emergencies of illness. Far from it. We must investigate not only the extent of service rendered by these societies, but also its adequacy and efficiency.

RACIAL BASIS OF BENEFIT SOCIETIES

To secure information in regard to the organizations of the foreign born is difficult. The data presented here have been gleaned between the Atlantic and Pacific coasts through many interviews with foreignborn doctors, doctors and members of fraternal societies, and from various articles and reports, particularly those of the Pennsylvania, Ohio, and Illinois Health Insurance Commissions. It is fragmentary, but it indicates the extent to which the foreign born have organized for protection against sickness.

Benefit societies are found in great numbers and are of much importance among the races of the new immigration - the Slavs, Italians, Magyars, Jews, Greeks, and Portuguese. They are usually racial in origin, founded on common language and heritages. In the United States benefits for illness and death play a significant part in membership. These organizations are such an important factor in the lives of the immigrants that American medical and health agencies should recognize and co-operate with them as far as possible.

The data and the impressions secured by our investigators furnish confirmatory and illustrative material from a considerable number of different communities in various parts of the country. For our purposes we have roughly classified societies among the foreign born which include benefit fea

tures into four groups, according to their chief reason for existence.

FOUR TYPES OF BENEFIT SOCIETIES

One type is based upon national or group consciousness. Of this the "Polish National Alliance" and the Jewish "B'nai B'rith" are examples. A major purpose of these societies is to keep alive the love of the homeland or of the race tradition and to aid in securing freedom from oppression for their fellow nationals in Europe. These societies usually have a large membership and are influential.

A second type might be classed as fraternal organizations, such as the Loyal Order of Moose, the Foresters, or the Fraternal Order of Eagles, some of which are international in influence. We usually think of these as American institutions, but many foreign born belong to them, and there are lodges whose whole membership is foreign born. They are not, however, typical of societies developed by the immigrants themselves for self-aid.

Societies of another type, highly developed among the Poles and Lithuanians, are connected with the churches. Mr. Horak remarks in the report of the Health Insurance Commission of Illinois:

Contrary to the general impressions, relatively few societies are connected with churches or have a definitely religious aspect. The chief exceptions are among the Italians and some of the German societies. It should be said, too, that the Catholic churches without regard to

1 Report of the Health Insurance Commission of Illinois, May 1, 1919, p. 524.

race have benefit organizations within them, but these have found no particular place in this study.

The investigations made by this study in several localities other than Chicago establish the connection between certain racial societies and the church. The Pennsylvania Health Insurance Commission also reports several church organizations as carriers of insurance in that state. Among them might be mentioned the "Lithuanian Roman Catholic Alliance of America," the "South Slovenic Catholic Union," and the "Slavonic Evangelical Union of America." These societies come into being primarily for social purposes and aid in sickness is a secondary function. There may be several such societies in a single parish.

The fourth group, reaching intimately immigrants from eastern and southeastern Europe-comprises the small local societies to be found wherever the foreign born have settled. The locals of trade-unions might be included in this group, although they give little aid in sickness. These societies have two general reasons for existence, the proximity in this country of individuals who speak the same language and have the same racial heritage, and their common origin in some village or town in Europe. These societies range in size from 25 members to 700 or 800; and as many as 300 societies among a single race may be found in some of our large cities. One hundred such Italian societies are reported to exist in Boston.

GENERAL CHARACTER OF SOCIETIES

Most of these organizations were formed for social and cultural purposes. The insurance feature, how

ever, has become very important with increased familiarity with the exigencies of life in the United States. Through these organizations both death and sickness benefits are extended to members.

Many employ a doctor to examine all applicants for membership, and all members applying for sick benefits. Others, however, do not bother with a special doctor. The member may choose his own physician and the society will pay a set amount for each examination or visit of that doctor. In some societies medical services are included, not only for members, but for their families as well. In others the doctors employed by the society give free service to society members only, but charge reduced rates to families.

Sick benefits are subject to several limitations in most societies, such as that one week of illness must elapse before benefits are paid, and that membership in the society for a year is required before application for sick benefit is allowed. A two weeks' membership usually secures the death benefit. In some societies the dues are graduated according to age, increasing in amount with the years.

Most of these societies admit men only to membership, some admit men and women, and some women only. The relative scarcity of women members reflects the attitude of the men of the new immigration toward their womenfolk. Among the Italians and Poles there are numerous women's societies organized chiefly for intellectual or cultural purposes. Benefits are attached, but they are of secondary importance.

The number of societies to which an individual may belong is limited only by the size of his pocketbook. An Italian, for example, may belong to one

national organization and several district or village societies in which he may have a right to membership. Dues must be paid to each, and, in case of illness or death, benefits are derived from all, as brought out in an investigation of health conditions in Ohio:1

Many of the miners, perhaps the foreigners more than others, carried sickness insurance in several organizations, so that the statement was frequently made that a man while sick might draw more money in sick benefits collected than he did while well and at work.

Conditions similar to this were found by this study in the mining regions of northern Minnesota and Michigan. Societies differ considerably according to the races represented in the membership. Only the church and the small local organizations will be considered in examining these racial differences. The Poles, Italians, Jews, and Greeks offer the most interesting variations. Much of the data on the Poles and Italians was secured by interviews with families in one of our large Eastern cities. Many of these families could not speak English. More than fifty-five Polish and about forty Italian families were visited and a chat of an hour or so held with each. These interviews have given some interesting sidelights on societies which could hardly have been secured in any other way.

CHURCH, KEYSTONE OF POLISH SOCIETIES

Among the Poles it was estimated that 70 to 80 per cent of the men belonged to at least one society, and

"The Health of Ohio Coal Miners," Ohio Health Insurance and Old Age Pension Commission Report, 1919, p. 375.