Quality of Life Indexes for National Policy: Review and Agenda for Research

A number of governments and public policy institutes have developed Quality of Life Indexes – statistics that attempt to measure the quality of life for entire states or regions. We develop 14 criteria for determining the validity and usefulness of such QOL indexes to public policy. We then review 22 of the most-used QOL indexes from around the world. We conclude that many of the indexes are successful in that they are reliable, have established time series measures, and can be disaggregated to study subpopulations. However, many fall short in four areas: (1) indexes vary greatly in their coverage and definitions of domains of QOL, (2) none of the indexes distinguish among the concepts of input, throughput, and output that are used by public policy analysts, (3) they fail to show how QOL outputs are sensitive to public policy inputs, and (4) none have examined convergent validity against each other. We conclude that many of these indexes are potentially very useful for public policy and recommend research to further improve them.     

A chronology of the study of older women's health: data, discoveries, and future directions

Women have been traditionally ignored in health and medical research. Some reasons for this mentality include a fear of harming a woman's reproductive ability, fear that variations in the menstrual cycle could confound results, fear that a woman's body could not withstand the rigors of clinical research, and an assumption that male and female body chemistry is similar. Thankfully, these fears and assumptions are being challenged and several major data-bases, designed specifically to study women's health, have emerged. The purpose of this paper is to: (1) characterize the major longitudinal studies on women's health, (2) summarize the major discoveries from these studies that are relevant to older women, and (3) pose several future directions for research throughout the paper.     

Responding to social service and health care needs of aging women veterans

This is a study about aging women veterans who served in the military during the 1940s, 1950s and 1960s. The Veterans Administration (VA) represents a formal network of health and support services that offers a wide range of benefits for veterans. However, older women veterans may not be aware of, or benefit from, all that may be available to them. The purpose of this study was to learn about aging women veterans' knowledge and utilization of services and benefits available through the VA. Telephone interviews were conducted in April 1998 with 220 women veterans in Massachusetts who were age 60 + years. There was generally strong identification with veterans' organizations among the women surveyed. These women veterans were likely to receive medical care-a major benefit available through the VA. The benefits veterans were least likely to know about included services that may be particularly relevant and helpful to an aging veteran, such as long-term care and home adaptation services. Strategies are suggested to enhance outreach efforts to aging veterans.     

$7.8 Billion for Everglades Restoration: Why Do Environmentalists Look So Worried?

The Comprehensive Everglades Restoration Plan, enacted in 2000, is a $7.8 billion federal/state investment in restoring the Florida Everglades ecosystem. The plan is a negotiated compromise between divergent interests in south Florida and promises to provide water and flood control for urban and agricultural users while maintaining a priority commitment to the natural system when allocating water produced by the 30-year project. The environmental community calls for independent scientific review of un-tested technologies, early and substantial hydrologic benefits to the remaining Everglades, including Everglades National Park, and strong programmatic regulations of the federal project to ensure that ecological restoration remains its primary purpose in spite of inherently conflicting interests at the state and local level.     

Evidence-based practice in community-based child welfare systems

The immaturity of the evidence base in some areas of child welfare practice demands that practitioners approach the development and refinement of practice in a systematic way that explicitly seeks to build on and learn from experience. The efforts of public child welfare agencies in Boston and Cleveland show that it is possible to draw on a broader base of knowledge and experience while responding to unique conditions and circumstances in each agency's community.     

Social context and adolescent health behavior: does school-level smoking prevalence affect students' subsequent smoking behavior?

This paper examines the links between individual adolescent smoking behavior and actual and perceived smoking behavior in the individual's school cohort. We hypothesized that students enrolled in schools with higher smoking prevalence among students in their grade are more likely to smoke subsequently. We also expected perceived school-level prevalence of smoking to have a greater impact than actual prevalence because the former is a more direct measure of perceived norms. Adjusting for demographics, actual school-level prevalence at baseline (grade 7) was strongly associated with smoking frequency one year later. However, the association disappeared after adjusting for individual smoking frequency at baseline. School-level prevalence did not moderate the association between individual's baseline and subsequent smoking frequency. Perceived prevalence of smoking among grade 8 students and two measures tapping the behavior of smaller peer groups--cigarette offers and exposure to friends and other peers who smoke--were associated with increased risk of smoking.     

The impact of touch-tone data entry on reports of HIV and STD risk behaviors in telephone interviews

Respondents concerns about privacy can decrease reporting of HIV and STD risk behaviors in general population telephone surveys. The purpose of this paper is to describe the results of an experimental study evaluating whether one method for increasing privacy, touch-tone data entry (TTDE), is effective in increasing estimates of sexual behaviors from a population-based survey. We conducted a random-digit-dial telephone survey of adults in New Jersey (n = 405), with half the respondents using TTDE for answering sexual behavior questions. TTDE led to increased reports of same-sex sexual behavior, certain HIV and STD risk factors, and concern about one s risk for HIV and STD transmission. TTDE also narrowed the difference between men s and women s reports of the number of different sexual partners over the past 10 years. The feasibility and limitations of TTDE are discussed, as well as possible alternative interpretations that consider the impact of TTDE on the dynamics of the interaction between the respondent and the interviewer.     

Substance abuse

Liddle and Dakof's (1995) comprehensive review of the status of family-based treatment for drug abuse concluded that this modality offered a "promising, but not definitive" approach to treating drug abuse among adolescents and adults. Less than a decade later, significant progress can be seen in the treatment of drug abuse problems using family-based approaches, particularly with adolescents. Family-based treatments are currently recognized as among the most effective approaches for adolescent drug abuse. Family-based treatment of adult drug abuse problems has also advanced in important ways with the recent systematic application and testing of engagement techniques and behavioral couples therapy approaches. The current review characterizes and discusses the developmental status of this subspecialty and outlines areas in which continued research attention is needed.     

Factors impacting the assessment of maternal culpability in cases of alleged fetal abuse

These studies explored attitudes toward maternal culpability in cases of alleged fetal abuse. In experiment one, general culpability for the use of various substances during pregnancy was assessed as well as the impact of other potentially relevant factors. One hundred and twenty students completed the survey. Participants overwhelmingly supported treating drug use by pregnant women as a criminal offense. With regard to the assessment of more specific questions, the lack of consensus regarding what factors effect culpability is striking. Experiment two examined the possible impact of the mothers' race (White or Black) and social class (Poor or Middle class) on the assessment of culpability. One hundred and sixty-four community members responded to a survey sent to randomly selected persons in upstate South Carolina. The results indicate that at least in response to a brief, written, case scenario, neither race nor social class make a large impact on participants' sanction recommendations.