Residential and Racial Mortality Differentials in the South by Cause of Death1

Abstract Mortality levels and differences by metropolitan-nonmetropolitan residence for blacks and whites are examined in the South using life-table techniques. Life tables are constructed for Southern subpopulations using U.S. vital statistics and census data for 1980, and differences in the life expectancies are decomposed by cause of death. Results suggest that life expectancy is higher for metropolitan and white populations. Racial mortality differences are slightly greater in metropolitan areas of the South when compared to the nonmetropolitan South. Residential mortality differences are attributable mainly to differences in the effects of heart disease and accidents. Most of the racial mortality difference is due to differences in effects of malignant neoplasms, cardiovascular disease, perinatal conditions, and homicide. Policy efforts aimed at specific causes of death in specific populations are suggested as a means of reducing racial or residential life expectancy differentials.     

The demographic evolution of human populations: The role of selection and environmental factors

Selection (genetic and cultural) and environmental variation are the principal mechanisms determining patterns of demographic change in human populations. Conditions exist under which the nature and intensity of these forces can be inferred from temporal trends in the demographic variables. These conditions, which can be expressed in terms of relations between the Malthusian parameter and population entropy, provide a means for evaluating the effect of selective and nonselective factors on demographic trends in human populations. The distinction between the roles of selection and environmental factors is illustrated by a study of the demographic transition in Sweden (1778-1965). This study shows that demographic changes during the pre- and posttransitional phases are determined mainly by environmental factors, whereas the changes during the transitional phase are mainly due to cultural selection. This analysis provides, for all three phases of the demographic transition, quantitative measures of the intensity of the forces (selective and nonselective) acting on both mortality and fecundity distributions.     

Community councils as a medium for public participation: a case study in Grampian region

Planning authorities in Scotland are obliged to consult the public before finalising policies and proposals to be included in their development plans. Community councils are intended to operate as ‘the voice of a neighbourhood’ and this paper analyses an attempt by a regional planning authority to use community councils as a vehicle for consulting the public in the preparation of a structure plan for a rural area. The paper concludes that the attempt was unsuccessful because the community councils were not clear about the role they were expected to play; nor were they adequately prepared for their role. The authors believe, however, that the involvement of community councils has potential for promoting greater public participation in the preparation of development plans.     

Participation or practice innovation: tensions in inter‐agency working to address disciplinary exclusion from school

This paper explores dilemmas and tensions between two models of school based inter‐agency meetings to prevent disciplinary exclusion from school. The first model is characterised by innovative practice developed through long established professional relationships and addresses both individual and strategic issues in supporting young people who are at risk of disciplinary exclusion from school. The second model strongly emphasises the right to participation of young people and their families in school based inter‐agency meetings. Research participants in three Scottish councils (parents, pupils, teachers and other professionals 1 ) had identified school based inter‐agency meetings as key to the process of inter‐agency working to prevent school exclusion.     

Hospital-physician relations: overcoming barriers to cooperation.

In the September-October 1986 issue of Physician Executive, we discussed the application of strategic business units (SBUs) to health care. SBUs are those corporate entities that market similar products to one or more target populations with similar characteristics. Examples of SBUs in health care are obstetrics, cardiology, orthopedics, etc. When the services within each SBU are linked together, they might resemble a vertically integrated health care system. In the case of obstetrics, a woman may have contact with physicians, a hospital, home care nurses, house-cleaning services, birthing teachers, and maternity clothing boutiques. Each of these are products/services within the SBU of obstetrics. Strategy development by SBU implies an external focus on the marketplace in terms of the specific mission of the SBU (clinical specialty). It also implies responding to the needs of consumers for whom the historical and present divisiveness between hospitals and physicians is immaterial and irrelevant. In this article, we will focus on ways to stabilize the relationship between hospitals and physicians within an SBU context in order to compete more successfully as a team in today's health care environment.