Childhood Accident as a Measure of Social Integration

A partir d‘une recherche anterieure ayant d6montr6 moins d’accidents chez les enfants orientaux que chez ceux de race caucasienne, l’auteur vbrifia et confirma l’hypothese que les enfants orientaux accultul-es sont plus enclins aux accidents que les enfants orientaux non acculturks, Des questionnaires furent expidies par la poste et des interviews furent obtenues des mPres de 151 enfants inscrits A un plan medical d’assurance en Californie. Les donnees indiquent que les enfants accultures de parents accultures sont enclins 2 un grand nombre d’accidents parce qu’on encourage chez eux l’independance et l’esprit d’aventure et que donc ils ont une vie hasardeuse Les donnees ne confirment que partiellement l’hypothese selon laquclle les enfants accultures dc parents non accultures auraient plusieurs accidents parce qu’ils souffriraient des conflits de l’acculturation et quc cet etat de chose les empecherait de se premunir contre les dangers auxquels ils sont expo&. Dans sa conclusion, l’auteur applique les concepts durkheimiens de l’kgoi’sme et de l’anomie a u types d‘accidents. Elle discute aussi des aspects methodologi- ques qui affecteraient la validit6 et la generalit6 de ses conclusions.

Childhood Accident as a Measure of Social Integration * Minako Kurokawa University of Waterloo

According to a study of the California State Department of Public Health,l Oriental children are much less frequently injured than Caucasian or Negro children. This finding presents a fascinating subject to explore not only because of the variability in accident rates, but also because of the broader theoretical implications that are brought forth by cross-cultural studies.

In recent years there has been a growing number of empirical studies about social factors in disease. The available data show that the degree of exposure to the risk of death, morbidity, disablement, delinquency, mental illness and so on, varies among different parts of a population,2 and is frequently related to some aspects of social structure, such as socio-economic status, race, and family structure. In these studies, however, there has been a great gap between areas covered by medical or public health researchers and by social scientists. Very few people have successfully translated structural strains into inter-personal strains and illness. Still less work has been done in systematic analysis of the processes based on a theoretical framework instead of mere complications of available statistics.

The present research is an attempt to establish a “sociology of accidents.” “Accident,” although not easy to de- fine,3 is an observable symptom rather than the hidden expression of strains or of chance mechanisms. It is a form of “concrete” social behaviour suitable for sociological study, and in this article is conceptualized in relation

*This paper was delivered a t the Pacific Sociological Conference, Vancouver, B.C., April 9, 1966.

1Bureau of Maternal and Child Health, California State Depart- ment of Public Health, “Epidemiology of Childhood Accidents,” directed by Dean I. Manheimer, Berkeley, California, 1960-63.

ZJohn A. Clausen, “Social Factors in Disease,” The Annals of the American Academy of Political and Social Science, 346 (March, 1963), 133-148; August B. Hollingshead and Frederick C. Redlich, Social Class and Mental Illness (New York, 1958); F. J. W. Miller et al., Growing up in Newcastle upon Tyne, A Continuing Study of Health and Illness in Young Children within Their Families (London, 1960).

3The definition of the concept “accident” is by no means simple. Suchman, for instance, has proposed to develop a “range definition” rather than a “class definition,” which includes as accidents not only those events that result in bodily injury but also such unexpected and unintentional events a s losing things or forgetting appointments. E. A. Suchman, “A Conceptual Analysis of the Accident Phenomenon,” in Behavioral Approaches to Accident Research (New York, 19611, 26-47.

to the normative system and social integration. “Social integration” here refers specifically to family solidarity against the forces from outside the family such as from children’s peer sub-culture.

There appear to be two basic determinants of accident- rates:* exposure to hazards5 or the extent to which the child finds himself in situations where risk of injury exists and ability to cope with haxardss or the extent to which the child is both motivated and able to control and direct his behaviour in such a way a s to reduce the risk of being injured.

There are grounds for thinking that Oriental families, because of their emphasis on family cohesion, exercise exceptionally close supervision over their children. If so, as Orientals become acculturated to the American way of life, their children may be expected to have a higher accident-rate. Thus, “acculturation” is chosen as the independent variable, and child’s accident experience as the dependent variable. First, let us examine the “exposure-to-hazards” factor.

The chief characteristic of the traditional nonacculturated Oriental family‘ is the formal structure that dedicates the lives of individuals to the continuity and welfare of the family group. In such a complex state of interdependence individual initimative and independent action are prohibited. This essential feature determines the method of child rearing and influences the socio-psychological characteristics of the child: the emotional dependence of the child on the family, and especially on the mother, is openly accepted

*Much of the literature on accidents is dedicated to a search for the physical and psychological characteristics of individuals which increase accident liability. The concepts of the basic determinants of accident were developed in the original study of the Public Health group, “Epidemiology of Childhood Accidents.”

5This concept was derived from industrial and military studies of accident repeatedness.

6Ability to cope with hazards involves the physical, sensory, per- ceptual, cognitive, and motivational characteristics of the child However, in this article, particular attention is called to motivational characteristics. In formulating this concept we are in- debted to many studies of psychological factors in accidents.

