Driving less for better air: Impacts of a public information campaign

In the wake of the 1990 amendments to the Clean Air Act, localities across the United States initiated public information campaigns both to raise awareness of threats to air quality and to change behavior related to air pollution by recommending specific behavioral changes in the campaign messages. These campaigns are designed to reduce the health hazards associated with poor air quality and to avoid federal sanctions resulting from the failure to meet air quality standards. As in many other communities across the country, a coalition of government agencies and businesses initiated a public information campaign in the Atlanta metropolitan region to reduce certain targeted behaviors, mainly driving. A two‐stage model used to analyze data from a rolling sample survey shows that the centerpiece of the information campaign—air quality alerts—was effective in raising awareness and reducing driving in a segment of the population. When the overall information campaign was moderated by employers' participation in programs to improve air quality, drivers significantly reduced the number of miles they drove and the number of trips they took by car on days when air quality alerts were sounded. Public information campaigns can be successful in increasing awareness, but changing well‐established behaviors, such as driving, is likely to require institutional mediation to provide social contexts that support the behavioral change, as well. © 2003 by the Association for Public Policy Analysis and Management.     

Should Abused Women's Reports of Partner Substance Abuse Be Accepted as Valid?

Current research suggests that a husband's substance abuse is correlated with severity of physical abuse and the woman's decision to leave a violent situation. Often, only the battered woman's report of abuse is available. This study compares women's reports of their partners' substance use/abuse with their partners' report using a brief measure of polydrug and alcohol abuse, the Substance Abuse Subtle Screening Inventory (SASSI) and the Conflict Tactics Scale (CTS). Data were analyzed for 25 recovery couples and 25 nonrecovery couples. The correlations for all 50 couples between the male's reported use and the female's report of her partner's use on the SASSI and the CTS were significant on all but one of the CTS scales. They ranged on SASSI from .73 to .33 and from .31 to .06 on the CTS. This suggests that the SASSI and possibly the CTS could be used as valuable tools for assessing women's reports of their partner's substance use/abuse.     

Comprehending life and death matters

Modern capital jurisprudence places special significance on judicial instructions to guide the discretion of the capital jury in reaching a penalty phase decision. Yet, previous social science research has raised doubts about the extent to which judicial instructions are generally understood by jurors and questioned their utility in producing intended effects. The present study measured the comprehension of the capital sentencing instruction employed in California. Data suggest widespread inability to define accurately the central concepts of aggravation and mitigation in use in virtually every state that currently has a death penalty statute, as well as the inability to distinguish properly the sentencing significance of the enumerated factors jurors are directed to use in reaching their life and death verdicts. In addition, an inordinate focus on the circumstances of the crime—to the exclusion of other potentially important factors—was identified, as well as special problems in comprehending the crucial concept of mitigation in constitutionally required ways.We would like to thank Suzanne Ban, Cori Nardello, and Maryanne Tagavilla for assistance in transcribing and content-analyzing the data.     

The need to know versus the right to know: privacy of patient medical data in an information-based society

"Whatever, in connection with my professional practice, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret."(1) "Safeguards to privacy in individual health care information are imperative to preserve the health care delivery relationship and the integrity of the patient record."(2) As early as the fourth and fifth centuries B.C., Hippocrates contemplated the importance of medical information to the care and treatment of patients. His oath suggests that privacy of a patient's medical information creates the foundation upon which a patient reposes trust in his or her physician. While defining the earliest version of the physician-patient privilege, the oath does not envision the extent of modern day access to healthcare information. A patient's relationship with the modern healthcare delivery system often includes a team of physicians, nurses, and other clinical support personnel. This relationship extends beyond direct caregivers and may include healthcare administrators, payor organizations, and persons unfamiliar with a patient's identity, such as researchers and public health officials. Accessing a patient's medical information links these participants to the patient's healthcare delivery relationship. The Hippocratic Oath does not contemplate such broad access, nor does it contemplate the emerging privacy crisis resulting from the application of computer technology to medical record storage and retrieval. The combination of broad access, individual privacy rights, and computer technology requires a rethinking of measures designed to protect the realities of the modern medical information society.     

A review of recent developments affecting COBRA rights

Due to the high cost of health care claims and COBRA's status as remedial legislation, COBRA has generated a significant amount of litigation in recent years. While the early COBRA decisions tended to broaden the law in order to provide a remedy to an otherwise uninsured qualified beneficiary, the recent trend in the case law has been to limit the expansion of COBRA rights based on a narrower construction of the statute. Even so, COBRA still represents a legal minefield for employers. As a result, a careful employer will minimize its exposure by monitoring changes in the law and its interpretation and making appropriate modifications to its COBRA documentation and administration. This article discusses some of the more significant recent changes in the law affecting qualified beneficiaries' COBRA rights--and therefore, employers' exposure.