摘要:

The “Great Society” may be characterized as a loosely knit program of policies for domestic reform, promulgated by the Johnson Administration in adaptation of the general philosophy and strategies of the New Deal, the Fair Deal, and the New Frontier to certain conditions of the middle 1960s. Among these conditions were demographic, social, political, and economic dimensions, both immediate and long term. The program was marked by some diversity in the strategies of reform and in the particulars of implementing legislation, but also by a general underlying view of the state of American society, the requisites for participation in the benefits of the society, and the appropriate role of the federal government in supporting prosperity and assuring freedom.

ISSN:0025-7079    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

This report analyzes socioeconomic differentials in mortality in the United States during 1959-1961 and 1969-1971 by comparing mortality rates—overall and by age, cause of death, and race—and life expectancy for the ten highest and ten lowest states by per-capita income and for three geographic divisions. The divisions and their characteristics are: Middle Atlantic—high-income, urbanization, and industrialization, although also containing many urban poor; West North Central—high-income and rural; and East South Central—low-income and rural. An earlier study indicated that differentials had been narrowing for many years, reaching low levels by 1960. As the present study shows, during the ensuing decade the trend reversed direction and widened, due entirely to changes in rates during mid-life and at the older ages (45 to 54 and above). While mortality declined at these ages in the low-income states, the decline was much larger in the high-income states. By cause of death, it was due almost entirely to heart disease, which similarly declined more in the high-income states than in the low and also, though to a very small extent, to malignant neoplasms. Factors identified as possibly contributing to the widening include the greater availability during the 1960s to populations in the high-income states (even their urban poor) of medical and surgical advances against heart disease and malignant neoplasms, and the greater impact on the poor in these states, compared with the poor in other states, of social and medical programs, especially Medicaid.

ISSN:0025-7079    

出版商:OVID    

年代:1977

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

This paper will look at changes over the past ten years in the differences between the poor and the nonpoor in selected measures of morbidity, disability, and utilization of health services. Data are from the National Center for Health Statistics' 1964 and 1973 Health Interview Survey, which consisted of interviews in approximately 40,000 households for each of the time periods. The poor are defined as persons in families with less than $3,000 income in 1964 and less than $6,000 income in 1973, which was approximately 20 per cent of the population in each time period. The health variables investigated include: discharges from short-stay hospitals; average length of hospital stay; persons with no physician and dental visits within the past two years; number of physician and dental visits per person per year; number of restricted activity days, bed days, work-loss, and school-loss days per person per year; and persons with limitation of activity due to chronic illness. The data are presented for four age groups (under 17, 17 to 44, 45 to 64, and 65 and over) and by color (white and all other). However, caution should be used in interpreting much of the data by color since the sampling errors are relatively high for most estimates for the “all other” category. The data indicate that some of the gaps that existed in 1964 between the poor and the nonpoor have been narrowed or eliminated, particularly in hospital and outpatient physician utilization. There is no evidence of marked changes between the poor and the nonpoor in dental care.

ISSN:0025-7079    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Because of the difficulty of measuring mental health status and the lack of systematic and longitudinal data reflecting economic status and mental health, an arbitrary definition is used for this paper: changes in the accessibility to and utilization of psychiatric services by the poor compared with that of the nonpoor will be interpreted as changes in mental health status. Patterns of utilization of mental health facilities in the United States and in Monroe County, New York, by economic variables and/or by race, for periods spanning the Great Society programs, are described. In addition, the location and availability of services provided by community mental health centers since their development are examined. Although these data indicate increased accessibility to facilities by the poor, there continue to be differences in the ways different economic groups use psychiatric facilities. In addition to a discussion of the implications of the findings for service delivery, definitional limitations are cited and additional information needed for making any judgments totward planning future mental health programs are explored.

ISSN:0025-7079    

出版商:OVID    

年代:1977

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

A number of health indicators are used to examine whether the gap in health status between the poor and nonpoor has narrowed in the period 1960-1972. Although the terms are recognized not to be synonymous, white and all other races are used as proxies for nonpoor and poor respectively, because of unavailability of data according to the latter characteristics. During this period, the geps between white and all others have narrowed for fetal, neonatal, postnconatal and maternal mortality. With regard to fertility, the gaps between white and all other races have narrowed for the maternal age groups beginning with 25 years of age; chief progress in narrowing the gaps was among higher birth orders. On a maternal age base, the gap in the proportions of illegitimate births of racial groups appear to be widening.The gap between the racial groups in the proportion of low birth weight infants has not changed significantly. Although real progress has been made in reducing infant mortality in the United States in the 1960s, its progress has not been sufficient to narrow the gap with other countries of very low infant mortality. While infant mortality has been declining in the United States, it has also been declining in countries of low infant mortality, such as the Scandinavian countries.

ISSN:0025-7079    

出版商:OVID    

年代:1977

数据来源: OVID

ISSN:0025-7079    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

Recent recommendations for prevention and treatment of chronic diseases emphasize long-term modification of patient health activities. Thus far, the public has accepted these recommendations only moderately. In a schoolbased topical fluoride program, urban and suburban seventh-graders were offered three fluoride treatments at five-and-a-half-month intervals. During the program, students were exposed to one of three techniques for increasing motivation to take part in preventive treatment programs: 1) information-alone, 2) information-plus-small rewards, 3) information-plus-group-discussion. “Information” refers to a slide show/demonstration designed to communicate information about tooth decay, fluorides, and the treatment program.Results indicated that 62 per cent of eligible students received all three fluoride applications during the 11-month period. However, the reward technique achieved significantly greater participation than either group discussion or information-alone. The major difference between rewards and information-alone was in motivating children to obtain parental permission, while the difference between rewards and group discussion was both in motivating children to obtain permission and in motivating them to return for second topical treatment. There were few important differences between urban and suburban students in overall compliance or in response to the motivational techniques.

ISSN:0025-7079    

出版商:OVID    

年代:1977

数据来源: OVID

摘要:

The forces for change seem more potent today than ever before; increased technological advancement and rapid “societal upheavals” create a more critical need for change and a more significant need for skills to manage and channel change toward meaningful ends. The area of health care delivery is probably one of the fields most impinged upon and most affected by these turbulent times. Organizational development is presented herein as an approach to assist people in health care organizations with the problems of adaptation and change. A specific change strategy, action research, is discussed and a concrete case example is presented to illustrate the ways in which the action research model can be applied. Advantages and pitfalls are discussed in the concluding section.

ISSN:0025-7079    

出版商:OVID    

年代:1977

数据来源: OVID