The “accident proneness” school represented mainly by psycho- analysts such as Alexander, Dunbar, and Menninger gives some clues to the understanding of the psychological mechanisms with which the child copes with hazards.

7Irene B. Taeuber, The Population of Japan (New Jersey, 1958), Ch. 6, 100-122; R. P. Dore, City Life in Japan, Berkeley and Los Angeles. University of California, 1958, Section 111, 91-190; Yoshi- ham Scott Matsumoto, “Contemporary Japan,” Transactions of the American Philosophical Society, Vol 50, Pt. 1, 1960; Takeyoshi Kawashima, Nihon Shakai no Kazokuteki Kozo (The Familial Structure of Japanese Society) (Tokyo, 1948); Hajime Tamaki, Nihon Kaxuko Seido-ron ( A Theory on the Japanese Family Sys- tem) (Kyoto, 1953); and Takashi Koyama, Gendai Kazoku no Kenkyu (A Study of Contemporary Family) (Tokyo, 1962).

68

and even encouraged;* the structural emphasis upon the descent group strengthens the parent-child relation rather than that of the husband and wife (for instance, the mother seldom leaves the child at home in order to go out with her husband); also, in the large extended family the child can fulfill his needs for dependence and growth in relation to many people who all offer protection from hazards.

If Oriental children are taught to be passive and are discouraged from being inde~endent,~ they are less exposed to hazards than children who are encouraged to take the initiative and to explore their surroundings. On the other hand, such children lack the opportunities to learn how to cope with hazards when they encounter them.

This brings us to the second determinant of the accident rate, the “coping” variable. Once exposed to hazards, the child exercises some control over the risk of injuries by the way he responds to it, the degree of his alertness, and his motivation to avoid injury. If the child is in a state of tension due to some conflict, he cannot be physi- cally alert. Also, if the tension is caused by unresolved needs, it may be much more important for him at the moment to reduce tension than to avoid injury; for instance, an Oriental child who is anxious to be accepted by a Caucasian peer group may do risky things to show off his courage.

A considerable body of literature suggests that normative conflict is experienced by second-generation Ameri- c a n s . * O Parental discipline has lost its effect since the American-born children are more and more influenced by

*Ezra F. Vogel, and Suzanne Vogel, “Family Security, Personal Immaturity and Emotional Health in Japanese Sample,” M a d g e and Family Living, XXIII:2 (May 1961), 161-165; and Charlotte G. Babcock, “Reflections on Dependency Phenomena as seen in Nisei in the U.S,” in Robert J. Smith (ed.), Japanese Culture: Its Development and Characteristics (Chicago, 1962).

9The relationship between the quality of maternal care and child‘s accident involvement has been studied by many researchers: E. Maurice Backett, and A. M. Johnston, “Sociat Pa t t e rn of Road Accidents,” British Medical Journal, (February 14, 1959), 409-413; Vita Krall, “Personality Characteristics of Accident Re- peating Children,” Journal of Abnormal and Social Psychology, XLVIII (19531, 99-107; S. B. Birnbach, “Comparative Study of Accident Repeater and Accident Free Pupils,” Center for Safety Education (New York, 1949) ; A. A. Fabian, and L. Bender, “Head Injury in Children,” American Journal of Orthopsychiatry, XVII (1947), 68-79; Irwin Marcus, “Research with Children Showing Repeated Accidents by Family Study Unit,” (unpublished paper), New Orleans, Tulane University, n.d ; and Harold Jacobziner, “Causation, Prevention, and Control of Accidental Poisoning,” Section on Pediatrics, A.M.A. Annual Meeting, Atlantic City, N.J , June 9, 1959

1oAs Matza points out, the image of these people is one of “drift,” “an actor neither compelled nor committed to deeds nor freely choosing them.” Their basis is an area of the social structure i!i which control has been loosened, coupled with the abortiveness

69

their peers. The traditional values of the parents no longer serve their children, who have seen in America new standards of conduct which contradict the ones taught at home. The break with traditions puts the child’s standards in flux, and creates a social and personal void. Thus, acculturated children of non acculturated parents are likely to experience normative conflict, which may affect their ability to cope with hazards.

Background For this research we used a study population of 404 Oriental children of the Oakland and Berkeley area in California, who were all under fifteen years old and all members of the Kaiser Foundation Health Plan. These 404 children were the Oriental components of the original population of 8,874 children in the Public Health Study.” The Kaiser Foundation Health Plan is a prepaid medical service plan by which members can receive comprehensive medical care at any of several facilities in the area, although the terms of membership encourage the use of a Kaiser medical centre. Members who live in Berkeley and Oakland generally use the Oakland Kaiser Centre so that the medical records there afforded a reasonably complete source of information about the accident history of the study population.

It had first to be decided whether the information was typical of urban children in general. The Kaiser Plan population represents a broad specirum of social classes, although under-representing the wealthy and the indigent. Tn racial composition, the distributions of the Kaiser membership and of the population of Berkeley and Oakland do not differ by more than 3 percent. However, when the total population of the country, or even the urban population, is considered, the Kaiser membership does not reflect the general racial distribution. The proportions of Negroes and Orientals in Berkeley-Oakland are much higher than in other parts of the country, except the South. On the other hand, the occupational distribution of the Kaiser membership does not differ substantially from that of the Berkeley-Oakland, urban, or total population of the country, although the former does under-represent semiskilled and unskilled workers. About three fathers in ten of the Kaiser population are in professional, technical, or mana-

of adolescent endeavor to organize an autonomous subculture. David Matza, Delinquency and Drift (New York, 1964).

