affected, the span of life of the aged has also been somewhat prolonged. Hence if this tendency continues the need of pensioning would increase.

A. Newsholme119 presents a table giving the annual death rate, per million persons living, from a few prominent diseases, showing that there is a falling off in the death rate from old age. The author adds: “If this were a real falling off, it would not be an indisputable advantage as most people would prefer to die of old age. The decline under this head, however, is chiefly due to an improved specification of the causes of which the old die.” He gives copious statistics on the causes of death. He also gives an interesting table (p. 237) on the basis of 100,000 of each sex, showing graphically the steady decline in death liability and that the percentage of death is least at 12 and the early teens and soon after begins slightly to increase, falling somewhat more rapidly after 40 and then becoming a little less rapid after 70; while at 90, only 2,000 of the original 100,000 remain alive.

Director Sam L. Rogers of the Bureau of the Census published tables of vitality statistics120 to show expectation of life at all ages for the population of New England, New York, New Jersey, Indiana, Michigan, and the District of Columbia (these being the mortality death registration states) on the basis of the population in 1910 and the mortality for three years. They are like life tables of insurance companies with the exception that they are based on the whole population. According to these tables the average expectation of life for males at birth is 49.9 years; for females, 52.2. Expectation of white males reaches its maximum at the age of 2 (57.7 years). At the age of 12, it is 59.2 years; at 25, 39.4; at 40, 28.3; at 50, 21.2; at 60, 14.6; at 70, 9.1; at 80, 5.2 years. During the first month of life the death rate of native white boys is nearly 28 per cent higher than that for girls. The twelfth year seems to be the healthiest for the native whites and thereafter there is continuous increase in the death rate. Expectation of life is not the same as saying that a man has an even chance of living that number of years, because expectation represents the average remaining length of life at any given age in a stationary population. A native white male child at birth has one chance in two of reaching sixty. At the end of his first year he has more than an even chance of reaching sixty-four. At forty-two he has an even chance of attaining seventy. At all ages women live longer than men and expectation in the country at all ages is distinctly greater than in the city.

R. Henderson’s work121 sets forth the theoretical relations with reference to the duration of human life, describing those mortality tables that have had the greatest influence on the development of the science of life contingency and its applications in this country. The author establishes a connection between mortality tables and mortality statistics and tells how to interpret the latter. The methods of constructing mortality tables from census and death returns and from insurance experience are then taken up. The writer deals only with life contingencies and not at all with monetary applications and gives us a new table. “The present value of a sum of money payable at death cannot be properly calculated in assuming it to be payable at the end of a definite period equal to the expectation of life.” Nor can the present value of a life annuity be calculated by assuming it to be certainly payable for that period.

W. S. Rankin122 tells how he applies vital statistics to sick towns or cities in a way to first restore consciousness by telling them just where they stand relatively with regard to death rates and second to bring about reforms. He has various charts and diagrams. The opinion of prominent people in every community is, in general, that their health conditions are good, but when asked what the death rate is they can give no answer. One community compelled a railroad to build and maintain an expensive overhead bridge at a cost of $1,500 a year to prevent one death and the aldermen appropriated only $150 to prevent fifty deaths. The first thing in treating sick social organisms is to restore consciousness.

Alexander Graham Bell123 in the study of a family which is almost classic found that the average duration of life was 34.6 years; 35.2 per cent of these persons died before they were 20 years of age, and 7.3 per cent lived to be 80 or older. A second danger period was found in adolescence, ending at 23. Both sexes showed an increase of deaths during adolescence. More females than males lived to be 95. But the fathers, on the average, lived longer than the mothers and the children born between four and eight years after the marriage of their parents lived longer than those born later. Those who live to be old come from long-lived parents. The long-lived seem to inherit disease-resisting qualities and also are more fecund than the short-lived. He says124 that in this family mothers who lived to extreme old age had, on the average, larger families than those who died earlier in life, for example, those who died before forty had, on the average, only three to four children apiece. The long-lived proportion is practically doubled when one parent lives to be old and quadrupled when both parents do so. The people who lived to be old represented the disease-resistant strain of their generation and on account of their superior fecundity this quality is distributed largely throughout the population. “A very large proportion of each generation is sprung from a very small proportion of the preceding generation; namely, from the people who lived to old age. The members of the short-lived group come from the short-lived parents. The children of the long-lived parents are on the average stronger, more vigorous, and longer-lived than the children of others, and there were more of them per family.”

Scott Nearing125 says that the years from 45 to 60 or 65 should be the most valuable ones from the social point of view. He reminds us that if the average length of life were doubled the population would in a generation double without any increase in the birth rate. The average length of life in the leading countries of the world varies much. In Sweden, for males it is 53.9; France, 45.7; England and Wales, 44.1; Massachusetts, 44.1; India, 23.0. Men born in America of native white parents live on the average only 31 years; those born of foreign white parents, 29.1 years. Men in the modern cities die when they are one score and ten. There is a great difference in occupations: for shoemakers the death rate per thousand is 8.7; farmers, 11.02; tailors, 13.65; cigar and tobacco makers, 21.67; servants, 21.78; and laborers, 22.3. Such figures suggest the dangerous occupations. As to the length of the working life, from 15 to 65, out of every one thousand males living at the age of 15, 440 will survive to the age of 65, while the rest will have fallen out for some cause. So society has lost more than half its working force at the end of the working period. In the 16th century the average length of life he estimates at 21.2 years; in the 17th, 25.7; in the 18th, 33.6; and in the 19th, nearly 40 years. Finkenberg thinks that in the 16th century it was between 18 and 20 years; at the close of the 18th, over 30; while to-day it is from 38 to 40. We have no data for the United States as a whole that are of any value. Among males in England the average length of life is increasing at the rate of 14 years per century; France, 10; Denmark, 25; Massachusetts, 14. Although these figures are only approximations, Nearing thinks life is probably twice as long as it was a few centuries ago.

