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.     

Specialization and the Survival of Self‐Help Organizations

This article examines the survival rates of 589 self‐help organizations in order to understand how self‐help niches, organizations specializing in biomedical, human services, and behavioral health, differentially impact longevity. Drawing on a study of the self‐help movement, we examine how the various mechanisms by which specialization impacts self‐help movement organizations' chances of survival. Extending the concepts of embeddedness, countervailing powers, and organizational specialization to self‐help organizations, we investigate how formal structures and professional alliances differentially promote longevity. Results show how formalization enhances self‐help organizations' longevity, and serves as a mechanism by which specialization impacts organizational viability. While formalization has a robust and beneficial impact on longevity, some professional linkages are negatively associated with survival and others are positively associated with it.     

Why Do They Start It? Explaining Reported Early-Teen Sexual Activity

This paper seeks an account of why young teens initiate consensual sexual activity. It does so by constructing statistical models aimed at distinguishing those who report having initiated sexual activity from those who have not in four samples of eighth graders from an Upstate New York county. Theoretical selection of the model variables is guided by insights from problem syndrome, control and differential association theories. From our findings we conclude the following: (1) Risk behaviors foreseen by the problem syndrome approach, including having used marijuana and having been drunk, are significant, powerful predictors of early-teen sexual activity. (2) The social setting of consensual sexual activity differs by sex at the eighth grade level. For example, having a boyfriend is a more consistent, powerful predictor variable for girls than is having a girlfriend for boys and there is evidence to support the hypothesis that boys initiate sexual activity in the context of status-seeking while girls are more likely to do so as a way of attaining approval. (3) Our findings do not give clear primacy to parents or peers as an influence on early-teen consensual sexual activity. Both control theory, usually associated with parental-influence variables, and differential association theory, usually associated with peer-influence variables, receive support. (4) The results of the research spanning a 2-year period of intensive community antiteen-pregnancy efforts by a Zero Adolescent Pregnancy (ZAP) campaign are consistent with the conclusion that such a multifaceted approach might help lower early-teen initiation of sexual activity.     

OCCUPATIONAL SEX SEGREGATION AND ECONOMIC INEQUALITY UNDER SOCIALISM:

An increase in scholarly attention to income differences between sex-typed occupations has generated a burgeoning literature. Typically-female occupations require preemployment education, not prolonged on-the-job training; receive less renumeration for work autonomy than male-typed occupations; and are concentrated in economically disadvantaged industrial sectors. However, these issues have received only preliminary consideration regarding noncapitalist societies and research has lacked an integrative, analytical focus. This study compares the earnings effects of education, type of work, and industrial sector between female- and male-dominated occupations in socialist Yugoslavia. As expected, average earnings are significantly higher in male than in female occupations. The results from the earnings regressions reveal a higher explained variance and larger economic returns to education among female- dominated occupations, especially in the managerial and professional strata. A decomposition of the earnings difference between sex-typed occupations suggests a variation in the source of inequality across skill strata. In the discussion, a comparison of capitalism and socialism reveals that while some aspects of the earnings attainment process may be unique to socialism, others are not.     

Evaluating employee assistance policy in an HMO-based alcoholism project.

One aspect of successful employee assistance program (EAP) implementation is the adoption of a formal, written policy, reflecting company commitment to EAP guidelines and goals. This study of criteria predictive of such policy adoption was conducted at the occupational alcoholism project of a New England health maintenance organization (HMO). Data on nearly 400 organizations contacted by occupational program consultants (OPCs) over a 20-month period were collected by questionnaire and interview. One third of these organizations adopted employee assistance policies and set about establishing formal programs. Stepwise multiple regression is the principal method used to pinpoint the correlates of policy adoption. Two of the most important of these are the attitudes of contact persons within the organization toward alcoholism and employee assistance programs, particularly their admission of alcohol problems within their social networks; and the consultants' persistence and marketing skills. The adopting organizations also had reputations for being progressive, and actively concerned about employee welfare; they tended to be large, their executives autonomous, and their union membership rates high. Inhibiting policy acceptance were fears that a written policy would jeopardize the reputation and image of the organization, and that an employee assistance program would remove internal control of personal procedures. The adequacy of the evaluative data and methods are discussed, and recommendations are offered in the interests of streamlining the efforts of OPCs and of achieving greater penetration of targeted organizations.     

Race,Region, and Earnings: Blacks and Whites in the South

Abstract Using data from the 1980 Public-Use Micro Sample (PUMS) A-file, we examine the effect of region on black and white earnings within the Black Belt and the rest of the South. We find that Black Belt residence depresses earnings for both blacks and whites, more or less equally. There was no support for the hypothesis that there would be a greater penalty to being black in the Black Belt, compared to being black in the non-Black Belt South. It is the additive effects of race and region that lead to lower earnings for Black Belt blacks. We conclude that region is a useful theoretical concept which needs to be more adequately theorized and incorporated into sociological analyses.