Normative conflict caused in the process of acculturation, re- sulting in crime or in neurosis, has been discussed by many people: Thorsten Sellin, Culture Conflict and Crime (New York, 1958); and Arnold W. Green, “The Middle-Class Male Child and Neurosis” in Seymour Lipset and Reinhard Ben= (eds.), Class, Status and Power (Glencoe, Ul., 1953). 1Whk is the study which indicated the lower accident rate among the Orientals than among the Caucasians or among the Negroes. The 8,874 children consisted of three racial groups: Caucasians (a), Negroes (1876), and Orientals (404).

70

gerial occupations, and about one in five is in semiskilled or unskilled labour.

“Accident” in this article is operationally defined as “medically-attended injury.” Based on the analysis of medical records, the number of medically-attended injuries within a specific period of enrollment was used for selecting high- and low-accident samples. Additional factors considered in choosing the sample of 151 children were ethnic group, sex, age, and persistence of the child’s accident pattern over time.12

An accident is a relatively rare event among Orientals, particularly among females. An equal sampling ratio for each accident group was impossible to attain. Thus, for high-accident-group samples, practically everyone in the population had to be included. In selecting the interme- diate group, sampling priority was given to those who had two accidents within a shorter period of time.

In choosing the low-accident children, the length of en- rolment time in Kaiser was considered. Sampling priority was given to those enrolled for a longer period of time. The sample was chosen from among children of the age of ten through fifteen as of 1964. In interviews any age- specific question concerning the child was directed to the time when the child was about ten years old.

Table I Comparison of Population, and Sample Sizes by Ethnic Group, Sex, and Number of Injuries

Japanese Chinese

Male FemaIe Male Female

Number of Injuries

0 30 20 30 20 41 20 55 20

1 24 0 22 0 21 0 31 0

2 16 10 8 8 18 10 16 10

3 or more 16 10 8 8 14 10 5 5 -

Questionnaires were mailed and interviewsl3 given to the mothers of the children in the sample. Questions were mainly concerned with such matters as acculturation, wcio-economic status, attitude toward medical service, family relations and child-rearing patterns, and the child’s personality traits.

W t was intended to choose 160 cases, representing Japanese and Chinese, males and females, and low- and high-accident groups. However, due to the lack of cases of high-accident female children, the sample size turned out to be 151.

13Reprints of the interview schedule and questionnaire are available upon request.

Theory The children in the study were grouped in three categories: Type 1. The acculturated child of acculturated parents. Type 2. The acculturated child of nonacculturated par- parents. Type 3. The nonacculturated child of nonacculturated parents.

We measured the degree of acculturation by using certain indices based on review of the literature14 on acculturation, and on the results of the pretesting. The adoption of these indices and the dichotomization of acculturated and nonacculturated were further justified by the fact that the sample presented a bi-modal distribution on these scales. The mother’s acculturation was assessed by these factors: her knowledge of an Oriental language; the racial composition of her friends; her membership in Orien- tal organizations; her concern with Oriental cultural activities; her subscription to an Oriental paper; the arrange- ment of her marriage; her opinion on the ideal number of children; her habit of leaving her children with a baby- sitter.

The child’s degree of acculturation was assessed by his knowledge of an Oriental language; the racial composition of his friends; his interest in Oriental games; his preference for Oriental food. We set out to test three hypotheses: that acculturated children are more likely to have accidents than nonacculturated children; that acculturated children of acculturated parents (Type 1) are likely to have accidents because they tend to be exposed to hazards; that acculturated children of nonacculturated parents (Type 2) are likely to have accidents since the former do not conform to the norms set by the latter and feel tension, which impairs their ability to cope with

14William Caudill, “Japanese-American Personality Accultura- tion,” Genetic Psychobgical Monographs 45 (Provincetown, Mass., 1952); William Caudill and George De Vos, “Achievement, Cul- ture and Personality: The Case of Japanese Americans,” Ameri- can Anthropobgist, LVI, (1956) ; David Te-ch’ao Cheng, Accultur- ation. of the Chinese in the U.S. (Foochow, China, 1948); Mary Ellen Goodman, “Values, Attitudes, and Social Concepts of Jap- anese and American Children,” in B. B. Silberman (ed f, Japanrsa Character and Culture (Tucson, 1962); Marcus L. Hansen, The Problem of the Third Generation Immigrant (Rock Island, Ill., 1938); D. G. Haring, “Japan and the Japanese,” in Ralph Linton (ed.), Most of the World (New York, 1949); Norman S. Hayner and Charles N. Reynold, “Chinese Family Life in America,” Amer- ican Sociological Review, I1 (1937), 630637; F. L. K Hsu, Clan, Caste and Club (New York, 1963); H. C. Hu, “The Chinese Con- cept of Face,” American Anthropologist, XLVI (1944), 45-64; Kian Moon Kwan, “Assimilation of the Chinese in the U.S. as Explor- atory Study in California,” unpublished Ph.D thesis, University of California, at Berkeley, 1958; and Rose Hum Lee, The Chinese in the United States (Hong Kong, 1960).