Irving Fisher126 says in Europe the span of life is double that in India. The death rate in Dublin is twice that of Amsterdam and three times that of rural Michigan. Life is probably twice as long as it was three or four centuries ago and is increasing more rapidly now than ever. The rate of progress is very variable in different countries, the maximum being in Prussia. Improvement is most in females and the rate of increase is accelerated perhaps four years a century on the whole, although during the last three-quarters of the nineteenth century Fisher thinks it has increased nine years. At least fourteen years could be added to human life by eliminating preventable diseases, which would be the equivalent of reducing the death rate about 23 per cent. In a table he shows that seven of the ninety causes of death are responsible for over one-half of the shortening of life. He gives us a diagram that shows where the saving of life has been and might be greatest. The area between the curves shows that from 1855 to 1897, 550,000 years were saved for a supposed group of 100,000 persons, or 5.5 years per person. The addition of 12.8 years to the lifetime of each of 100,000 persons might be divided into three groups, namely, that of preparation, the working period, and the decline. The chief cause of prolongation is found in new hygienic ideals.

Metchnikoff thought that the lengthening of human life would at once decrease the burden on the productive period, which is some 55 per cent of the total years lived—assuming the working period to be from 17 to 60—and that the latter limit would shift forward. As life becomes complex and as knowledge increases the period of preparation should be prolonged. Men should graduate later. Life should be lived on a larger scale, with more utilization of accumulated experience and less disastrous immaturity. Now we have to force young men into positions prematurely because of their vitality. Metchnikoff says “Old age, at present practically a useless burden on the community, will become a period of work valuable to it.” Human life will become much longer and the par value of old people will become much more important than it is to-day.

Willcox thinks the death rate in the United States is at least eighteen per thousand. Moreover, we have some three million persons always on the sick list, more among the old than the young since morbidity increases in age. But at least one-third are in the working period. The loss by consumptives alone is figured at sixty million dollars. Now, it costs no more to raise a man capable of living eighty years than it does to grow one who has the capacity of living only forty. Health means increased vitality and makes life, in Mallock’s phrase, better worth the living, for health is the first wealth. We can do much to raise American vitality.

Fisher adds127 that in the United States the general death rate has steadily fallen for several decades, as is common in all civilized countries. Many think this means a gain in national vitality. This may be true for the younger age but the “gain has served to mask a loss of vitality at the older age periods. This latter phenomenon, a rising mortality in elderly life, is something almost peculiar to the United States.” In other lands this fall in death rate has been due not solely to the reduction of mortality in infancy and adult life, for most countries have improved their mortality at every age period. Probably this is due to “some unknown biologic influence or to the amalgamation of the various races that constitute our population. It must be ascribed in a broad sense to lack of adaptation to our rapidly developing civilization.” The American decreases in younger ages are not as great as in England and Wales and they change into increase at about the age of forty-five and continue to increase thereafter, while in England and Wales the decline occurs at all ages. In 1900 or thereabouts the death rates in the middle ages of life were heavier in the United States than in Prussia, France, Italy, and Sweden. Since then death rates in the United States at these ages have grown even greater.

Better hygienic methods, according to Fisher,128 started with Pasteur, who said it was within the power of man to rid himself of every parasitic disease. Hygienists have followed this clue. The Roosevelt Conservation Committee in its report on national vitality and the summary of European life tables show that human life lengthened during the 17th and 18th centuries at the rate of only 4 years per century, while during the first three-quarters of the 19th it lengthened almost twice as fast and since that four times as fast, or about 17 years per century. If we could continue to increase life seventeen years a century, the world would soon be peopled with Methuselahs. We are witnessing a race between two tendencies, the reduction of the acute infections, such as typhoid, and an increase of the chronic or degenerative diseases, such as sclerosis, Bright’s disease, etc. The degenerative tendency appears more in evidence here than elsewhere. In Sweden the expectation of life increases at all ages. Even the nonagenarians have more years to live than did those of former days in the United States. We are freer from germs than our ancestors but our vital organs wear out sooner. And this degeneration of our bodies follows that of our habits. In England, where these diseases are not increasing, individual exercise out of doors probably has something to do with it. In Sweden individual hygiene is better cultivated than anywhere else in the world. It is the only land where public health includes private habits and touches the life of the people, especially through the school. The best statistics show that a large number of our young men and women suffer from diseases of heart, kidneys, lungs, and circulation, with impairment enough to consult a physician, that is, over half of our young men and women in active work and presumably selected for their work as fit, are found, although unaware of the fact themselves, to be in need of medical attention; while 37 per cent are on the road to impairment because of the use of too much alcohol, tobacco, etc. Now, a stitch in time saves nine. Thus the lesson to all of us is obvious.

I. M. Rubinow129 says the problem of poverty among the old is connected with inability to find work because productive power has waned forever. American experience in tables of mortality shows that of 100 persons at the age of 20, 53 will reach 65; 12, 70; at which time the average expectation of life will be 8½ years. If we take 100 people at the age of 30, 53 will live to 65; 48 to 70. But this table was compiled half a century ago, although it is still used—to the great profit of insurance companies as expectation has greatly increased. Ten to fifteen years of life over sixty-five are assured to more than half all wage workers. In 1880 the percentage of persons 65 or over was 3.5; in 1890, 3.9; in 1900, 4.2; in 1910, 4.3. The number over 65 per 1000/15 increased from 54 to 60 in 1890, and to 63 in 1910. Employed males over 65 per 1000/15 constituted 50 in 1890; and in 1900, 47. Thus the production of old men is increased while the proportion of old men is declining. In 1880, of all old men over 65 years of age, 73.8 per cent were gainfully employed; in 1900, only 68.4 per cent. The total number of men over 65 in 1900 was 1,555,000. Thus economic progress in ten years meant an additional hundred thousand thrown out of employment. In agriculture, 6.1 per cent of the men employed are over 65; in the professions, 5.5 per cent; but in manufacture and mechanics, only 3.5 per cent; and in trade and transportation, 3 per cent. Thus old men are either thrown out or shifted to unskilled occupations. What does the “iron law” of the increase of old age dependency under a system of wage labor mean? It is wrong to seek the cause in exceptional misfortune or in psychological or ethical feeling. The author of “Old Age Dependencies in the United States” says after sixty men become dependent by easy stages—property, friends, relatives, and ambition go and only a few years of life remain, with death final. The wage-earner is swept from the class of hopeful, independent citizens into that of the helpless poor.

