Conducting a Hispanic Health Needs Assessment in rural Kansas: building the foundation for community action

Healthy People 2020 states ethnic health disparities are a priority for the US. Although considerable national statistics document ethnic-related health disparities, information specific to rural areas is scarce and does not provide direction for implementing chronic disease prevention programming. Therefore, the purpose of our project was to use the Hispanic Health Needs Assessment (HHNA), a tool designed by the National Alliance for Hispanic Health (NAHH), in culturally diverse, rural Southwest Kansas. Our focus areas included: access to healthcare, heart disease, diabetes, overweight, nutrition, and physical activity. METHODS: The assessment followed six steps: (1) developing the assessment team, (2) data gathering using community member surveys, existing statistics and community leader interviews, (3) assembling the findings, (4) formulating recommendations for action at individual, institutional, community and policy levels, (5) sharing findings and program planning, and (6) sharing findings with NAHH. We identified several challenges collecting health related data in rural communities, but overall, the HHNA was a comprehensive and useful tool for guiding a community level health assessment. CONCLUSION: This process has provided our community partners with locally relevant statistics regarding the current status of health, health behaviors, and perceived community needs to inform resource allocation, program planning and applications for new funding initiatives.     

The pattern of mortality change in Latin America

Using 69 new life tables recently made by Arriaga for Latin American countries by stable-population methods, the authors examine the mortality trends for more countries and more periods of history than have previously been available for analysis. For the late nineteenth and early twentieth centuries, the new tables yield a substantially lower life-expectancy than that shown by previously published life tables; for recent decades the difference is smaller, though in the same direction. As a consequence, the new tables show a speed of mortality decline in Latin America greater than the speed hitherto assumed. When the trend is analyzed in terms of economic development, it appears that the decline was extremely slow in the more backward Latin American countries until around 1930, whereas in the more advanced countries of the region, a more rapid decline had set in before that. After 1930, however, in both groups of countries the pace of decline was faster than ever, and it was virtually the same for both groups, suggesting that after that date public health measures were exerting a strong influence independently of local economic development. This result is confirmed by comparison with the past history of now developed countries; the mortality decline in Latin America after 1930 was much faster than it was historically at the same level in the industrial countries. As compared with other underdeveloped countries today, the unprecedented decline of mortality in Latin America is typical. In most underdeveloped countries, whether in Latin America or elsewhere, mortality change seems increasingly independent of economic improvement and more dependent on the importation of preventive medicine and public health from the industrial countries.     

Keeping a close watch– the rise of self-surveillance and the threat of digital exposure

Digital technologies have given rise to increased occurrences of self-surveillance and forms of 'virtual vigilantism'. This has progressed from key moments such as the video recording of the Rodney King incident, to recording human rights abuses, to citizen grassroots surveillance. From this has emerged the phenomenon known as citizen journalism where recent urban crises have been recorded on mobile phones by the individuals involved. Also on the increase are forms of mob vigilantism, or 'participatory panopticon'; examples here include phone images spread over the Internet as severe forms of 'community punishment'. I argue that these unmediated forms of bottom-up surveillance – sousveillance – show the early signs of a new type of civil responsibility that stands unregulated and without restraint. This paper addresses the issues of increased individualised self-surveillance and asks whether this is the consequence of a personalised resistance to an ever increasing surveillance society.     

The pattern of puerto rican fertility

The vital statistics of Puerto Rico for the period 1943–8 reveal a continuation of high crude birth rates and age-specific fertility rates. A careful examination of the figures does not suggest that there is as yet any decline in fertility, though with increasing urbanization such a decline may be expected to take place in the not too distant future.     

Declining birth rates and growing populations

Excitement over declining fertility in the Third World needs caution for several reasons. First, it is now too late to solve the world's population problem. Second, the common belief that the birth decline is widespread and is affecting virtually all developing nations goes beyond the data. Third, the notion that birth rates are declining with great speed is not true when the rate is measured against either urbanization or mortality decline. Fourth, a sample of countries indicates that the decline is now slowing rather than accelerating. Fifth, the idea that the declines are due mainly to family planning, and can therefore be assured of continuance in the future, seems unwarranted.Revised version of a paper given at the annual meeting of the American Sociological Association, San Francisco, September 7, 1982.     

The rural population turnaround: a case-study of North Devon

The change from depopulation to population increase in the more remote rural areas of England is analyzed using data from a survey of 300 households in North Devon. The heterogeneous nature of the migrants and their reasons for migration are stressed. "The reasons for leaving the former area of residence tended to relate to lifestyle, personal or environmental factors whereas the reasons for choosing North Devon were more often about jobs and house prices. This complexity and diversity clearly makes difficult the quest for a single theory of the repopulation process."