During the 19th and early 20th centuries, ordinary Americans erected formidable networks of individual and collective self-help for protection. These social welfare systems fell into two broad categories: hierarchical relief and reciprocal relief. Hierarchical relief was characterized by large, bureaucratic, and formalized institutions supported by donors who usually came from significantly different geographical, ethnic, and income backgrounds than did the recipients. Reciprocal relief tended to be decentralized, spontaneous, and informal. The donors and recipients were likely to be from the same, or closely related, walks of life, and today’s recipient could well be tomorrow’s donor.

Hierarchical relief appeared in such guises as taxfunded alms houses, usually at the county level, and organized private charities. Because Americans of all classes and ethnic groups attached great stigma to dependence on this form of relief, however, few applied for it. In 1880, for example, 1 in 758 Americans was in an almshouse, and by 1903, this number had been reduced to 1 in 920. This pattern of reduced dependence was not limited to almshouses. According to the U.S. Census, in 1904, 1 in 150 Americans (excluding prisoners) resided in public and private institutions, including hospitals, orphanages, and insane asylums. The numbers of Americans dependent on other forms of government relief also were small. As late as 1931, about 93,000 families received mothers’ pensions, the statefunded antecedent to Aid to Dependent Children.

Reciprocal relief was far more prevalent than either governmental or private hierarchical relief. In the United States, it found its most visible expression in the numerous fraternal societies. These organizations were most often characterized by an autonomous system of lodges, a democratic form of internal government, a ritual, and the provision of mutual aid for members and their families. Some examples included the Odd Fellows, the Knights of Pythias, the Sons of Italy, the Polish National Alliance, and the Ladies of the Maccabees. Organizations of women that met these criteria generally embraced the label of fraternal rather than sororal.

The Order of Freemasons was one of the earliest fraternal societies in Europe and the United States. While Masonic legends and ritual claim great antiquity, often embellished with fanciful tales of King Solomon’s temple, the order probably developed from the stone masons’ guilds of England and Scotland in the early 18th century and had spread to the American colonies by the 1730s. The Revolution was a who’s who of American Masonry, among them Benjamin Franklin, Paul Revere, John Adams, and George Washington. By the late 18th century, Masonic lodges, both at the local and state levels, had established relief programs to aid members and their dependents who were in need. Later fraternal societies of all types borrowed much from the structure and practice of Masonry. They imitated its system of decentralized, but affiliated, lodges and embraced key elements of the Masonic ritual, especially its emphasis on different degrees of membership.

With the possible exception of churches, more Americans by the mid-19th century belonged to fraternal societies than any other kind of voluntary association. In 1910, the combined membership of these organizations was at least 13 million. The proportion of Americans who were lodge members is more difficult to gauge. Many individuals belonged to more than one society, and large segments of the fraternal population, such as blacks and immigrants, were often undercounted. A conservative estimate in 1910 was that one third of all adult males over the age of 19 were members.

The Australians and the British developed their own version of the American fraternal society: the friendly society. The first friendly societies, most notably the Manchester Unity of Oddfellows and the Ancient Order of Foresters, appeared in the late 18th century and grew rapidly thereafter. The friendly societies specialized in health insurance, including direct medical care. More than half of all wage earners in Great Britain and Australia may have had access to doctors through friendly societies at the turn of the century.

In contrast to Great Britain and Australia, fraternal societies in America were more likely to focus on the provision of life insurance, rather than health coverage. By 1920, members of these societies carried over $9 billion worth of life insurance. After the turn of the century, however, American lodges increasingly dominated the field of health insurance. They offered two basic varieties of protection: (1) cash payments to compensate for income lost through illness and (2) physician care. Some societies, such as the Security Benefit Association and the Modern Woodmen of America, founded tuberculosis sanitariums, specialist clinics, and hospitals. Blacks, especially in the South, established some of the most successful of these fraternal hospitals, most of which date from the period between 1920 and 1940. One example was the hospital of the Knights and Daughters of Tabor in Mound Bayou, Mississippi. Between 1942 and 1964, it cared for more than 135,000 patients, many of them sharecroppers. In 1944, annual dues of $8.40 entitled an adult to 31 days of hospitalization, including major or minor surgery.

Despite the spread of these black hospitals before and after World War II, the overall growth in fraternal membership had already leveled off by the 1920s and plummeted during the period of the Great Depression. The unprecedented length of the economic crisis made it difficult for members, many of whom were unemployed for long periods, to keep paying their dues. Despite the severity of the Great Depression, few societies suffered bankruptcy or reduced their benefits to members. Per-person benefits for social welfare services were in fact higher in 1935 than in 1929. The numbers of children in fraternal orphanages and homes for the elderly also increased during the worst years of economic decline.

While millions of Americans still belong to societies in the early 21st century, these organizations have shed most of their social welfare services. The sources of fraternal decline have included changing cultural attitudes, restrictive governmental insurance regulation, commercial and employer competition in the provision of services, and the opposition of medical associations that fought, often in league with state regulators, the efforts made by fraternal organizations to offer health care. Additionally, there was another, more subtle, factor at work: the rise of the modern welfare state. It is no coincidence that these societies began to significantly reduce social welfare services in the late 1930s after the introduction of governmental welfare programs such as Aid to Dependent Children and Social Security. Mutual aid throughout history has been a creature of necessity. Governments, by taking away social responsibilities that were once the purview of voluntary associations, seriously undermined these organizations’ reason for being. In the process, much that transcended monetary calculations was lost.

Further Readings

Beito, David T. From Mutual Aid to the Welfare State: Fraternal Societies and Social Services, 1890–1967. Chapel Hill: University of North Carolina Press, 2000.

Green, David G. Working Class Patients and the Medical Establishment: Self-Help in Great Britain from the Mid- Nineteenth Century to 1948. New York: St. Martin’s Press, 1995.

Murray, Charles. In Pursuit: Of Happiness and Good Government. New York: Simon & Shuster, 1988.

Olasky, Marvin. The Tragedy of American Compassion. Washington, DC: Regnery Gateway, 1992.