As to the population problem, Raymond Pearl has studied the ratio between births and deaths in France, Prussia, Bavaria, and England and Wales from 1913 to 1920130 and finds that, in general, the birth ratios rose during the war—in England to the 100 per cent mark—and that immediately after the war was over the death-birth ratio began to drop rapidly in all countries. Vienna suffered perhaps more than any other city but made the best recovery, showing how promptly the growth of population tends to regulate itself back toward the normal after even so great a disturbance. Thus the war, which was the greatest depopulator since the epidemic of the Middle Ages, caused “only a momentary hesitation in the steady onward march of population growth.” If we take any given land area of fixed limits, there must necessarily be an upper limit to the number of people it can support, but this limit will be approached asymtotically and the most rapid rise will be midway between the upper and lower limit, namely, at that point where half the possible resources of subsistence have been drawn upon and utilized. The statistician must approach this problem as the astronomer does in calculating the complete orbit of a comet, that is, he must construct his curve from a limited number of specific data. If we study the curve of growth of population in this country, we find that we have long since passed the most rapid rate of increase. If we compare this with that of France, which is an old country and much nearer the upper limit than ours, which started near the lower asymtote only a century and a half ago; or compare it with that of Serbia, which is intermediate, all the statistics available conform with singular accuracy to the theoretic curve.

Professor Pearl concludes that this country has passed the point of most rapid increase, that this rate began to decline about April 1, 1914, when our population was 98,637,000, and that our upper limit will be reached about the year 2100, when the population will be 197,274,000 or nearly double what it is now, with about 66 persons per square mile. Our population will be then far less dense than in many other countries, but the latter are not self-supporting. He even estimates how many calories, vegetable and animal, each individual will require daily and compares this with the agricultural possibilities of the future. Such considerations lead him to stress the importance of birth control. This had long been practiced in France before the war, where the birth- and death-rate nearly balanced, so that industrial development simply raised the standard of living. Germany, on the other hand, encouraged the increase of her population by every means and her scheme was, when the pressure became too great, to facilitate the overflow of her surplus population elsewhere. “A stationary population where birth-rate and death-rate are made to balance is necessarily a population with a relative excess of persons in the higher age groups, not of much use as fighters, and a relative deficiency of persons in the lower age groups where the best fighters are. On the contrary, a people with a high birth-rate has a population with an excess of persons in the younger age groups.”

In his discussion of life tables Pearl starts with that of Glover based on the registration area of the United States in 1910. If we assume an original hundred thousand starting together at birth we note that at the beginning of the second year of life only 88,538 survive. In the next year 2446 drop out; the year following, 1062. At forty about 30,000 have passed away and the line descends with increasing rapidity until about eighty, when it drops more slowly till soon after the century mark all the original hundred thousand have passed away. Expectation of life is the mean or average number of persons surviving at a stated age. Pearl’s diagrams show that the expectation of life of those born in Breslau in the seventeenth century was very much lower than that of an individual born in the United States in 1910, the difference amounting to 18 years. At the age of ten it has sunk to 12; at twenty, to 10 years; at fifty, to 4. But the individual of eighty in Breslau in the seventeenth century could expect to live longer than the individual of the same age now in the United States. The same result is found if we compare United States tables now with those of England in the middle of the eighteenth century, where expectation was also less before and greater after eighty. Pearson’s study of Egyptian mummy cases two thousand years old shows that expectation there was far lower yet through all the early stages of life, although after seventy those who survived had a greatly increased expectation. Thus either man to-day is constitutionally fitter to survive or else he has made himself better conditions up to about the seventh decade. The reason why expectation increased after that period is because conditions were so unfavorable that all but the very most rugged succumbed earlier in life and the proportion of those who reached advanced age was far less than now. In Rome, during the first three or four centuries of the Christian era, the expectation was less yet until nearly sixty, after which it rose, and it is significant that expectation of life was far less under the conditions then prevailing for women than for men at all ages of life, which is the reverse of conditions now prevailing. In the Roman provinces, however, expectation was greater than in the Eternal City. In the Roman-African population, although there was greater mortality to about forty, expectation of life was superior after that age in the early part of the Christian era to what it now is.

In considering life tables that give the number of deaths occurring at each age, which give an S-shaped curve falling very rapidly before the end of the second year and reaching its highest subsequent point at seventy, Karl Pearson finds in this S-shaped curve five components which he typifies as five Deaths shooting with different weapons and with differing precision as the procession of human beings crosses the Bridge of Life. The first Death is a marksman of deadly aim and unremitting diligence who kills before as well as after birth. The second, who aims at childhood, has a very concentrated fire. The third, who shoots at youth, has not a very deadly or accurate weapon but one rather to be compared with a bow and arrow. The fire of the fourth marksman is slow, scattered, and not very destructive, as if from an old-fashioned blunderbus. The last Death plies the rifle, which none escape. Pearl justly criticises this conception because “no analysis of the deaths into natural divisions by causes or otherwise has yet been made such that the totals in the various groups would conform to these frequency curves.” Thus he holds that Pearson’s concept of the five deaths does not represent any biological reality but only demonstrates, as any other equally successful curve would do, that deaths do not occur chaotically but instead “in a regular manner capable of representation by mathematical function in respect of age.”

