Social indicators for health planning and policy analysis

The concept of health involves two dimensions: The level of function at a point in time and the probability of transition to other levels at future times. By applying measured social values to the distribution of the population among a set of levels, a Function Status Index aptly summarizes the Level-of-Well-Being of a population at a point in time. By incorporating empirically determined transition probabilities into a simple stochastic model, a Quality-Adjusted Life Expectancy can be computed that approximates a comprehensive social indicator for health. The indicators possess the statistical properties required for time series and interpopulation comparisons, for studying outcomes and quality of medical care, and for health system optimization in planning and policy analysis.     

Public policy and health resource distribution

Despite federal health programs of the thirties, the Great Society programs and the establishment of health planning agencies in the sixties, health resources continue to accumulate in wealthier areas. According to a rational decision-making model public resources would be expected therefore to be directed toward those poorer areas with perceived needs. This paper explores the distribution of public and private health resources among towns of Connecticut. Using a rational decision-making model, the distribution of these resources is tested in a series of stepwise regression equations against the socioeconomic and health characteristics of the population. Private allocations of health resources (such as physician distribution) respond to socioeconomic factors while public resources do not show a clear pattern of overcoming the maldistribution effected by private actions. We find little evidence to support the hypothesis that Connecticut's town and state decision makers in health were following a rational model such as is the basis for health planning. Some other more complex model, such as a bureaucratic politics model, would explain better public policy decisions in health resource allocation.Research for this paper was carried out under Department of Health, Education, and Welfare Grant #5-R01-HS-00900. We wish to thank Berton Freedman for assistance with computer programming, and our former Yale Health Policy Project colleagues, George A. Silver, James Warner Bjorkman, and Christa Altenstetter for comments on an earlier draft. This earlier paper entitled Socio-Economic Indicators, Health Resources and Health Status: A Statistical Analysis and its Policy Implications was presented to the Statistics Section, American Public Health Association Meetings, November 16–20, 1975, Chicago, Illinois.     

The meaning of party labels

To determine the meaning(s) of the concepts Republican, Democrat, and Independent, the most frequently cited attributes of each party label were scaled in terms of their semantic centrality. An analysis of the magnitude scale values demonstrates that the labels Republican and Democrat have unique cognitive properties which easily discriminate one label from another. The most characteristic and discriminating properties refer to (1) voting, (2) electioneering, and (3) other forms of electoral behavior. Although these two labels have many strong properties over which there is considerable agreement, such consensus is lacking for the fewer and weaker properties which characterize and discriminate the label Independent. Whereas Republican and Democrat are sharply delineated, semantic inversions of one another, the concept Independent is ambiguously defined and only weakly distinguishable from other concepts.