Wt is of course necessary to differentiate the types of accidents as related to acculturation types. The kind of accidents which occur among Type 1 children a re likely to be caused by their active interaction with human or nonhuman environments, such as

72

Findings 1. While in many studies, apparent differences in accident rates disappear when racial groups are broken down by social class, this proved not to be the case in the study by the California State Department of Public Health. This leads to the conclusion that race seems to be a more important determinant of accident experience than father’s occupation.

Table 11 Childhood Accident R a t e by Father‘s Occupation and Race

Father’s occupation Average number of accidents per year per thousand children

Caucasian Negro Oriental Rate Number Rate Number Rate Number

276.9 2335 236.5 95 149.1 la Professional, technical, managerial

Clerical,sales, skilled labour 260.0 2462 181.6 514 268.0 137

Semiskilled, unskilled labour 256.6 696 193.3 1018 W.8 72

~ ~ ~

Other: deceased, not living

occupation unknown with family, retired, 262.7 841 190.0 249 138.0 34

Source: Dean I Manheimer et al., “A Descriptive Analysis of Nonfatal Injury Records of 8,874 Children,” California State Department of Public Health, Berkeley, n.d., Table III, submitted for publication to Public Health Reports.

Rates shown are standardized for age. Number of children shown are those enrolled for at least one four-year period. Father’s occupation is according to the time of the child’s enrol- ment in the Kaiser Plan.

2. The first hypothesis (that lacculturated children are likely to have more accidents than nonacculturated children) was proved. Table III indicates that Type 1 children are likely to have m’my accidents. What is striking is the extremely high correlation between Types 2 and 3 and accident-rate, particularly among girls. Thew is not a single nonacculturated child who has had more than two accidents during two or more of the specified two-year periods. This is a significant finding, yet also provides a starting point for further testing. Details of methodolog- ical issues will be discussed later.

3. To prove the second hypothesis (that acculturated children of acculturated parents are likely to have many

injuries caused in sports. Accidents in Type 2 are likely to in- volve interpersonal conflicts, such as injuries due to fighting with other children, or s e l f - a c t e d injuries due to fighting with other children, or self-afflicted injuries due to frustration. Such a classification of accidents has to be derived from the examination of the events leading up to accidents. In the present research it was not possible to delve into this aspect but a further elabora- tion of the accident typology is being planned.

Table I11 Distribution of Acculturation Types by Sex and Accident Rate (in percent)

Accident Numbers of Male Female rate injuries Type1 Type2 Type3 Type1 Type2 Type3

High 2 or more 66 75 0 69 100 0

Low none 34 25 100 31 0 ,100

Total 100 100 100 100 100 100 (Number) (38) (20) (22) (32) (9) (30)

accidents because of greater exposure to risk) we had to examine “exposure” factors both in child-rearing and child personality. To do this we formulated two sub- hypotheses: first, that training in independence is likely to be related to the high-accident rate because i t increases the exposure of the child to hazards, and secondly, that an active, gregarious, independent and daring child is more likely to be exposed to hazards and hence have more accidents than an inactive and dependent child, and that such a child is more likely to be found among Type 1 acculturated children.

First, training in independence: We judged this on the basis of the mother’s preference for the equalitarian to the maternal role; her permissive attitude toward the child’s risk-taking activities; the child’s role in decision- making; and the mother’s masculinity-demand on the child.

We found that acculturated mothers (Type 1) say that they prefer to assume an equalitarian role in relation to

Table IV Child-Rearing Practice and Childhood Accidents by Sex and Acculturation (in percent)

Male Female

H L H L H L H L H L H L

N:25 13 15 5 0 22 22 10 9 0 0 30

Prefers maternal role 24 46 93 (3)a 0 92 32 30 (9) 0 0 90

Takes permissive attitude 96 69 67 (5) 0 18 100 30 (7) 0 0 7

Demands masculinity 88 38 47 (2) 0 18 91 60 (3) 0 0 10

Decision-making Authoritarian 4 O n t o ) 0 1 8 0 O ( 1 ) 0 0 7 Decisive 8 23 33 (0) 0 45 5 0 (61 0 0 57 Keeping final Work 8 15 27 (2) 0 23 9 10 ( 2 ) 0 0 30 Equalitarian 28 15 13 (3) 0 9 23 30 (0) 0 0 3 Voicing opinion 20 38 0 (0) 0 5 18 60 (0) 0 0 0 Laissez-faire 16 8 0 (0) 0 0 38 0 (0) 0 0 3 Negligent 16 0 O ( 0 ) 0 0 9 O ( 0 ) 0 0 0

&Where the sample is too small, absolute figures are given in parentheses instead of the percentage.

74

their children. They tend to see the child as a friend or companion and take great pride in being able to “share” his or her activities. They feel uncomfortable when they must be strictly “mothers,” such as when the child requires discipline, or displays dependence needs.