II

Let us glance briefly at the public and private provisions in different lands for the care of the aged, another large topic with a literature of its own. Here, too, we find great diversity of method and theory which it would be premature to attempt to harmonize. Indeed, so limited is our present knowledge of old age that the available data here also open rather than close most of the great questions about it, although we do seem to be at the beginning of a new era regarding this stage of life. If on the one hand, the length of life is increasing, as we have seen, on the other the intensity of modern life and industry is steadily reducing the age of maximal efficiency so that we feel the handicap of years earlier in life than formerly. The pressure of the advancing upon the retiring generation is ever-growing and if the manual laborer lives longer, he feels the impairment of age sooner. In fact, society is coming to a clearer realization, on the one hand, that youth must be served and conserved and, on the other, is just beginning to see that the same is true of old age.

Not only is the average length of human life increasing as civilization advances but so is the relative and absolute number of old people. Although under the harder conditions that once prevailed those who reached advanced years did so by inherent energy of constitution as the choicest products of natural selection (even though relatively fewer in numbers), it is fortunate that those who now attain 60, 70, 80, etc., are on the average far more comfortable, as well as more numerous than ever before. Not only is eyesight conserved, loss of teeth made good, and many of the ailments of the aged mitigated by modern medicine and hygiene, but by homes, pensions, etc., their lot is made far easier.

Youth tends to live in and for the present and middle life is too absorbing; while the decrepitude of old age seems so remote and its attainment so uncertain that the masses of mankind are still far too improvident of the future. It is somewhat as if our race had developed in tropical abundance where there was little need of providing food, clothing, and shelter, and had not adjusted even to a more northern climate, still less to the complexities of modern civilization and least of all to the increased chance of attaining old age with its infirmities. Still, great progress has been made in foresight and futures play an ever greater rôle in human calculations. The impulse to accumulate possessions itself always has a protensive factor and we cannot amass property without thinking of its safety and its use, and so we lay by, insure and bequeath.

Nevertheless, under the conditions of life in the modern city, and especially since the Industrial Revolution and the employment of masses of women and men at wages that always tend to gravitate toward a minimum, it is impossible for many to save and also to rear families, while intemperance and vice always furnish their quota to the classes that outlive their serviceable years in dire poverty and, as old age advances, become increasingly dependent not only for subsistence but also for personal care. There are still a few students of the social and economic questions here involved who urge that all the aged, even the latter group, should, if possible, be cared for in their own homes by their children and grandchildren and that to remove them to institutions, public or private, not only robs them of interest in life but weakens filial piety and is detrimental to the interests of the family and to the instincts upon which it rests. They urge that all children owe to all parents this return for the care that was bestowed on them during their early, helpless years and that such ministrations are essential for a true and complete home, etc. But even if we grant all this, there still remain the childless old and poor who are alone in the world. There are also the vicious, toward whom their children, with too much reason, feel that they owe nothing, that their own very existence was due to the accidents of passion, and that they were not only unwelcome guests but were made the victims of cruelty, want, etc. Then there are the sick who cannot be properly cared for at home and each additional mouth always means less food for all the rest.

The old most of all need personal provision and suffer most from mass treatment, for they are not a class but are hyperindividualized. Not only do some become old while they are yet young in years, and vice versa, but there is the greatest diversity in food, regimen, and in most bodily and psychic needs. To say nothing of disposition, diathesis, or temperament, the old often develop what seem to others senseless idiosyncrasies that are really expressive of essential traits and require not only kindly consideration but careful study. It is hard for them, most of all for old women, to be deprived of contact with the young and to be confined to intercourse with only those of their own generation. It is also hard on them to be denied the privilege of privacy at will, of having certain things all their own, with a secure place accessible to them alone in which to keep them. For myself I am convinced that the so-called moroseness of old age is largely due to the inconsiderate treatment it receives. Its real instinct is to serve no less than to conserve. Even in the best appointed homes for the aged that I have visited the great need seems to me to be occupation with things felt to be useful and individual exemptions from rigid rules mechanically enforced for all. All have their own tastes, aptitudes, habits, as well as mementos and keepsakes, which should always be respected, and every possible facility should be given not only for visits and correspondence but for current reading in order to maintain a larger surface of contact with the world without. The old thus constitute, in a sense, a privileged and even a new “leisure class,” which Veblen omitted to characterize. The very fact that they have survived means that they have borne the burden and heat of life’s trying day better than those who have died. In a large over-all sense, thus, they survived because they were the fittest and even though they may have wrought solely with an eye to their own personal benefit they have, nevertheless, helped on the world’s work. Our streets, buildings, machines, farms, mines, goods, produce, means of transportation—all these are, in a sense, the bequest of vanished and retiring to future generations, and even whatever stamina their children have is more or less due to their virtue, while their very longevity is perhaps the best of all they have transmitted to their offspring for, as A. G. Bell has shown, fecundity and long life go together.

Again, as the young and middle-aged most often show the energy that impels to migrations, it is often inferred that newly settled lands contain the lowest percentages of old people. This, however, seems to be true only for a very limited period and indeed the reverse may soon come to be the case, for the very vigor that impels the emigrant is a trait of those who will also live long; whence it often comes that after a few decades new territories have relatively more aged people than are found in older communities from which the more viable have emigrated and the less viable been eliminated by death. This is, on the whole, fortunate, because the wisdom that only years bring acts like a balance wheel to regulate the impulsions of youth, which always need to be more or less controlled. Thus, in our Western communities we often observe, along with the most advanced ultra-modern steps in material progress and the newest political devices, a certain conservatism in social mores, creeds, etc., which show not only a stagnation but a regression of culture that is typical of progressive senescence and its psychic retardation.

