Journal of health & social policy最新文献

Purpose of the study: This paper considers evidence of indirect influences of the Harry and Louise media campaign on public support of single payer health coverage in a conservative state.

Design and methods: Data from a statewide, representative public opinion survey on health reform conducted in Oklahoma over a two-year period, 1992-1994, were combined with data on the Harry and Louise media campaign broadcasts. A two-stage structural-equation model tested the hypothesis that support for single payer varied inversely with support for "mainstream" health reform.

Results: Findings support the hypothesis, providing evidence that a campaign affecting support for mainstream health reform inversely affects support for single payer, despite the tendency for support for health reform to correlate with support for single payer.

Implications: Findings suggest that an unintended indirect effect of a campaign against mainstream health reform may have been increased support for single payer. Those proposing future reforms should be aware of available media technologies and how they will be used.

Age-related vision impairment is a major cause of functional limitations in mobility and independent living. Research findings suggest that vision impairment in later life affects social, emotional, mental as well as physical well-being, and daily functioning. The purpose of this study was to examine the relationship between ethnicity and visual problems, i.e., whether Bedouin and Jewish elderly persons differed in terms of visual impairment prevalence and the extent to which visual impairment affected their ability to perform activities of everyday life. This study sampled 88 Bedouin and 111 Jewish elderly persons aged 60 and older in the southern region of Israel. The findings show that the majority of the respondents reported visual problems. Bedouin elderly tended to have more problems with distance sight as a result of living conditions than Jewish elderly. In terms of ability to perform ADL and IADL functions, elderly Bedouins reported more problems. The study findings are discussed in terms of policy and service provision. In addition, recommendations for additional research are presented.

Early newborn discharge legislation began a movement in health policy towards incremental changes in how medical consumers receive services. While well intentioned, these initiatives may undermine national efforts to address problems through more comprehensive reform, while stifling smaller efforts to address the problems locally. This paper discusses early newborn discharge legislation in Kansas: its origins, apparent impact, and implications. Findings from a hospital survey and two-year follow-up suggest a minimal effect of the legislation on health services in the state. Though acute hospital care appeared to replace home-based programs in many hospitals we spoke with, the more longstanding impact of the legislation seems to have been its precedent in how health policy is now made.

Although studies over the years have measured the prison adjustment of male prison inmates by examining the frequency and severity of their disciplinary infractions, there is much less similar research on the adjustment of female inmates. While there is evidence that female inmates commit more, but less serious, infractions than do male inmates, it is not clear how these infractions affect the adjustment of women to prison. This article includes a study of the disciplinary behavior of a sample of 222 women released from a large maximum security prison. The sample is divided into different disciplinary groups based on the seriousness of behavior. Logistic regression analysis is utilized to assess the implications of disciplinary behavior. The study attempts to delineate the circumstances and conditions that provide the best opportunity for a woman's adjustment to prison. The findings indicate that the majority of women inmates do not commit infractions or engage in only minor infractions. However, there is a core group of chronic offenders who engage in violent infractions, and whose characteristics can be used to determine prison placement and programming for all inmates.

Research surrounding welfare to work programs suggests a number of potential factors that mediate welfare dependency ranging from a person's degree of employment barriers to their psychological well-being. This study explores how employment barriers, health barriers, background barriers, human capital barriers, and psychological well-being of individuals in receipt of TANF are related to earned income. Findings indicate that employment barriers, background barriers, human capital, and perceived locus of control are significant factors in determining welfare recipients' future earned income. Other barriers including physical health and psychological well-being such as depression, happiness, life satisfaction and optimism were not strong predictors of earned income.

This paper reports on the utilization of complementary/alternative medicine (CAM) services by women with breast cancer. Study participants were women with invasive breast cancer diagnosed 23-36 months prior to contact about the study, and randomly selected from the Ontario Cancer Registry. From among 1,119 eligible women sent survey questionnaires, 731 returned completed questionnaires (65%). A total of 20% of respondents used at least 1 CAM service. Among those who responded to a question about whether they would have liked specific services, 39% reported that there was at least one CAM service they would have liked to use, but were unable to access. Factors shown to be related to greater utilization of services included: younger age, higher household income, employed or student status, private health insurance coverage, and having received chemotherapy. Study results speak to the importance of acknowledging that professionals outside of the formal cancer care system play an important role for many patients. Patients would welcome experimentation with service models in which CAM practitioners and cancer specialists collaborate in providing care.

For the past decade our nation has turned its focus to personal responsibility and has subsequently formulated polices that have reformed welfare and strengthened child support enforcement. Parents are held more accountable for the support of their children, regardless of their income levels or age. Teen fathers continue to present dilemmas for policymakers because of their status as minors, lack of understanding of the policy implications for parenthood, lack of skills, and high unemployment rates. Alternative services and policies need to be developed to involve teen fathers with their children, both socially and financially.

Our findings indicate how health outcomes regarding adolescent pregnancy and maternal and infant health care are intertwined with a case management process that fosters measures that are social in nature-the provision of direct services, as well as the encouragement of informal social supports systems. They also show how case managed services in a small, nongovernmental organization (NGO) with a strong commitment to its clients may provide the spontaneity and caring which results in a "match" between client needs and the delivery of services-and positive outcomes for pregnant women, early maternal health and infant health. The delivery of such case managed services in a manner which is intensive, comprehensive, flexible and integrated contributes significantly to such improved health outcomes.

Since 1988, when the term chronic fatigue syndrome (CFS) was coined, considerable discussion has occurred about stigma associated with this diagnostic term. In particular, patients with CFS have felt that this term trivializes the serious nature of this disorder. A Name Change Work group, appointed by the CFS Coordinating Committee, developed an umbrella term: chronic neuroendocrineimmune dysfunction syndrome (CNDS), and proposed that there would be sub-types under this term, one being CFS. The present study examined attributions of this new umbrella term when compared with CFS. Nurses and physician assistants (PAs) were presented a case study of a patient with symptoms of CFS. They were told that the patient had either "chronic fatigue syndrome," "chronic neuroendocrineimmune dysfunction syndrome," or "chronic neuroendocrineimmune dysfunction syndrome, which had formerly been called chronic fatigue syndrome." The different terms led to different attributions, with PA respondents rating the "CNDS" label as more severe. Results suggest that a more medical sounding term (CNDS) may lead to attributions that this syndrome is a more serious, disabling illness. The policy implications of these findings are discussed.

Through analysis of Community Tracking Study Physician Survey, a nationally representative survey of U.S. physicians, we find that women physicians are significantly less satisfied with time for patients than their male colleagues. Among primary care physicians, about one third of the gender difference is explained by physician attributes, practice characteristics, geographical location and patient profiles. Control variables explain all of the gender gap among specialist physicians. Among primary care physicians, the effects of practice type and perceptions of patient complexity on satisfaction with time for patients are mediated by physician gender. Among specialist physicians, gender interacts with practice ownership and hours spent in medically related activity to determine satisfaction with time for patients.