The validity of indices for rural health manpower needs assessment

Population-to-practitioner ratios have long been the primary index in the designation of health manpower shortage areas. This paper documents that application of the widely used population-to-dentist index results in understatement of the need for dental health manpower in rural areas. Through the analysis of utilization data collected from a statewide health screening program in Colorado, the practice of sole reliance on the population-to-dentist indices as an indicator of need was tested. Another measure, the area-(square miles) to-dentist ratio was formulated, examined, and found to be a more useful referent of the need for additional health manpower in rural areas. Utilization of dental services in sparsely settled rural counties of Colorado was unrelated to population-to-dentist ratios. A strong, statistically significant association of utilization with land area-to-dentist ratios was found. The findings of this analysis suggest a need for reevaluation of needs assessment methodologies used in the designation of health manpower shortage areas. Indices more sensitive to consumer circumstance than to the number of health care providers available must be considered.     

Deterrence in the workplace: perceived certainty, perceived severity, and employee theft

The phenomenon of employee theft is examined empirically, utilizing a deterrence paradigm. Employees selected randomly from three different industry sectors and metropolitan areas were asked to self-report their involvement in a number of property theft activities within the employment setting. Using a weighted least-squares logit regression analysis, the study found that the perception of both the certainty and severity of organizational sanctions were related to employee theft. Males reported more theft than did females, but contrary to previous research, no gender/certainty or gender/severity interactions were observed. The best-fit model did, however, contain two significant first-order interactions: age/certainty and age/severity. These interactions strongly suggest that younger employees are not as deterrable as their older peers, especially under conditions of both high certainty and high severity of punishment. While a number of possible explanations might account for differential deterrability according to age, a commitment to or stakes in conformity explanation is proposed.     

A time series analysis of Swedish illegitimacy rates, 1911-1974

Using a sociodemographic model of the determinants of illegitimacy rates, a multivariate regression analysis of annual change in age-specific Swedish illegitimacy rates is applied to the 1911-74 period. The proxy measure of change in sexual activity was significant for all age groups. Legitimation rates for out-of-wedlock conceived births were significant for all ages except teenagers, and the final predictor, women's status, was significant for all ages except women 35-44. Explained variance for annual change was highest among ages 20-24 (66%), 25-29 (66%), and 30-34 (63%) and lower among teens (34%) and women 35-44 (47%). These results support earlier research that used a sociodemographic model to explain post-World War II change in cross-national illegitimacy rates among 23 developed countries.     

Public opinion and the privatization of welfare: some theoretical implications

The social policy of the Thatcher government is characterized by an abrupt shift in the direction of the private sector. To what extent does this reflect what people want? The Institute of Economic Affairs conclude from the only suitable national opinion survey that such a move is strongly supported. Our reanalysis of their data shows that this strand in public opinion can coexist with, and need not contradict, an equal public enthusiasm for state welfare. Such results have important implications for our understanding of social policy. We conclude, therefore, with a discussion of contrasting marxist and liberal accounts which seeks to show that the evidence of ambivalence in popular attitudes about the welfare state supports particular developments in theory.     

Policy sources of worker dissatisfactions: the case of human services in aging

This article explores job dissatisfaction experienced by service providers in the field of aging and the policy sources of such dissatisfactions. Workers interviewed identified four major areas of complaint about their jobs: lack of resources, agency problems, mandates and regulations, and client characteristics. Such problems, it is argued, are associated with specific characteristics of policies under which the respondents work. These characteristics include the symbolic nature of legislation, policy ambiguity, universal entitlement, and calculated fragmentation. Whether or not policy changes should be made to alleviate worker dissatisfactions is discussed in the concluding section of the article.     

Social and demographic determinants of abortion in Poland

Summary Most abortions in Polish hospitals and clinics are performed on social indications. In the 22 administrative areas of Poland, the high rates of divorce and large proportions of total population employed in non-agricultural pursuits reflect the individualistic approach to family planning which is characteristic of present-day urban society. Industrialization is disruptive to the normal functioning of the country's traditionally large families. In addition, the gross reproduction rate increases directly with the proportion of the peasant population in 17 voivodships and five large cities of Poland, whereas in the urban sector the gross reproduction rate has fallen below replacement level in the past few years. Rural birth rates will continue to decline. In view of increasing needs for future manpower, population policy aimed at increasing births through incentives to prospective mothers may achieve a limited degree of success in cities only among the educated segments of the female population.