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To be meaningful social indicators must be components of some social systems model so that changes in the values of these social statistics over time tell us something about the functioning of the social system. A necessary next step in developing social indicators is constructing models involving interrelated sets of social indicators in each major institutional area of society. This paper reports an initial effort to derive a set of social indicators for the area of health care. A structural equation model has been constructed fox the health care system serving the state of New Mexico. The model includes a network that specifies the causal relationships hypothesized as existing among a set of social, demo graphic, and economic variables related to the availability and use of health services and to health status; a set of structural equations that indicate the direct effect of variables in the model on each endogenous variable; a set of reduced form equations that indicate the combined direct and indirect effect of each predetermined variable on each endogenous variable included in the model. The model can be used to provide monitoring information pertaining to the effect of a change in a particular variable on all other variables comprising the health care system. Also it provides explanatory information regarding the differences in the availability of health care services, their use, and the health-status of the population in various counties. Finally, predictions of the effects of alternative health care policies that would affect the supply, the organization of care, or patterns of use of health services can be made based on the model. [ABSTRACT FROM AUTHOR]

In a previous paper on ‘Cats and Childhood Leukemia’ the authors found that children 1–14 years of age have roughly a double relative risk of leukemia if they were reported to have been exposed to a cat which was sick or died. This finding, based on the childhood leukemias of the Tri-State Survey, has now been confirmed by a similar finding in approximately 1,400 adult cases and adult random-sample controls. A somewhat stronger relationship was found for exposure to ill or dead canaries and parakeets. An equivocal relationship was found for pet dogs. Degree of relationship depends on type of leukemia. These findings do not necessarily conflict with the data for earlier negative reports. It is shown that unless the health status of the pet is included in the analysis, the relationships will be missed. [ABSTRACT FROM AUTHOR]

Fifteen years after 270 persons 60 years of age and over were first studied in a multidisciplinary longitudinal study of aging, 83 panelists were available for a sixth observation. In an investigation of the relationship between self and physicians' assessment of general health status the following was demonstrated: (1) There is a persistent, positive congruence of the two types of health ratings. (2) Whenever there is incongruity the tendency is for the individual to overestimate his health. (3) There is a substantial stability of both types of ratings through time. (4) The self health rating tends to be a better predictor of future physicians' ratings than the reverse. (5) Self-ratings of health have utility as a measure of health in survey research when objective measures are not feasible. [ABSTRACT FROM AUTHOR]

A correlation analysis was used to assess the similarity between mental health need priority systems set up under the Community Mental Health Centers Act, and priority systems developed using a simplified scheme of mental health indicators. Data came from Community Mental Health Centers State Plans for six Southern states. Results indicated that the simplified. scheme provides adequate replication of the priority systems. Hence, time and effort need not be expended on elaborate schemes for developing priority systems (or sets of mental health indicators for research) unless it can be demonstrated that they have superior validity. A second implication developed from the data concludes that sets of techniques, like other procedural systems may, if not evaluated, tend to be perpetuated when in fact they should be replaced. [ABSTRACT FROM AUTHOR]

The article investigates the effectiveness of nurse clinicians' service delivery in the U.S. In this study, the researchers compare the effectiveness of nurse clinicians with that of physicians with regard to health status of the patients, time spent with the health provider, and time spent in the clinic. The general approach and evaluative measures utilized in examining these areas should be applicable in the study of the effectiveness of other health care providers. The investigator found patient interviews effective in obtaining information of patients' perceived health status. The patient questionnaire or similar patient interviews should be administered to patients in other studies to obtain information about their knowledge and behavior relevant to service delivery.

A review is presented of the need for planned health services for migrant workers. Problems and projects are presented and discussed. Guidelines for action are indicated. [ABSTRACT FROM AUTHOR]

A proposed measure of health status (Function Status Index) is based on a conception more specific than one that equates health with quality of life but is still relevant to theoretical frameworks that view health in terms of its social behavioral aspects and its relationship to social and cultural variables. Three dimensions of function status (activity, mobility, and movement) are measured objectively by an interview schedule administered to 2,629 persons in two Northern Alabama counties. Content, criterion, and construct validity are assessed. Evidence is sufficiently strong to recommend use of the index to test hypotheses about social functioning and to evaluate the effectiveness of different health-care delivery systems. [ABSTRACT FROM AUTHOR]

