Evaluating a private foundation's health program

Public policy decisions in health are increasingly difficult and expensive. Although there will never be enough information available, private foundations can help to bridge the most important gaps in knowledge. Larger foundations may also wish to respond to those who doubt the value of foundation activities. This article reviews the experiences over the past eight years of The Robert Wood Johnson Foundation in employing evaluation and related social research procedures in the planning and implementation of a major philanthropic effort to improve the health and medical care of Americans. Discussed are the still evolving Foundation evaluation framework, the unanticipated problems in undertaking specific evaluations, and the substantive findings of some of the studies.     

A study on mortality rates and expectation of life at birth in demography]

An "age-time-area diagram" (referred to as a-t diagram) which is used as the basis for discussing different used and applications of variously defined mortality rates, as well two kinds of measurements for life expectancy is proprosed. The proposal is built upon the Lexis diagram. The a-t diagram is used to define a new way of measuring child mortality, projecting population, and proposing a formula for measuring successive and nonsuccessive life expectancy.     

The health demographic profile system: current and longitudinal data base for social area analysis

The development of the Health Demographic Profile System, which is based on the 1980 census, is described. The system includes social and economic indicators designed to identify high risk target populations, in terms of mental health and general health service needs, as well as to describe the social and economic structure of both mental health service and other small geographic areas. The report describes: (1) the original system, that is, the Mental Health Demographic Profile System (MHDPS), which is based on the 1970 census, including details of the approach and content, (2) the 1980 provisional indicators and planned products, (3) plans for the development of a longitudinal system based on 1960, 1970, and 1980 data, and (4) current and future studies related to the 1980 Health Demographic Profile System.     

Comment on 'facts and artifacts in the study of intra-uterine mortality: a reconsideration from pregnancy histories' by henri léridon(1)

Abstract Extract I have suggested that at a given birth order the probability of having a further pregnancy is greater when the last pregnancy had been spontaneously aborted than when it resulted in a birth.(2) Léridon,(3)in the course of a valuable paper on foetal wastage, presents data which, according to him, impugn my suggestion. I would like to question his claim.     

Contraceptive behavior among unmarried young women: A theoretical framework for research

Adoption of the most effective methods of contraception requires individual decision-making and negotiation with contraceptive providers. In order to take account of both behavioral elements, a two-dimensional framework for understanding contraceptive adoption and continuation by unmarried young is proposed, incorporating a "social-psychological model" of individual decision-making and an "interpersonal model" of factors affecting provider-client interaction. The social-psychological model is based on an earlier value-expectancy theory of behavior motivation as applied to health-related behaviors. The interpersonal model is derived from conflict-bargaining perspectives on professional-client interaction; it is suggested that expectations for this interaction are based on a limited number of internalized "models": the "professional"; the "bureaucratic"; the "commercial"; and the "parental." Insofar as client and professional "models" disagree, communication may break down and client understanding and/or acceptance of provider advice cannot be assured. The components of the social-psychological and interpersonal models are described in detail, and a combined framework is proposed.     

Approximations of rational criteria under complete ignorance and the independence axiom

Rational decision making under complete ignorance, a limit case of uncertainty, is defined. Through a concept of approximation, a meaning is given to a criterion almost possessing a property. Rational criteria depend almost on the sole bounds of the outcome range of each decision, they are almost continuous, they can almost possess a transitive indifference relation; however, under Savage's Independence Axiom, this last property restricts possible criteria to those which can be approximated, at least partly, by either the Maximin or the Maximax criterion.