Physician-nurse migration to the United States: regional and health status origins in relation to legislation and policy

This article examines the origins of physicians and nurses who were admitted as permanent immigrants to the US from 1962-1979. Data are mainly from the Immigration and Naturalization Service. Countries used in the developmental analysis are only those whose population was estimated at 1 million or more as of mid-1979, encompassing 99% of the physicians and 97% of the nurses. Life expectancy at birth is the criterion used to differentiate origin countries by developmental dimension of health status. During the study period, health workers constituted about 30% of immigrants admitted to the US; of these, nurses and physicians constituted 72-82% throughout the study period. The period 1962-1979 has 4 distinct phases, marked by important legislative and/or policy changes; 1) 1962-1965, when the McCarran-Walter Act prevailed; 2) ending in 1968, the 2nd phase covers the transition mandated under the 1965 Immigration Act, which encouraged physician immigration; 3) the 3rd phase, 1969-1976, covers the transition to the 1976 Immigration and Nationality Act amendments; and 4) the 4th stage is 1977-1979. Results show that 1) under the McCarran-Walter Act, North America became the dominant physician source; 2) from 1966-1968, Asia attained dominance as the physician source and became even more predominant after 1968; 3) North America produced relatively few physicians in the early 1970s; 4) Europe produced substantially fewer physicians in the 1970s than in the 1960s; 5) South America, Africa, and Oceania were the lowest contributors of physicians; 6) during the McCarran-Walter years, North America and Europe produced almost 90% of nurses admitted into the US; 7) the 1965 Immigration Act and its aftermath resulted in Asia becoming the dominant source of nurses; 8) prior to the 1965 Immigration Act, Canada generated 20% of the aggregate number of physicians; 9) the Philippines surpassed Canada during the transition and India led after the transition; and 10) Canada supplied 30% of the nurses up through the transition, with the Philippines in the lead 1969-1979. Low health status countries were a relatively minor nurse source. Health status at the origin was a far less significant determinant of physician immigration than that of nurses. English language high and low health status country groups produced substantially more physician and nurse immigrants that their corresponding non-English language counterparts. The US attracted more physicians and nurses from less developed countries than more developed countries after 1968.     

The influence of income on family fertility in the light of the results of empirical studies

Based on data from the 1973-83 Polish Family Budget Survey, this study examines the influence of income as a source of maintenance and income as a determinant of childbearing on family parity. It is assumed that income influences parity as a source of maintenance and as an influence on lifestyle or reproductive behavior. As a source of maintenance, the influence will be positive. As a life-style factor, it could be positive or negative. The hypotheses are 1) that positive influences are characteristics of older couples with a lower educational level and living in villages and small towns and income is a source of maintenance, and 2) a negative influence on parity reflects younger couples with higher educational levels from larger cities and income is a life-style factor. Some examples of how the theory of income influences total fertility are given in addition to a further elaboration of the theory. Other concepts introduced, as related to childbearing, are the value of goods and services with unchanged preferences and an increase in income, with preferences changing with income increases, with income preferences for nonprocreational and for procreational needs, and income as a factor influencing procreational needs and behavior. Correlation analysis is conducted for 33 subpopulations based on duration of marriage, educational level of the household, and size of residence. The results indicate that, in years 1973, 1975, and 1978 when income and parity are significant, the sign is positive. In 1980, there was a decrease in the number of subpopulations with a significant relationship, and in 3 subpopulations the results were negative. The 13 positive subpopulations were similar to those in the 1970s. In 1983, income explained an even smaller amount of parity. The subpopulations with a postive relationship usually have longer marriage durations, which suggest income as a source of maintenance. Negative results were among subpopulations with shorter marriage durations, which suggests life-style factor effects of income.     

Mortality among three Puerto Rican populations: residents of Puerto Rico and migrants in New York City and in the balance of the United States, 1979-81

"This study attempts to explain similarities and differences in the mortality experience of three population groups: Puerto Ricans on the island commonwealth, Puerto Rican born persons in New York City and Puerto Rican born persons in the rest of mainland United States. Mortality is much higher among Puerto Ricans in New York City than among those residing elsewhere. Much of the difference is due to excess mortality caused by cirrhosis of the liver and homicide. Puerto Rican born persons living on the mainland but outside New York City generally have low mortality, even when compared with U.S. whites."     

Federal statistics in a complex environment: the case of the 1980 census

A discussion of the 1980 U.S. census is presented. The authors suggest that the taking of a national census is not just a statistical exercise, but an exercise involving ethics, epistemology, law, and politics. They contend that conducting a national census can be defined as an ill-structured problem in which the various complexities imposed by multidisciplinarity cannot be separated. "The 1980 census is discussed as an ill-structured problem, and a method for treating such problems is presented, within which statistical information is only one component."     

Ethnicity,immigration process and short-term occupational mobility

The relationship between the ethnic characteristics of immigrants to the United States and their occupational mobility in the short term is explored. The data concern the period 1965-1970 and are taken from the 1970 census. The results indicate that race and sociocultural distance have important effects on occupational mobility. The study also shows that if educational status is controlled, the performance of Asian immigrants is more similar to that of blacks or Hispanics than it is to that of whites. (summary in FRE, SPA)     

Gambling and the Law®: Endless fields of dreams

This article examines the current trends of proliferation of commercial gaming, especially in the United States, in the context of the third wave of legalization of gambling that has been experienced since the founding of the nation. The author looks at the historic foundations of the spread of casino-style gambling, and notes the types of casino gaming that have led the way in the current expansion. He also points out why it is reasonable to expect that this wave too may come crashing down, as general acceptance of wide-spread casino gaming in America may indeed be short-lived.Gambling and the Law^® is a registered trademark of I. Nelson Rose.     

The administrative costs of non-profit health insurers

Interest in the efficiency or inefficiency of non-profit firms has spawned research on the administrative costs of Blue Cross and Blue Shield plans. Relying on plausible implications of the property rights theory of the firm, both Blair, Ginsburg, and Vogel (1975) and Vogel (1977) noted some evidence of inefficiency in these firms. Our analysis, however, utilizing their models and more recent data, reveals little convincing evidence for the view that Blue Shield plans are inefficient.