We do little to fit for old age and so come to it unprepared and uninformed. The senses fail, but usually so gradually that we rarely realize the full extent of our loss; at any rate, we have time to become adjusted and perhaps reconciled to it. The muscles very gradually atrophy, so that all efferent energy declines and we can do ever less. Indeed, in a new and quite scientific fashion we can speak of old age as the “great fatigue,” for Hodge, Dolley, and Richardson and Orr have shown that the changes in brain cells are almost identical in both. Loss of memory for recent events disorients the old from their environment. They forget names and their vocabulary contracts as the brain shrinks. The mental pace slows down. Their feelings and emotions are less intense, while control over them is often diminished. The friends of their youth are dead; their authority is gone; they are not consulted where once they had everything to say. And so they come at last by slow degrees to realize that they belong to a generation that is passed and the little world about them of which they were once so vital a part is neglecting if not actually crowding them aside. If they come to see that things go on very well without them, both they and their environment are fortunate; but alas! for both if they gravitate toward the conviction that as they withdraw all goes wrong.

Nearly every civilized country to-day makes some provision for the aged poor. While they are often cared for along with the infirm and sick in hospitals, or with paupers in poor- and workhouses, or allowed to beg on the street, etc., there are now many charitable funds and pensions, public and private, provided especially for the aged. Most funds for all the dependent classes can also be used for their benefit at home or in institutions; and social and philanthropic work, where it exists, is always ready to consider helpless age, which has its own appeal to sympathy and benevolence. The number of such cases is almost everywhere increasing and so are the provisions for them. As charity has always been praised as a virtue, it is now becoming also a science, and the peculiar nature and needs of old age are being better understood, although there is yet very much to be done in studying this stage of life which has in the past been so neglected and misunderstood. We are now far more ignorant of senescence than of adolescence, childhood, or middle age, but it is quite as unique, on the whole, and more apart than any of these other periods. There is a sense, too, in which those in each stage of life know least of it. The child knows little of childhood, which had to be discovered in this “century of the child.” The second childhood of old age often knows itself only little better. The child cannot, the old will not, realize their age for what it is and what it means.

Our conspectus is as follows:

The first German Old Age and Invalidity Insurance Law dates from 1889 and has been modified since by various supplementary acts so that it is now very comprehensive. These acts were due to the social democratic agitation that prompted Bismarck to set a backfire and thus allay the discontent of the working classes. Old-age insurance has been obligatory since 1889 upon practically all laborers and officials paid under $500 a year and the right to insure voluntarily is extended to others. The employer is held responsible for the insurance of everyone and deducts the workman’s share of the premium from his wages. In 1910 some 14,000,000 out of a population of 60,000,000 were thus insured. The obligation to insure begins with the 17th year and a percentage of the wages must be paid for 1200 weeks. The Empire and the employer also contribute—the former a fixed annual sum of $11.90. There are five wage classes and a special postal service with insurance stamps. It is, however, impossible to obtain from German reports much data for old age alone, which is almost always classed with invalidity and often with accident, sickness, etc. As in every country, there was at first much discussion whether such social insurance should be compulsory or voluntary, contributory or non-contributory, universal or partial, etc., and different countries and agencies have decided these questions differently.

Austria since 1906 had a limited system of old age insurance for certain salaried employees of the middle class. But a sweeping change in the bill in 1908 was intended to include nearly 10,000,000 of the population. Old-age pensions could be paid at 65 to those insured for a period of thirty years. The scheme was worked out in very great detail but, as in other German lands, was a distinctly political measure provoked in Austria by the Socialists, who, as elsewhere, at first hesitated to adopt a measure that gave the Government, to which they had been opposed, the prestige of having realized so many of their own ideas by these measures. The movement soon won many supporters, however, from their ranks. As a political coup it was a great success and most Socialists could find no alternative but to accept it, at least in principle, although criticism of the small and inadequate funds received by the pensioners is common.

H. J. Hoare131 best describes the British Old Age Pension Acts 1908–1911, the scheme of which is as follows: Both sexes, married or single, over 70, of British nationality, who for 12 years out of the last 20 were residents, and whose yearly income does not exceed 31 pounds and 10 shillings, are eligible for pensions. They make no contributions, the money coming from the state. The scheme is worked jointly by the Civil Service and local authorities; and only inmates of workhouses, asylums, inebriates’ homes, prisons, and those who have habitually failed to work are disqualified. The pension cannot be charged or assigned and if the pensioner is bankrupt, the pension cannot pass to a trustee or creditor. The receipt of such a pension deprives of no franchise or privilege and subjects to no disability, as is the case with those who accept the poor rates. In 1913, 363,811 men and 604,110 women were pensioners, 62.5 per cent of all being women. Where the yearly means of the pensioner does not exceed 21 pounds, he or she receives 5 shillings a week; if between 21 and 23 pounds 12s. 6d., 4 shillings a week; and so on through 6 classes, those whose income is between 28 pounds 7s. 6d. and 31 pounds 11s. receiving one shilling a week. As a matter of fact, however, 94 per cent of the pensions are at the full rate. The expense of administering this system is less than half of one per cent of the total amount of pensions.

In 1920, 920,198 old men and women received pensions.132 The chief grievances the old find against this system are: (1) that it does not begin at 65; and especially (2) that it is so little, for, of course, no one can begin to exist to-day on 5s. a week. Both these limitations cause very acute complaint among the beneficiaries themselves.

Practically every other European country has adopted some form of old age relief.133 Denmark in 1891 put in operation a scheme of outdoor relief for the deserving aged poor. This, too, was done as a political move to reconcile radicals and liberals. Its pensionable age of 60 years is, I believe, the lowest anywhere found. The amount of the dotation is not fixed; local authorities decide it in each individual case. It must be, however, “sufficient for support.” Communes and the state bear the expense equally.

Belgium’s Old Age Pension Act of 1900 is a comprehensive scheme of assisted insurance and non-contributory pensions. It aims, first, to encourage workers to save; and, second, to help the aged by special grants. It has its own superannuation fund bank. Annuities rarely exceed $72 and are payable at 65. The pensions are graded according to the age of the insured, and at last accounts nearly a million, or one-eighth of the population, benefited.