Nonacculturated mothers are more likely to assume maternal roles. They let the child know who has “senior- ity” and are distressed by disobedience. Their relation with the child is accompanied by the knowledge and feel- ing that they are doing something primarily for the good of the child.*6

The association of high accident rate and preference for the equalitarian role in each acculturation type is not statistically significant. Type 2 high-accident boys are more likely to have mothers who prefer the maternal role than low-accident boys, but the sample size is too small to be conclusive.

The way in which the maternal or equalitarian role is related to the rate of childhood accidents is in the degree of maternal protection. The equalitarian mother is likely to be permissive, which would increase the child’s exp+ sure to risk situations. (Tetracoric correlation coefficient +.75.)

Acculturated mothers are more likely to be permissive towards their children. They take a hands-off attitude towards what the child wants to try. They allow the child to take risks at an earlier age and do not keep track of where he is and what he is doing. In general, they do not set many rules to control the child’s activities such as bedtime, watching TV, making noise at home.

The Type 1 high-accident child tends to have a permissive mother. This association is stronger among girls than among boys: if the mother is permissive, girls are more likely than boys to have accidents (statistically significant at .05 level by chi-square test).

Mothers of Type 1 high-accident children are likely to have a laissez-faire or almost negligent attitude to decision-making. Typically they say, “I don’t Care what the child decides to do.” Low-accident children in Type 1 are found in the middle range, that is, their mothers have neither an authoritarian nor a negligent attitude to decision making. Mothers of both Type 2 high-accident and Type 3 low-accident children are likely to assume an equalitarian role and to tell the child what to do.

In Type 1, both male and female children whose mothers score high on the masculinity demand” scale are signifi-

W e e the description of the scale of “maternal vs. equalitarian role” in Public Health Study (unpublished paper available a t the California State Department of Public Health).

17This scale consists of two dimensions: a) the extent to which the mother denigrates caution or admires risk-taking of the child; b) the extent to which the mother demands the masculine role of a son, and the feminine role of a daughter. An example of the latter may be: “Something is wrong with a fivcyeax-old boy who plays with dolls.”

75

Table V Child Personality and Accident Involvement by Sex and Acculturation (in percent)

Index Male Female

Type1 Type2 Type3 Type1 Type2 Type3

H L H L H L H L H L H L

N:25 13 15 5 0 22 22 10 9 0 0 30

Gregarious

Independent

Venturesoma

Athletic

80 54 20 (5)a 0 36 82 100 (2) 0 0 13

84 69 27 (5) 0 23 82 100 (3) 0 0 13

72 38 73 (2) 0 14 59 30 (5) 0 0 7

56 46 13 (0 ) 0 27 82 50 (0) 0 0 17

aWhere the sample is too small, absolute figures are given in parentheses instead of the percentage.

cantly more likely to have a high accident rate. In Type 2 the masculinity demand is fairly low for high-accident children.

Secondly, the exposure factors in child personality and behaviour: We assessed these on the basis of his independence, venturesomeness, athletic ability, and on the frequency of his interaction with other children.

Among Type 1 boys the hypothesis holds that high- accident boys are more likely to be gregarious, independent, venturesome and athletic, while among Type 1 girls the relation is reversed in terms of gregariousness and independence. Type 2 high-accident children, on the other hand, are likely to be nongregarious, dependent, and nonathletic. Type 3 children are likely to be nongregarious, dependent, nonventuresome and nonathletic.

Thus, the hypothesis of acculturation and “exposure” variable are fairly well supported among Type 1 children with regard to child-rearing and child personality.

The third hypothesis (that acculturated children of nonacculturated parents are likely to have many accidents) led us to examine the factors affecting the child’s ability to cope with hazards. Again, we formulated two sub-hypotheses: first, that children who are frustrated in the family situation are likely to have accidents, and such frustration is likely to be caused in the child who is pulled by two sets of contradictory norms; and, second, that a maladjusted, frustrated, and aggressive child is more likely to have accidents than a well-adjusted, nonaggressive child.

First, frustration in child-rearing: We assessed this on the basis of the mother’s prohibition of child’s aggressiveness; her authoritarian punishment; the father’s authoritarian attitude; a cold and detached father-child attitude; a cold and detached family relation.

We found that one of the reasons for frustration experienced by Type 2 children can be that they are prohibited from expressing aggression or asserting their rights against their traditionalistic parents. However, our data show that both Type 1 and Type 2 mothers of high-accident

4.

