himself, not unreasonably, as a contributor to social scientific knowledge. Despite a recent volume by Horder on ‘obscurantism’, there were still ‘too many obscurantists about’. Titmuss was clearly in no mood to pander to the Eugenics Society’s traditionalist and, as he saw it, reactionary elements. But he did not entirely dismiss hereditarian ideas. In a concluding passage which embraced a number of his concerns, Titmuss argued that if
we wish to reap a richer harvest – in terms of quality – in the future, when the quantity of our population will be declining, then it is for us not to be content only with weeding out the demonstrably unfit; we must look equally to the improvement of the social environment.18
So in a situation of declining population, a central tenet of Titmuss’s beliefs at this point, the ‘demonstrably unfit’ needed ‘weeding out’. Titmuss gave no indication of who these might be, and who might make decisions about them, on one level a classic example of traditional eugenicist value judgement. On another, though, the need to improve the social environment was unequivocally reasserted.
Many of these issues were addressed in Birth, Poverty and Wealth: A Study of Infant Mortality, which came out in 1943. Prior to publication, Titmuss circulated a draft to leading Eugenics Society members Blacker, Newfield, and Byrom Bramwell, chair of council, and possibly others. In a letter to Bramwell, Blacker remarked of Titmuss’s manuscript that he had been impressed with its argument, and its presentation of statistical material. He agreed with Bramwell, who clearly had also read and commented on the draft, that ‘political’ commentary should be reduced, as the ‘left-wing humanitarians and professional idealists will provide as much of that as we are likely to want’. On the same day, Blacker also wrote to Newfield, noting that the book was ‘original and important’, that he approved of the Society’s financial support, and equally of the decision to keep this quiet for the moment. ‘You and I’, he continued, ‘think that it would be a eugenically desirable thing to reduce or abolish the gradient of inequality.’ But this would not be the view of the older generation, still represented on the council.19 Newfield also provided the book’s introduction. Editor of Eugenics Review from the early 1930s, Newfield was reform minded, described himself as a ‘liberal socialist’, and sought to transform the Review from a journal speaking to the converted to one which embraced debates on issues such as birth control.20 Newfield duly praised Titmuss’s diligence, and suggested that the chances of survival, and healthy subsequent development, for any new-born child depended ‘of course on his congenital equipment’. But he immediately added the important rider, ‘but only in part’. To a ‘very large measure’ survival and development relied, too, on ‘such external influences as the wealth of his parents and their capacity to take advantage of the medical knowledge and social services available for his welfare’.21
In his acknowledgements, Titmuss thanked Morris, Newfield, and the psychiatrist and Society member Aubrey Lewis for their input. He also thanked the Leverhulme Trust and the Council of the Eugenics Society for the grants they had awarded, while stressing that these bodies, and his colleagues, were not ‘in any way committed to my conclusions. For these and for the collation of the data from which they are derived I take the full responsibility myself’.22 Titmuss was being cautious here as he knew, as Blacker had suggested to Newfield, that his arguments would not appeal to more ‘traditional’ eugenicists for whom heredity was all. The Society grant was, meanwhile, effectively a subsidy to the book’s publishers, Hamish Hamilton. Blacker grumbled to Titmuss that the Eugenics Society had not received any review copies of his work, and that ‘our subsidy of £100 was, in the event, a gift to HH’. All in all, the publishers had shown ‘either carelessness or discourtesy to the society’.23 In fact, and as Blacker almost certainly knew, having such a work published without some form of subvention would have been difficult, especially in wartime.
So what arguments did Titmuss put forward? In a sense, the title says it all. Infant mortality was now, as it always had been, ‘a broad reflection of the degree of civilisation attained by any given community’. Carefully laying out his data, Titmuss then addressed the view that extreme contrasts in infant mortality were the ‘outward and inevitable expression of a defective genetic constitution’. The evidence did not support this analysis, however, and so ‘we are left with environment, in the widest sense of the term, as the greater determinant’ of differential rates. Such an approach was backed up by, for example, recent advances in the social and medical sciences. Titmuss conceded that Britain’s infant mortality rate had declined, but noted, too, that it had done so to a much greater extent in other countries, such as Holland. Indeed the relatively poor data for Scotland was ‘sufficiently disturbing to warrant a full-length study’, with Glasgow singled out as a city which had performed extremely badly when compared to, among others, Chicago and Oslo. As to what caused all this, inequalities of income and wealth were the culprits. Not only were the poor more vulnerable to infant mortality, the situation had actually worsened, again a recurring theme in his work. For Titmuss, the ‘inescapable lesson’ of his study was that the ‘infants of the poor are relatively worse off to-day than they were before the 1914 war’. British society was thus, notwithstanding increased social service expenditure, ‘further away from the goal of equalised health than we were thirty years ago’. Was it, therefore, too much to suggest that ‘if the gradient of economic inequality had become gentler with the years, a statistical study of infant mortality would have yielded results very different from those recorded in this book?’.24 Blacker’s observation about how this would be received by more conventional eugenicists is easy to understand in the light of such arguments.
For such traditionalists there was, though, to be no respite. Reviewing the book in Eugenics Review, R.R. Kuczynski told its readers that it was a ‘brilliant study of infant mortality’. Summarising Titmuss’s work, Kuczynski noted the importance of social class, that the situation had actually deteriorated over the past few decades, and that other countries had performed better – here he cited the author’s comparison of Glasgow with other cities. So it was ‘very much to be desired that the conclusions arrived at by Mr Titmuss be universally known’. Parliament, and the general public, were being ‘spoon-fed with complacent statements about the allegedly extraordinary decrease in our infant mortality rate’, without acknowledgement of how much better results had been achieved elsewhere.25 The notice in The Times, meanwhile, was largely descriptive but broadly sympathetic, notably remarking that Titmuss’s findings were in ‘complete disagreement’ with Galton’s prioritising of nature over nurture.26 Kuczynski’s brother, Jürgen, was clearly also a fan. In his capacity as chair of a branch of the Association of Scientific Workers, he suggested a talk by Titmuss on the subject of his book. As the branch secretary told Titmuss, a large proportion of his membership was ‘drawn from the medical and allied sciences, and we feel sure that they would especially welcome the opportunity of taking part in the proposed meeting’.27 It is not clear whether Titmuss did talk to this body, his employment as a civil servant possibly preventing him from doing so, but the invitation indicates the sort of impact the book was having. His old political ally Richard Acland, meanwhile, wrote to ‘congratulate you on the amazing reviews you are getting for your book’ while conceding that he had not actually read it himself, a common enough fate for academic authors.
