Hospital Community Benefit in Rural Appalachia: One More Gap*

Non‐profit hospitals are important anchors in Appalachian communities, in part because of the concentration of health care dollars within these institutions. Community benefit efforts of these hospitals, therefore, have the potential to fill gaps in public health and social service provision in underserved areas with documented health disparities and access barriers. To date, however, we do not fully understand how community benefit practices vary by hospital setting. Employing hierarchical linear modeling using a multilevel mixed‐effects approach, this study analyzes data from the years 2010 to 2016 to assess community benefit practices and spending between hospitals in Appalachia and non‐Appalachian counties. Findings indicate that hospitals within Appalachian counties, and rural hospitals in this region, in particular, spent less on community benefit than hospitals, not in this region. Given the potential for community benefit to impact health outcomes and access to care, this disparity is important to state and local public health efforts and suggests the need for additional support for hospitals to engage their communities around critical health needs.     

方言词汇的时代性

本文讨论如何利用方言词汇结合汉语词汇史的研究给方言分区，一共举了三个例子，闽语的“鼎”字和“拍”（打）字以及粤语的“睇”字，指出词汇溯源的困难以及单用词汇作方言分区的局限。     

Organizing the past: A history and its (de)construction

This paper explores some aspects of the textuality of historical narrative as a mode of organizing the past, drawing its inspiration from the work of Hayden White. The paper is unusual in that it takes as its central text for analysis a piece of historical narrative constructed ‘naively’ by the author prior to the writing of the current paper. This text, which attempts to account for the varying development of the discipline of Business History in Britain and the United States, is explored for its narrative implications and implicit story-lines. The reactions of a number of readers of the original text are also examined, and an attempt is made to account for these in terms of the types of story each reader understands the text to be telling.