76

Table VI Child-Rearing Practice and Childhood Accident by Sex and Acculturation (in percent)

Index Male Female

H L H L H L H L H L H L N:25 13 15 5 0 22 22 10 9 0 0 30

Encourages aggression 88 8 80 ( 2 ) a 0 0 91 20 (7) 0 0 13

Mother’s punishment Spanks 0 0 7 ( 0 ) 0 0 0 O ( 0 ) 0 0 0 Yells 76 8 27 (0) 0 0 41 0 (0) 0 0 0 Gives extra chores 16 15 0 (0) 0 14 23 40 (0) 0 0 17 Refuses to talk, tells child that he should be ashamed 8 31 53 (1) 0 55 5 0 (7) 0 0 27 Reasons with child 0 49 13 (4) 0 32 27 60 (2) 0 0 57 Ignores the incident 0 0 O ( 0 ) 0 0 5 O ( 0 ) 0 0 0

Close father-child relation 28 92 53 (5) 0 91 24 70 (3) 0 0 93

Close family relation 16 46 67 (4) 0 60 9 20 ( 8 ) 0 0 97

Father’s punishment Non-disciplinarian 36 0 0 (0) 0 0 45 0 (0) 0 0 3 Unexpressive 24 8 13 (0) 0 14 27 0 (0) 0 0 17 Entrusting to mother 12 15 7 (0) 0 14 14 0 (0) 0 0 27 More lenient than mother 12 37 7 (3) 0 32 14 40 (3) 0 0 20 As strict as mother 0 3 8 O ( 0 ) 0 2 7 0 6 0 ( 1 ) 0 0 7 Stricter than mother 8 8 2 7 ( 2 ) 0 1 4 0 O ( 2 ) 0 0 2 7 Authoritarian 8 0 4 7 ( 0 ) 0 0 0 O ( 3 ) 0 0 0

~~

aWhere the sample is too small, absolute figures are given in parentheses instead of the percentage.

children are more likely to encourage aggression or to be permissive about it. Detailed analysis indicates that Type 1 mothers positively encourage their children to assert their own wills, to “stick up for one’s rights,” while Type 2 mothers are likely to accept passively the fact that their children are aggressive. In Type 3 no mother encourages aggression.

Mothers of Type 1 high-accident children often resort to “yellirig.” These mothers are acculturated and feel free to release tension by expressing their feelings. On the basis of a content analysis, mothers who are frustrated for some reason employ irrational acting-out methods such as “yelling.” Mothers of low-accident children employ rea- soning as the method of discipline.

Among Type 2 and 3 boys, the “shame” method is used frequently. Whether this induces anxiety and frustration as claimed by Gorerls and others remains to be seen. At any rate, in Type 2, the “shame” method is related to a high accident-rate, while in Type 3 it is used by mothers of low-accident children.

IsGeoffrey Gorer, “Themes in Japanese Culture,” in Bernard S . Silberman (ed.), Japanese Character and Culture (Tucson, Ari- zona, 1962).

77

Among Type 1 high-accident children, fathers tend not to participate in disciplining mainly because they are away from the children most of the time, attending conferences or engaging in social activities outside the home.

A sizable proportion of Type 3 fathers also do not share the task of disciplining, but their reason is different from that of Type 1 fathers: they consider that child-training is a mother’s job, and maintain an attitude that is unexpressive and detached, although not necessarily authoritarian.

Type 2 high-accident fathers are reported by their wives to be stricter disciplinarians than the wives, and to tend to be authoritarian. This supports our hypothesis that Type 2 children tend to harbour frustration and aggression against their authoritarian fathers. However, of Type 3 fathers with low $accident children, a fairly large percentage employ strict disciplinary measures, although the percentage is smaller than that among Type 2 fathers. Both being traditionally oriented, Type 2 and mpe 3

fathers basically take similar attitudes toward child-training. The question is whether there is a substantial difference in disciplinary methods of Type 2 and Type 3 fathers or whether the differences lie rather in the children’s perceptions of disciplining. Some Type 2 acculturated children may be rebellious against the image of a traditional father even if he is not a dictator. This kind of father-child relation may be perceived by the mothers as a conflict, and the mother may report the father as being authoritarian.

It should be noted that 17 children of Type 2 seem to have psychological tensions, according to the mothers’ reports. A case study showed that the fathers of 10 of these 17 children were reported to be authoritarian, even more strict than the mothers. This suggests that the notion of frustration-induced accidents is applicable only to this small number of children in Type 2.

Fathers of low-accident children in Type 1 participate in disciplining with almost the same severity as their wives. Thus, the total picture of the father’s disciplining and the accident rate is curvilinear. On both ends of the punishment scale, there is a higher rate of accident.

Type 2 high-accident children are less likely to have close relation with their fathers than Type 3 children. However, in comparison with Type 1 high-accident cases, there is a fairly large proportion of Type 2 children who have close relations with their fathers, and hence experience less tension at home than Type l children.

Concerning family relationships in general, Types 2 and 3 are hardly distinguishable from each other, since both have close family integration. We cannot assume that Type 2 children suffer from tension and conflict within the family. This finding is in direct opposition to the original hypothesis about acculturation conflict in Type 2. A possible interpretation may be that Type 2 includes some maladjusted children who act out their frustration toward themselves.

78

~ ~

Among Type 3 families, the child seems to be the centre of attention. Parents seldom do anything without the children. They actively participate in formal or informal activities to which they can take the children. When the question was asked “What does your son do with his father on Sundays?” most mothers could not answer because they did not think of father and son as individuals, the unit of activities being the family as a whole. The father tends to stay at home evenings, watching TV, playing chess with family members, or just being with the children.

Secondly, the factors in child personality and behaviour that affect his coping: We judged the child’s psychological tension by his aggressiveness to his peers and his mother; his desired image at school: his disobedience to his parents; necessity of frequent punishment by parents; the child’s resentment of punishment; his tendency to pout and sulk; and his tendency to hurt himself when angry.