France has a voluntary, contributory old-age insurance system administered through a national bank with a state guarantee, which goes back to 1850 but has been much perfected by subsequent legislation. It differs only in detail from the Belgian scheme. The amount of the insurance is not less than $12 or more than $48 a year and may be given in money, hospital service, or provisions. The permissible pension age in France is now 65.

Since 1898 Italy has had a system of voluntary, contributory insurance, subsidized by the state, which provides annuities after the age of 60 if the recipient has paid his dues for 25 years.

The chief British colonies have adopted very wise and comprehensive systems of old age pensions. New Zealand provides a maximum pension of $130 a year in monthly installments to those of 65 who are “of good moral character and have led a sober, reputable life.” Each pension is only granted for a year but is renewable upon request.

The Australian colonies, one after another, enacted old-age pension laws near the close of the first decade of the present century. These grants are made “as a right and not as a charity,” and the commissioner determines the amount of the pension within limits according to what he deems the needs of each case. A special investigation is made for each applicant.

The Canadian system (1908) differs widely from that of Australia. Its preamble states that it is to promote thrift and to encourage individual provisions for old age. The Minister of the Interior may contract with any Canadian for the sale of an annuity, between the limits of $50 and $600, although none can be payable under the age of 55. If the purchaser of an annuity dies before it becomes payable, all of it with compound interest is returned to his heirs. As this system is voluntary, very vigorous efforts were made by organizers and lecturers to bring it to the attention of, and make it attractive to, the people, and these thrift campaigns have been highly educative.

Francis A. Carman134 tells us that the Canadian scheme, like most others, was to alleviate the universal dread of the poorhouse. It was adopted to circumvent the growing demand for the support of old age by the Government. Its unique features are: no forfeiture in case payments are interrupted or ceased, and the annuities cannot be mortgaged, seized for debt, or anticipated. Admirable as is the scheme, there have been less than two thousand to enjoy its full benefits. It has not reached the day laborer but, for the most part, only clerks and teachers.

The United States is the only nation that has no retiring system or provision for old age, even for its employees, save for soldiers and for judges of the Supreme Court, who may retire after ten years of service or on having attained the age of 75 on full salaries. Military pensions go back nearly to the Revolutionary War. There has been much legislation since. In 1908 there were no less than 951,687 pensioners who received more than $153,000,000, the survivors of the Civil War constituting 65 per cent of all. There are also retirement pensions for officers and enlisted men in the regular Army. Officers at the age of 64 must be retired, with no option, on three-fourths pay.

No American state has established any system of old age pensions, although many Southern states provide for Confederate veterans; but many states or cities have provided for firemen, policemen, teachers, and certain other public employees.

Mabel L. Nassau135 personally studied the history of one hundred poor old people in the very heart of New York city and observed them as a neighborhood study, dividing her cases into those wholly or partly self-supporting, and wholly or partly dependent upon their families or upon charity. She stresses the fact so abundantly illustrated that it was impossible for most of these destitute individuals to put by money for their old age. The lives of most of them had been spent in the direst poverty, with low wages, almost no industrial training, long intervals of non-employment, illness often due to malnutrition, not to mention the really not very common effects of drink and vice. They often have little experience in buying and have all their lives been cheated and imposed on. Very many have the finest sensibilities, although this is often not suspected because they lack education to express their feelings. In this stratum of society, although the young are often underfed and the middle aged overworked, the old have the hardest time. The burden of the aged falls hardest upon the children, who must get a work certificate as soon as possible to help feed their grandparents. The old generally have a horror of going to an institution; and many of these are so managed as to justify this dread, separating married couples, imposing senseless rules, providing poor food and perhaps no recreation, and greatly restricting liberties, so that life is hopelessly monotonous, with no incentive for personal effort. The inmates generally have no private place, even a locked drawer, to keep personal effects, so that they can really own nothing. Mills’ hotels seem nearer the ideal. Many systems to help the old involve conditions that amount to dominating their lives. Old age is really a risk to which all are liable and self-respect and thrift require us to give more attention to it. It should be no more of a disgrace to accept a pension for old age than for service in war. State aid assumes that the old have added to the health and power of the state by their work, and recognizes this.

The Baltimore and Ohio Railroad established the first pension system in this industry in 1884 and in the last two decades many corporations, mercantile houses, banks, etc., have established such systems. The above Massachusetts Report supplies many details of fifty of these systems. In the modern business world the problem of dealing with aged employees is increasingly difficult. The use of machinery, specialization, and the modern efficiency ideals have made it increasingly hard for the old to keep the pace and the universal demand now is for younger men, so that many firms actually refuse new men over thirty-five. Men wear out fast. To carry the incapacitated on their payroll is not only not economic but discouraging to the working force and it is not humane to turn them adrift. The general scheme adopted in view of these facts is either voluntary or compulsory retirement at a certain age, with weekly or monthly allowances, the amount of which depends upon the length of service and the wage, the expense of the system being borne by the employer with help from the employee. The economic motives, of course, have been more potent than the humanitarian. It has been good business policy, for it not only prevents the waste of using worn-out men but it stimulates loyalty on the part of the working force. Voluntary retirement is generally at 60 and compulsory at 70, but this varies greatly, as does the time of service upon which aid is conditioned, which is usually from 10 to 30 years. Often the allowance is one per cent of the average wage during the last 10 years; for example, an employee who has worked 40 years at an average wage of $50 a month would receive $20. The system is generally administered by a board composed of both employers and employees. Some firms expressly repudiate all contractual rights.

Inquiry was made in Massachusetts of over a thousand employers but only three hundred and sixty-two replies were received; and of these only four had regular systems of retirement pensions, although often special grants were made. This was a very delicate inquiry and the excuses for the absence of any pension system usually were that the business was itself too insecure or that the working force was too unstable and transitory.

