about social security and, rather revealingly, that in any case he had given little thought to eugenics for the past two years.17 Nothing seems to have come of Titmuss’s initiative, and the Eugenics Society was not among the bodies listed as having given evidence to Beveridge.
Titmuss’s exchange with Blacker is nonetheless revealing. First, there is mention of his involvement with PEP, an unofficial body undertaking important social research in the 1930s. It is not entirely clear exactly what level of engagement Titmuss had with this organisation. PEP’s practice of, for the most part, publishing its findings anonymously adds to the problems of identifying particular authors. Nor is there any mention of Titmuss in any of its main histories. Nonetheless, he did keep a file of material relating to PEP and knew, or came to know, a number of those actively involved, including Carr-Saunders, and François Lafitte, a leading figure in the organisation in the 1940s.18 There are also at least two pieces in the PEP journal Planning, the first in 1936 and the second in 1940, which show Titmuss-like concerns. The first draws on material which Titmuss was to use in Poverty and Population, while the second makes similar points to a pamphlet he produced for the Army Bureau of Current Affairs, discussed in Chapter 8.19 This piece also cited Poverty and Population. None of this is conclusive, and, given the contemporary interest in population issues, it is unsurprising that similar sources were used, and at least on some occasions similar conclusions reached. But it is suggestive, shows the tight-knit circles in which Titmuss moved, and his association with ‘progressive opinion’, of which PEP was an important part in the 1930s and beyond. Second, why did Titmuss approach Blacker to write a memorandum in the first place, given his own interests in issues of this sort, and his willingness to use most opportunities presented to advance his own research and heighten his own profile? In part, the answer must lie in the fact that by late 1941 he was gearing up to carry out research for the Cabinet Office. Even Titmuss may have felt that doing detailed work for a Eugenics Society submission to Beveridge was a commitment too far, as well as contravening Civil Service regulations.
Government statistics and population health in peace and war
Titmuss had not exactly been idle over the preceding years. We now look at another of his obsessions, the poor quality of government statistical data, and the implications of poor population health, German as well as British, for the impending war. Titmuss’s scepticism about government data was a recurring complaint from the 1930s onwards. Always keen to draw on history, Titmuss was fond of referencing population analysts from as far back as the seventeenth century, such as John Graunt and William Petty, key figures in the creation of ‘political arithmetic’.20 In a post-war review, Titmuss described Graunt and Petty as ‘pioneers not only of medical statistics and vital statistics but of the numerical method as applied to the phenomena of human society’.21 By implication, the virtues of past researchers simply highlighted the vices of contemporary official data collection and analysis. Specifically on the latter, in early 1939 Titmuss wrote to H.W. Singer at the University of Manchester. Singer was a German refugee, one of John Maynard Keynes’s first doctoral students, and later famed for his work on the economics of developing countries. Titmuss had recently read a Ministry of Health report which denied any link between population health and economic distress. This contradicted both his own work and that of Singer. In response, Singer claimed that he knew that the Ministry fought shy of this linkage because of its ‘undue aversion to more refined statistical methods’.22 But while Singer was making a valid methodological point, there was more to it in that political concerns also came into play.
There was a coda to this exchange which reflects well on Titmuss. In July 1940, he wrote to the Ministry of Information protesting about the ‘harsh and altogether shameful policy applied to the internment of refugees’. The government was hypocritical in claiming to seek to defend Europe while behaving in this way, and its actions were having a negative impact on American public opinion. Titmuss explicitly cited Singer’s case. The latter had helped Titmuss in his own work, and contributed to the Pilgrim Trust’s survey Men Without Work, an important study of the corrosive effects of unemployment. But he was now interned near Liverpool.23 Why? Over the preceding two months the German armed forces had had stunning successes in Scandinavia, the Low Countries, and France. This had prompted the government to intern ‘enemy aliens’, that is British-based nationals of countries at war with Britain. By the time of Titmuss’s letter, France had fallen, and British and French military personnel had been evacuated from Dunkirk. The government was also tightening control over society through measures such as the Emergency Powers (Defence) Act, passed in May 1940. Most of the population felt a German invasion to be imminent.24 To take a stand on refugees in this understandably tense atmosphere showed courage on Titmuss’s part, and further evidence of his concern for civil liberties. Around this time Lafitte published an exposure of the treatment of ‘enemy aliens’, which Titmuss reviewed in early 1941. Lafitte’s book reminded British society of a ‘crime we committed in 1940, and for which we have not yet made full restitution’. It was necessary to ‘understand the nature of the war we are fighting, and that we discriminate, not between Britons and “aliens” or between “friendly aliens” and “enemy aliens” in the present way’. Rather, what was required was to distinguish between ‘those who stand for freedom and those who stand for tyranny in every country’. As Lafitte had demonstrated, the refugee issue was ‘indissolubly linked with the whole character and conduct of the present war’.25
To return to official data, in spring 1941, Titmuss, in a piece primarily concerned with inequalities in health outcomes, noted that for over three decades ‘we have relied on a Cost of Living Index based on family budgets collected soon after the Boer War’. While this might have been acceptable down to 1914, a lamentable lack of action ‘during the twenty uneasy years following the Armistice’ accurately reflected society’s failure to understand that the ‘condition of the people must always be at the root of all political doctrine in a democratic system’. The punchy title of this piece was ‘The Cost of Living and Dying’.26 A few months later, in a letter to the BMJ, Titmuss protested about what he called ‘the statistical black-out’ of medical data in England. This was not the case for Scotland, though, where material released showed ‘a serious rise in both infantile and maternal mortality’. Immediate measures were required to deal with these. If the medical profession, and local authorities, were to act effectively, then information was crucial. Should the latter need to be withheld for security reasons, then ‘let the authorities be democratically frank and tell us so’. Either way, the situation should be consistent across the whole country.27
More specifically on the question of population health and war, in 1939 Titmuss was co-author of Our Food Problem: A Study of National Security. Titmuss’s fellow author was Frederick (‘Bill’) Le Gros Clark, despite his blindness a prolific writer, and a leading activist in organisations such as the Committee Against Malnutrition. Le Gros Clark was clearly an admirer of Titmuss, having recommended him, for example, as a speaker on malnutrition to the Medical Society at University College Hospital (UCH) in London.28 As we shall see in Chapter 9, political radicals at UCH were central to the development of social medicine. Titmuss had previously contacted Le Gros Clark suggesting a joint survey of the depressed areas, but the actual