In order to develop an operational definition of health, we found it necessary first to develop the concept of function/dysfunction as a continuum, based on one's ability to carry on the usual daily activities appropriate to social roles. Then, to those operating the health system, each member of the population can be seen as belonging to one and only one state from a class of functional states that can be defined on an ordinal scale. Next, we found it necessary to assign to each state a weight defined on a cardinal scale, the set of weights for these states being called the Health Status Index (HSI). The HSI rests on value judgments, of a societal nature, ex- pressed by the administrators responsible for policy decisions. Prognosis is then defined as the transitional probability of a change in functional state with time. Thus, the concepts 'state of health' and 'severity of illness' are decomposed into the parameters function/dysfunction and prognosis. Finally, together with an operational definition of time and target population, it becomes possible to give a quantitative definition of the output of a health program (or health system) as the changes in the functional history of the target population resulting from the intervention of the health program (or system). Other concepts that are given quantitative definitions are program effectiveness and population health status. This study next explores the relation between health program output and modem decision theory for program planning, and shows how these analytical tools are useful for fitting the results of the study into larger conceptual frameworks. Finally, the method developed is illustrated, first with a simplified simulated program for computer use, and then with an analysis of a small section of a. tuberculosis-control program. [ABSTRACT FROM AUTHOR]

The article presents the Cornell medical index health questionnaire as the recognition of emotional disturbances in a general hospital. Physicians generally recognize that a patient's symptoms are often significantly related to an emotional disturbance. Physicians generally recognize that a patient's symptoms are often significantly related to an emotional disturbance. Yet, because of their interest in other aspects of the patient's medical problem, some physicians may overlook these disturbances.

The tuberculosis incidence rate is not a reliable index in suburbia according to this report. A more precise index of tuberculosis was developed in terms of ‘designated poverty tracts,’ which include areas of concentration of low income households, welfare recipients and poor housing, as well as several other factors. Use of these tracts is discussed. [ABSTRACT FROM AUTHOR]

Are the aged becoming more like a minority group? Does the relative status of the aged tend to decline in industrial society? An affirmative answer to both questions is supported by an analysis of the trends in the gaps between the aged and nonaged in economic, social, and residential indicators. Two health indicators show decreasing gaps. The basic method of analysis is the comparison of similarity indexes from 1940 through 1969. [ABSTRACT FROM AUTHOR]

A study of students in a community college showed this population to be at high risk from a public health viewpoint. A higher prevalence of health needs was discovered than was initially suspected, as well as decreased ability to deal realistically with them. How far the findings apply to similar populations in other parts of the United States is not clear, but important questions are raised. [ABSTRACT FROM AUTHOR]

The resumption of relations with the People's Republic of China has aroused the interest of health workers in the United States concerning the organization and provision of health care in that country. This comprehensive review of the political, economic, cultural and legal determinants which have molded the Chinese system for the delivery of health care throws light on some aspects, and raises questions requiring more information. [ABSTRACT FROM AUTHOR]

The article evaluates the medical evidence related to demographic transformations in England in the eighteenth century. The evidence supports the conclusion that specific medical measures introduced during the eighteenth century are unlikely to have contributed substantially to a reduction in the death rate. It also suggests that decline in mortality is the main cause of the increase in population than a rise in the birth rate. Eighteenth century saw the expansion of hospital, dispensary and midwifery services; notable changes in medical education; advances in understanding of physiology and morbid anatomy. However it would be wrong to conclude that these changes contributed materially to the health of the people. To arrive at a reliable opinion one must look closely at the work of doctors during the eighteenth century, and enquire whether modern knowledge has contributed to the health of their patients. It is widely believed that a rise in the birth rate was the primary cause of the increase in population during the second half of the eighteenth century.

This article discusses personal health care services and their impact on the health status of the population. It also deals with the issue of compensation of medical injuries. Estimates of the impacts of personal health care services on the health levels of definite populations range widely. Despite the lack of focus by policy-makers upon socio-environmental factors, a high correlation between such factors and health status is evident. To assume that well being is the result of only those services which are personally provided by practitioners is patently foolish. Perhaps one of the main reasons for lack of attention to the impact of socio-environmental factors upon health status is the growing pressure to improve the system for delivery of personal health care services. There is a limited arena that medical injury compensation has afforded through malpractice litigation, where the "impact" of personal health care services is assessed and even judged with some finality. An injury sustained by a patient on his or her way through the health care system can be clearly identified and even occasionally traced to its cause through the malpractice reparations system.

The phenomenon of leukopedesis in gingival and periodontal tissues was measured by counting the number of orogranulocytes migrating into the mouth during repeated intervals of 30 seconds. Measurements were carried out with a computerized electronic cell grading system and classified as a non-subjective laboratory routine for indexing oral inflammation. For orogranulocytic migratory rate (OMR) readings above 1.2 X 106/30 sec, a minimum of three determinations is required for reliability. Single readings suffice for OMR's below 0.5 X 106/30 sec, which indicates that the system is suitable for mass screening purposes. [ABSTRACT FROM AUTHOR]

What should be the respective roles and responsibilities of citizens and professionals in dealing with environmental problems. This important topic is the subject of the Homer N. Calver Memorial Lecture presented below. [ABSTRACT FROM AUTHOR]