The first hypothesis holds valid not only for Type 2, but for Type 1 children, although among the Type 1 girls the correlation is not significant. Type 2 children who have many accidents are found to be more aggressive than Type 1 high-accident children.

There is a sizable number of nongregarious and dependent children in the Type 2 high-accident group. These children tend to be aggressive. Hence the concept of tension-induced accident applies only to this group of children. These children turned out to be the ones who seek popularity more than anybody else.

5. So far we can see that “accidents” defined as “medically attended injuries” are highly correlated with the degree of acculturation. The artificial device of acculturation types fits into the accident rate so neatly that some doubt may arise about the validity of the indices.

The most crucial factor which might have a spurious effect on the correlation is the mother’s attitude toward medical service. A high-accident rate may simply mean that the mother is more ready to take the child to the doctor for minor injuries. This is a particularly important consideration for the Oriental people who are noted for their reluctance to go to hospital.

One way of examining the degree of predisposition to medical service is to compare racial groups by their ratios of severe injuries against all medically-attended injuries. If parents make frequent visits to the hospital for minor injuries, the ratio should be small. However, no statistically significant nor consistent difference in ratios was dis- covered according to race and occupation.

Next, a scale of predisposition to medical care was developed based on the following hypothetical questions : “What would you do if your child were six years old and had a rash on the face and the neck; swallowed a small, smooth glass bead; had a bad stomach ache, etc.? Would you: take the child to a doctor at once? treat it your- self? etc.”

There was no significant correlation between medical predisposition and accident rate in any of the subgroups

79

Table VII

Ages Professional Clerical Labourer Other (by race) Boy Girl Boy Girl Boy Girl Boy Girl

Birth through age 3 White 0.10 0.11 0.11 0.10 0.13 0.07 0.12 0.13 Negro 0.13 0.06 0.09 0.14 0.12 0.12 0.11 0 . a Oriental 0.00 0.06 0.17 0.10 0.20 0.00 0.00. 0.00

Ages 4 through 7 White 0.13 0.13 0.15 0.12 0.19 0.11 0.15 0.16 ’Negro 0.00 0.00 0.11 0.17 0.16 0.17 0.08 0.28 Oriental 0.30 0.20 0.00 0.13 0.W 0.20 0.00 0.00

Ages 8 through 11 White 0.17 0.18 0.17 0.19 0.19 0.17 0.16 0.14 Negro 0.19 0.00 0.21 0.17 0.22 0.12 0.10 0.15 Oriental 0.14 0.20 0.00 0.13 0.29 0.25 0.22 0.00

Ages 12 through 15 White 0.23 0.15 0.22 0.15 0.19 0.23 0.20 0.08 Negro 0.29 0.00 0.17 0.20 0.n 0.19 0.14 0.00 Oriental 0.20 0.00 0.22 0.00 0.00 0.00 0.00 000

Ratio of Severe Against All Injuries for Eeach Age-Period by Sex and Father’s Occupation (N: 8,874)

-

Discussion

Source: Dean I. Manheimer, Progress Report, California State Department of Public Health, December 10, 1962.

divided by sex and acculturation except in the female nonacculturated group. The nonaccultured mothers (Type 2 and 3 ) who are predisposed to medical services are more likely to have high-accident daughters. This partly ex- plains the high correlation between acculturation type and accident rate. It means that the high-accident rate in Type 2 girls is not entirely accounted for by the acculturation of the children, but is in part the result of their mothers’ greater willingness to take them to a doctor.

Basically this article has attempted to relate the independent variable “acculturation” to the dependent variable of “accident experience” of children. A number of other variables such as family structure and relations, child- rearing patterns, child personality traits and behaviour, are used as intervening variables. At this preliminary level of the research, it is difficult to formulate a neat theory to systematize the findings. Existing theory in sociology offers no ready-made solution. However, it will be worthwhile to explore the possibilities, and perhaps two of the most important guideposts are Emile Durkheim’s concepts of anomie and egoism.lg

IgEmile Durkheim, Suicide, translated by J. A. Spaulding and G. Simpson (Glencoe, Ill., 1962); Talcott Parsons, The Structure of Social Action (Glencoe, Ill., 1961) ; Bruce P. Dohrenwend, “Durk- heim’s Egoism, Altruism, Anomie, and Fatalism,” American So- ciological Review, XXIV, 4 (August 1959), 466-472; Jack P. Gibbs,

80

Percentage of Mothers Predisposed to Seek Medical Care by Accident Rate, Sex, and Acculturation (in percent)

Male Female

Acculturation High Low High Low accident accident Total accident accident Total

Acculturated 7‘0 (no.)

47 48 47 49 48 50 (25) (13) (38) (22) (10) (32)

Non-acculturated % 18 13 16 33 16 20 (no.) (15) (27) (42) ( 9 ) (30) (39)

Total % (no.)

