Rural development and urban migration: can we keep them down on the farm?

This study tests the hypothesis that rural development projects and programs reduce rural-urban migration. The author presents various factors in the social theories of migration, including those relating to origin and destination, intervening obstacles such as distance, and personal factors. 3 economic models of migration are the human capital or cost-benefit approach, the expected income model, and the intersectoral linkage model. Empirical studies of migration indicate that: 1) rural areas with high rates of out-migration tend to have high population densities or high ratios of labor to arable land, 2) distance inhibits migration, 3) rural-urban migration is positively correlated with family income level, and 4) selectivity differences in socioeconomic status between migrants and nonmigrants often are grouped into development packages which might include irrigation, new varieties of seed, subsidized credit, increased extension, and improved marketing arrangements. The migration impacts of some of these efforts are described: 1) land reform usually is expected to slow rural out-migration because it normally increases labor utilization in rural areas, but this is a limited effect, 2) migration effects of the Green Revolution technology are mainly in rural-rural migration, and 3) agricultural mechanization may stimulate rural-urban migration in the long run. Development of rural social services migh have various effects on rural-urban migration. Better rural education, which improves the chances of urban employment, will stimulate rural-urban migration, while successful rural family planning programs will have a negative effect in the long run as there will be reduced population pressure on arable land. Better rural health services might reduce the incentive for rural-urban migration as well. It is suggested that governments reconsider policies which rely on rural development to curb rural-urban migration and alleviate problems of urban poverty and underemployment.     

The aims of population statistics and demographic research

A detailed program for the improvement of population statistics and for the development of demographic research is presented, with particular reference to the USSR. Topics covered include global and regional population projections, special surveys on demographic behavior, and the need for improvements in migration data.     

Toward a Copernican revolution in our thinking about life's beginning and life's end

This article attempts to narrow the range of moral disagreement surrounding the issue of abortion by exploring current assumptions and comparing thinking about abortion with our thinking about death. Focusing the abortion debate on questions such as when life begins or whether the fetus is a person has thrust us into scientific uncertainty and definitional disputes. It is suggested that the focus of the debate should be shifted to the issue of whether the fetus merits our protection. Moral judgements regarding personhood represent a complex balancing that involves weighing our interests in protecting an entity against the loss to our liberty implied by such protection. This approach requires a Copernican revolution in our thinking about abortion, in which 3 major factors--the nature of the entity, the impact of its mistreatment on our broadest human interests, and the specific implications of its protection for our liberty--are considered in a relational whole. Similarly, the continuum in the dying process requires us to determine which aspect of human death will be recognized as morally significant. Since determinations with regard to life and death are arbitrary, societies must select their own moral values and take responsibility for collective moral decisions. It is concluded that the US Supreme Court decision that allows free access to abortion in the 1st trimester, imposes a requirement of medical supervision in the 2nd, and prohibits abortion in most cases in the 3rd trimester represents a reasonable response to the moral issues at stake.     

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."     

The use of statistics to examine the association between fluoride in drinking water and cancer death rates

"The basis of statistical tests of significance of association between fluoride level in drinking water and cancer death rates is discussed. Reference is made to two reported studies in each of which cancer death rates of a number of [U.S.] cities were used. It is argued that between city variation should be taken into account when performing tests of significance. In one of the two studies this was done informally; in the other between city variation was ignored."     

Comparison of indirect and direct approaches to measuring patient satisfaction

One indirect (PSQ) and two direct (CSQ-18B and ERS) measures of patient satisfaction were compared across a series of psychometric, acceptability, and concurrent validity criteria. None of the three measures was significantly related to health status or demographic characteristics. Each measure performed as expected from prior research on their psychometric properties. The scales contrasted, however, in regard to acceptability, with the PSQ being much less acceptable to patients than the other two. The PSQ also produced more missing data. The results on the PSQ reflected patient inconsistency on cross-check items and patients tended to be uncertain in their responses to many items. In multivariate analyses the three measures were used as predictors of patient-rated indices of global service satisfaction. The CSQ-18B and the ERS were significant predictors of patient-rated indices of global service satisfaction, whereas the PSQ was unrelated to these indices. It was concluded that the direct and indirect approaches measure different satisfaction domains. The PSQ likely assesses more generalized attitudes about health services while the CSQ-18B and the ERS efficiently reflect opinions about the specific setting in which they are administered.     

Patient satisfaction with mental health services: a meta-analysis to establish norms

Patients typically express high rates of satisfaction with their mental health care. This finding and the lack of well controlled studies on patient satisfaction in the literature underscore the need for meaningful guidelines for clinicians and program evaluators in interpreting patient satisfaction data. To address this problem a meta-analysis was undertaken to establish norms on patient satisfaction for various types of mental health programs. Programs were categorized according to three dimensions: inpatient vs. outpatient vs. residential care; chronic vs. non-chronic; and conventional vs. innovative. Meta-analysis procedures were modified to accommodate the single-group study designs that dominate the literature. The analysis revealed that chronic patients express less satisfaction with their treatment compared to non-chronic patients. Innovative programs are viewed more positively than conventional ones. No differences were found in rates of patient satisfaction between inpatient and outpatient programs. Acceptably reliable norms and confidence intervals of patient satisfaction were established for conventional inpatient programs serving either chronic or non-chronic patients; conventional outpatient programs for non-chronic patients; and for all programs combined according to chronic vs. non-chronic, inpatient vs. outpatient, and conventional vs. innovative. However, data were insufficient to compute norms for other program types. The norms thus established can be used for comparative purposes by program evaluators. A cumulative, national data base on patient satisfaction is recommended to further refine these norms.     

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.