How well is debt managed by nonprofits?

Little is known about why nonprofits accrue debt, how much they owe, and whether the funds they borrow are used productively. This article distinguishes between productive, problematic, and deferred debt. Employing a data base representative of 114,726 tax-filing charitable nonprofits in the United States in 1986, it examines the pervasiveness of nonprofit debt and the relation between this debt and nonprofit financial health. The analysis finds that over 70 percent of the nonprofits hold debt, the distribution of this debt is highly concentrated, and the level of debt and leverage varies with asset size and type of activity. Nonprofits with higher leverage and absolute debt levels are financially healthier than those with lower levels. While the analysis does not determine whether financially stronger nonprofits are better able to borrow, the results support the view that borrowing in the nonprofit sector is economically efficient.     

The health care Titanic: women and children first?

The plight of people who lack access to health care has captured national attention and led to a number of proposals to remedy the problem. The authors look at three types of proposals being advanced--"pro-competition" plans, "pay-or-play" plans, and a national health care system--and find that they fail to address adequately the pressing needs of two groups of the poor: women of childbearing age and elderly women.     

The changing character of contemporary migration

"Although the flow of human beings between countries and continents has marked the behaviours of populations for centuries, present international migration is clearly characterized by a number of new factors which make it distinct from international movements of people in the past. This paper aims to identify such new factors relating to the underlying reasons for the international mobility of people, including the motivations of the individuals concerned, and attempts to examine the consequences as they are being faced by the individuals involved, the countries concerned and--in more general terms--the international community." (summary in FRE, SPA)     

Physician perceptions of medical malpractice and defensive medicine

Using judgments obtained in interviews with 33 Massachusetts physicians, the annual statewide volume of expenditures incurred for defensive medical reasons in 1982 was estimated to be $1.0 billion, 12% of all medical care expenditures. Estimates for the nation were $37 billion, 14% of expenditures. Nationally, 180,000 cesarean deliveries were thought to be performed for defensive motives. In their own institutions, respondents judged 43% of all skull x-rays following injury to be medically justified, 30% to be defensive medicine, 16% to be placebos, and 11% to be physician misjudgments. In considering the economic and noneconomic costs of medical malpractice procedures, the dollar costs of insurance were considered most serious, followed closely by defensive medicine, unfairness, and poorer relations with patients. Thirty-two percent of the responsibility for the negative aspects of malpractice processes was assigned to lawyers, 21% to physicians, 18% to legislatures and courts, 16% to patients, and 13% to insurance companies.     

Major obstacles to control of irregular migrations: prerequisites to policy

This paper examines 3 basic obstacles thwarting all attempts to reduce irregular migration. The 1st, rather well known and analyzed, underscores the dependency of all regulation of migratory flows on the system of economic and political relations between developed and developing countries. The 2nd obstacle resides in the persistance and growth of subsequent dependent irregular migration. This obstacle also reveals the relative autonomy of population movements compared with the employment situation in the labor market. The 3rd generally ignored obstacle is the role played by migration itself, particularly the discriminatory status of foreign workers in the labor market, in producing irregular migration.     

An elusive concept: the changing definition of illegal immigrant in the practice of immigration control in the United Kingdom

This paper examines changing concepts of immigration practice in the UK. Immigration control at the port of entry has extended to internal control within the UK. The burden of proof of legality of status is increasingly on the immigrant, against a background of administrative rather than criminal justice. The changing and broadening definition of illegal immigration in the UK is part of a set of policies, which are governmental responses to what is conceived of as public opinion. THE GUARDIAN suggested that the Home Office has tightened up its application of the rules as the price to the Tory Right for their silence over further changes to the immigration law, thus demonstrating the political aspects of the concept of illegality. The Home Office replied that the UK was now one of the most densely populated countries in Europe and that, in terms of services, the country simply could not support all those who would like to come there. Nor can more than a certain number of newcomers be absorbed by any host community without the risk of friction. However, the host community is now multi-ethnic, and there is a black vote. The growth of administrative justice against which there is little effective appeal, the retrospective application of the 1971 Immigration Act, the ever-widening definition of the concept of illegality along with the fact that there is no time limit under the 1971 Act for one of the most common offenses, that of over-staying, have given rise to an increasing number of campaigns in support of individuals or families. These campaigns against the deportation of "illegal" immigrants may be an indication of a change in public opinion.     

Geographic distribution of undocumented immigrants: estimates of undocumented aliens counted in the 1980 census by state

"This article presents estimates of the number of undocumented aliens counted in the 1980 [U.S.] census for each state and the District of Columbia. The estimates, which indicate that 2.06 million undocumented aliens were counted in the 1980 census, are not based on individual records, but are aggregate estimates derived by a residual technique. The census count of aliens (modified somewhat to account for deficiencies in the data) is compared with estimates of the legally resident alien population based on data collected by the Immigration and Naturalization Service in January 1980." Estimates are provided "for each of the states for selected countries of birth and for age, sex, and period of entry categories.... The origins of the undocumented alien population [are described], as well as some of their demographic characteristics. Some of the implications of the numbers and distribution of undocumented aliens are also discussed." This paper was originally presented at the 1984 Annual Meeting of the Population Association of America (see Population Index, Vol. 50, No. 3, Fall 1984, p. 435).     

Mental health services for Chinese in a community health center

Serious mental health problems exist within the Chinese population of the United States. This article describes one center's attempt to meet the psychiatric needs of both nonpsychotic and psychotic Chinese patients through bilingual, culturally relevant treatments.