Whether accidents in general are analogous to suicide and crime as phenomena of social pathology, as is some- times asserted, is questionable.20 However, Durkheim’s model is a good guide in that he amounts for the rates of suicide by the degree to which individuals are integrated into the normative system. It may be possible to study a child’s accident experience in relation to the degree to which he is a part of the family collectivity or his peer subculture group.

Parallel to Durkheim’s egoistic suicide, the “egoistic accident” arises from the freedom from collective control. Independence of the child will broaden the scope of his activities and increase his exposure to hazards. Egoistic accidents are likely to OCCUT among the acculturated children of acculturated parents who exercise a discipline similar to that of the “Protestant,”21 that is, an emancipation of the individual.

“Anomie,” in contrast with both egoism and altruism, is a state of “deregulation” and “declassification,”2z marked and Walter T. Martin, “Status Integration and Suicide,” American Sociological Review, XXIII, 2 (April 1958), 140.146; and Elwin H. Powell, “Occupation, Status, and Suicide: Toward a Redefini- tion of Anomie,” American Sociological Reuieto, XXIII, 2 (April

20H. Laurence Ross, “Traffic Law Violation: A Folk Crime,” So- cial Problems, VIII, 3 (1960-61), 231-241; Austin L. Porterfield, Traffic Fatalities, Suicide, and Homicide,” American Sociologacal Review, XV (1960), 897-901; and T. T. Paterson, “The Theory of the Social Threshold,” The Sociological Review, Britain, XLII, 3 ( 1950 ) z1“Egoism” is said by Durkheim to be a state of society “in which the individual ego asserts itself to excess in the face of a social ego and a t its expense . . . ’’ (Durkheim, Suicide, 209). This state is one marked by “excessive individualism.” However, as Durk- heim points out in relation to the Protestant doctrines, the development of individual personality is not a mere matter of the removal of social discipline, but of a particular kind of such discipline The individual must assume the responsibility to be independent and exercise his freedom. ZTbhrenwend, “Durkheim’s Egoism, Altruism, Anomie, and Fatal- ism.”

1958), 131-139.

81

by the absence of norms altogether. In terms of social structure, the concept of “anomie” can best be applied to the subculture group composed of the second-generation Americans who are pulled by two sets of norms-traditional Oriental society and contemporary American society. The label of “anomic accident” may be given to the injury caused by the tension which the child experiences due to normitive conflict.

“Altruism” is characterized by the enforcement of normative requirements based on collectivity-orientation. In traditional Oriental society the role of a child is submerged into the hierarchical family structure. A child is expected to be dependent on his parents; he is discouraged from doing anything on his own, though he is well protected by parental supervision. When such a child by chance en- counters hazards he is very vulnerable because he has had no chance to develop a skill to cope with hazards. When an accident is caused by a child’s inability to cope with risks, which in turn is the result of his conformity to the norms of collectivity orientation, we may call this type of accident “altruistic.” A group of nonacculturated school children may be likely to experience altruistic accident.

The finding that “accident” defined as “medically attended injury” is highly correlated with the acculturation of the child, to the extent of a perfect prediction (Table III) , raises some doubt about the validity of the methodology. Also, unusually high correlations are found among child personality traits and child-rearing variables. For instance, the tetracoric correlation approaching .8 between a crude index of material competence and an index of the child’s aggressiveness stands up for all subgroups by sex and acculturation. Presumably, then, a mother who describes her child as aggressive by the same token tends to describe herself as incompetent.

First of all, we should suspect contamination of the data when coding. Where sufficient information was lacking for one variable in a response to an open-ended question, the tendency of the coders was to use substitute items which might have been used to constitute another variable. For instance, a response such as “he plays with his friends after school and does not stay around with his mother” had to be used to assess the degree of his gregariousness as well as independence. The dimension such as “independence” is difficult to measure, since we cannot be sure whether a “lonewolf” or a “socialite” is more independent.

Secondly, although the effect of medical predisposition upon the frequency of medically attended injuries has been considered, the former was measured mainly by mothers’ responses to hypothetical questions. The present study did not include certain information in the medical charts, such as the frequencies of immunization and routine check-ups, which may serve as good indicators of medical predisposition.

Finally, accepting the findings of the present study as valid, there is still a problem in their interpretation. A question arises how the nonacculturated girls, for instance, dif-

82

fer from the children of a restrictive American family: in other words, to what degree is this restriction on behaviour unique to the Oriental mothers? Other ethnic or religious groups, such as Irish or Catholic families, practise strict child-rearing : many researchers have studied social-cl~ differences in child-rewing and have found variations among the Caucasians. Thus we cannot conclude that differences found in the Berkeley-Oakland study are primarily caused by the differences between Oriental and Caucasian

In order to correct the above-mentioned biases, further studies 'are under way. One is a follow-up Berkeley-Oak- land study, involving recoding of raw data to eliminate variable contamination; analysis of medical records to control medical predisposition; and selection of an additional sample to eliminate sampling bias. Another is a study of Menno- nites in Waterloo County, testing the hypothesis that there is a parallel between Orientals and Mennonites in the process of modernization of family structure and in its effects upon child-rearing and child behaviour. Finally, the Berkeley-Oakland study is to be replicated among Japanese- Canadians in Toronto.

83

Documents

Childhood Accident as a Measure of Social Integration