Many fraternal organizations have old-age benefits. But the early history of this movement is strewn with financial wrecks, because the rates were too low and philanthropic impulses outweighed scientific methods. Very few of these organizations had anything that can be called old-age pensions or benefits, although some of them are now coming to do so.

A few trade unions have superannuation features, particularly the International Typographical Union and the Amalgamated Societies of Engineers, also carpenters and joiners. But here, again, benefits are small.

Industrial insurance is really life insurance for small amounts and is designed for wage earners, with premiums payable weekly, collected from homes by agents, and the premiums graded in multiples of five cents. This method really began in London in 1854 and despite initial errors the movement has grown rapidly, so that there are now many millions of industrial policies in force in that country. But only very recently have they attempted specific insurance against old age. Here the premiums usually cease at 65 and the annuity is rarely over $100.

The Krupp Company at Essen had, before the war, one of the most elaborate systems of age insurance, conducted solely for the benefit of the employees and to which the Company contributed largely. The scheme is complex and was often interpellated in the Reichstag, especially on the point of forfeiture of payments of members who leave the firm. Each workman pays 2½ per cent, which is deducted from his wages. The system is chiefly for those who do not earn over 2000 marks a year. Retirement is permissible after 20 years of service or on reaching the age of 65. After 20 years the workman receives 40 per cent of his earnings, increasing yearly by 1½ per cent up to a maximum, after 44 years, of 75 per cent. If he dies, his widow receives half his pension, and each child 10 per cent. If the mother dies, each child receives 15 per cent. The total membership varies from 30,000 to 40,000, and the average pension is 683 marks. A number of other large German industrial concerns have adopted certain features of this scheme.

Most of the Friendly Societies of Great Britain make provision for old age insurance but only to a limited extent, insuring at the same time against sickness, unemployment, providing death benefits, etc. The germ of all such work is found in the medieval trade guilds, and the necessity of it was immensely enhanced by the development of the factory system and what is called the Industrial Revolution.

After 20 years of discussion, the Sterling-Lehlbach Act, passed by Congress and which went into effect in August, 1920, provides federal civil-service pensions for all classes of employees upon retirement. It is contributory and compulsory, requiring each to contribute 2½ per cent of their salaries. The minimum age of retirement is 65; all must retire at 70; and 15 years of service are required for eligibility to an allowance, the annuity running from a minimum of $180 after 15 years of service to a maximum of $720 after 30 years. The scheme takes no account of the amount of salary at the time of retirement and certainly $720 is no inducement to a man receiving $2000 to resign.

In recent years there has been a growing conviction not only that the salaries of teachers must be increased, “but some kind of retiring allowance provided for all public school teachers, if teaching is to become a profession.”136 These are provided by nearly every country of Western Europe; and in 1916, 32 states in this country had made some provision for the retirement of teachers, most of them contributory systems where teachers insured themselves against disability.

Our country, however, is still far behind others in this respect.137 The first city-school system to provide retirement funds was in Chicago in 1893, followed two years later by a New Jersey mutual-benefit plan, and there are now eight or nine types of state, county, and city pension systems in the country. The peculiar difficulty here is found in the fact that one-fourth of our 720,000 school teachers leave teaching every year, making the average term of service four years and causing 185,000 new inexperienced teachers to begin each year. Thus few expect to benefit from such a system and so long as it is voluntary it is utterly inadequate. “While pensions and tenure help to secure and hold good teachers, they also make it possible to free schools with social justice and dignity from superannuated and incapacitated teachers. This is almost as great a benefit as the others to the schools, the children, and society.”

There are two volumes138 which, as Professor H. S. Pritchett well says in an able article on pension literature (Fifteenth Annual Report of the Carnegie Foundation, 1920) “mark the close of one period in the history of pensions and the beginning of a new scientific one.” The most difficult question is the method of calculating the amount of superannuation benefits. If the basis is the flat rate, this is simple; but if it is the average of the salary given during the last five or ten years, or during the whole period of service, the difficulty in determining the amount of actual contributions to yield the prospective benefit becomes very great. Teachers’ salaries are, especially now, very unstable. A pension system based on anticipated pay leaves too much in suspense. It is difficult to provide pensions on a subsistence basis, which also bears some relation to final salary. If the pension is too high, there is temptation to retire too early; if it is too low, to retire too late. Ultimately, too, teachers must be able to migrate without loss or change of status and this would involve reciprocity between different cities and even states. In New York, before the new system went into effect in 1921, there were 2,000 different rates; and in Pennsylvania, 86. The new system of New York, which developed because the old one had settled into bankruptcy, although optional for teachers appointed before 1921 is compulsory for those appointed after and the pension is to consist of half the average salary during the last five years; the payment is not to exceed $800 and this will be paid after 25 years of service. The old view which held that the very word “pension” suggested a cripple and real manhood would compel everyone to lay by for old age, and which flattered those who entered their profession in youth with the hope that in old age they “might be permitted to sun themselves on the veranda of a state poorhouse,” has entirely passed away. But pensions are no longer considered as a form of charity or a form of paternalism, or even as a reward for service. They only demand of the teacher the same thrift as do savings and their proper function is to secure efficiency of service and they should be regarded “as a condition of service just the same as a salary.” Most of even the best recent systems, like that of the District of Columbia and the Y. M. C. A. officers’ pension plan, which is just about to go into operation, are a compromise between the old and the new ideas. The same is true of civil-service pensions in New York state and city.

The Carnegie Foundation for the Advancement of Teaching in 1920 had a total fund of $24,628,000 and its retirement allowances for that year were $875,514.04, with allowances then in force to 555 individuals, or an average to each of $1,568.77. The fund was originally administered solely in the form of gifts but the unexpected number of applicants made it necessary to gradually change to a contractual plan involving very moderate contributions from the institutions benefited, which now include those of Canada as well as of this country. It is one of the most wise and beneficent gifts of the great philanthropist who founded it and its influence in giving permanence in the sense of security to active professors still efficient, and relieving institutions of those past their usefulness to make way for younger men, is unquestionably for good.

The President of the Foundation has grappled with the whole subject of industrial pensions. It was at first planned that the same principles should be applied here as those in the more stabilized professions but this is impossible because of the labor turnover each year, which amounts to 100 to 200 per cent of their employees in some industrial establishments. It is one of the functions of the pension system to reduce the turnover and to secure continuity of service and avoid migrations. Many systems do not provide for the return of the employee’s contributions in the cases of withdrawal or dismissal, or for the use of such contributions for other purposes, so that the fund accumulated would soon, in some cases, run into millions. It does not follow, however, that the opposite tendencies now manifest to seek a solution of the problem in a non-contributory scheme are sound, for this would still encounter the opposition of labor unions, who see in all such schemes a return to feudalism or an attempt to make labor stick to its job by the use of vague promises, to the fulfillment of which the employee himself contributes in the long run in the form of depressed wages. The Metropolitan Life Insurance Company, however, seems to have found a way out and has proposed to “write annuity contracts maturing at the age of 65 under which the pension is purchased each year in small units representing either flat rate or a percentage of salary. The employer, the employee, or both, make a contribution each year toward the pension to fall due on the retirement of the employee,” who receives a bond each year that assures him a pension when he retires, each bond being complete in itself. This scheme costs little to administer and it meets the objection against a non-contributory system, that although pensions defer pay only the employee who survives in the same service until retirement receives the benefit promised, by the provision that this bond is given each year and becomes his property, to be realized at a fixed age in later years.

Frederick L. Hoffmann139 gives us one of the sanest and most compendious summaries of the negative views on this whole subject. Present systems have not eliminated poorhouses or the pauper’s grave. Of the 1,981,208 individuals in the United States over 70, according to the census of 1898, a great majority would welcome a pension; and of all legislation this is most irreversible. On the contrary, old beneficiaries constantly agitate for more. State pension systems, too, do not materially reduce the cost of charitable relief, whether indoor or outdoor. Only in a last resort should the state attempt to do what can be done by private institutions or by private individual foresight and nothing should discourage voluntary thrift of any kind. Where pensions have caused the removal of beneficiaries from asylums or almshouses, the results have generally been unfavorable. Pensions are chiefly of benefit to those not within the scope of poor law administration or private charitable aid. It is just this class which pensions would help that is now most efficient in helping themselves. If the family is at all kept up to its ideal, the young will help the old as they have been helped by them. This is not charity but mutual aid based upon mutual obligation for service rendered and there can be no substitute for this. It is this class that forms the backbone of a nation and which, by even moderate foresight, could provide for a modest support in their old age. The billions of dollars that they have invested in savings banks and in insurance institutions of various kinds show that they are not unmindful of the future. Legislation is needed to stamp out fraudulent enterprises designed to attract small savings on the plea of large returns; therefore, security should be the first consideration in such investments. The prevailing wages should make it possible for the masses of wage earners to provide the support necessary for their old age, at their own cost and in their own way, if they are given sufficient intelligence and motive and could feel sufficient security. To take an example, 5 per cent of a wage of $900 per annum, or $45, commencing with the age of 30 and continuing to 65, would produce an annuity of $450. Of course, the earlier in life the periodical payment begins, the smaller would be the annual amount required to be paid. The fact is that parents who have done well by their children seldom come to grief in their old age, except by special misfortune. Nothing must be done to weaken the virtues here involved. The view that old-age pensions should be given as a right and not as an act of charity is one-sided, because wage workers have not spent their lives in behalf of the state but have sought to aid themselves in their own way and sold their services to the highest bidder.140

L. W. Squier141 tells us that of the 18,000,000 wage earners in the United States, about 1,250,000 reach the age of 65 in want and are not sufficiently supported by public or private charities which, in round numbers, cost the country $250,000,000. Of the 2,000,000 non-fatal accidents Hoffmann estimates per year, the old, to be sure, have somewhat less than their share. The United States Bureau of Labor lately estimated that $220,000,000 per annum is the average the laborer has to pay for medicines alone, not including doctors’ bills, and about 79 per cent of those in almshouses are either physically or mentally defective. Our total pension outlay for the War of the Revolution, that of 1812, the Indian wars, Mexican, Civil, and Spanish, in regular establishments and unclassified, he estimates at $4,230,381,730. Despite the world unrest there are probably ever increasing numbers who look forward to a quiet old age, and we must depend more and more upon inculcating thrift wherever possible and encourage all to earn more than a living wage.

Present-day man, at his best, is certainly far below the standard, for nowhere among wild animals do we find so many with defective teeth, vision, tonsils, bowels, flat foot, etc., and the rejection of nearly one-third of the drafted men for physical unfitness was a most significant fact. The trouble is men will not take pains to prolong life and still shrink from medical examinations at all ages. Some tell us that old people do so most of all, fearing to know the truth about their condition.

This very cursory sketch must suffice to show the increasing interest in and the growing magnitude of the economic problem of old age. But before closing this chapter let us glance at the efforts of the new Life Extension Institute to prolong life and increase efficiency. It is said to be “five per cent philanthropy,” and all those whose lives are insured are to make a definite effort to avoid sickness and defer death. Members are inspected gratis and all others can be for a moderate fee. A regular system of examination for repairs is provided for, just as all manufacturers do for their machines, with a written report to the person’s family physician. At the start the Postal Life Insurance Company turned over to the new organization its well established system of examinations for policy-holders and the Metropolitan Life made an agreement for periodic examinations. The company’s conservation policy leads an impaired man to consult a physician before it is too late, and this, we are told, has reduced the death rate among those examined. They plan to extend this over the whole country. Two-thirds of the profits beyond 5 per cent are to go toward increasing the further usefulness of the Institution. Judge W. H. Taft is chairman of the Board of Directors while Irving Fisher is chairman of the Committee of One Hundred on Hygiene.142