Availability and usefulness of selected health and socioeconomic data for community planning

A critical appraisal of the Navajo health care system

The purpose of this study is to assess the health needs of the Navajo Indians of North America, and the appropriateness of the health care services provided by the Navajo Health Care System with respect to these health needs. Our study is based on the analysis of the secondary socioeconomic and health related data collected and compiled in the Navajo area, and on the interviews conducted among health care professionals and administrators working in the Area. The 'Q index' was used for priority ranking of the most prevalent diseases. Appraisal is based on the holistic health concept components. Navajo Indians have not yet reached the health status of the general US population. In spite of the fact that the Indian Health Services has decreased the disparity between the Indians and the US population in general, especially regarding communicable diseases, other more complex health problems created by biculturalism and the on-going acculturation exceed the limits of the Navajo Health Care System which is basically oriented toward medical care. Alcoholism and alcohol abuse, inadequate nutrition and lack of geographic and socio-organizational accessibility are the main risk factors in the Area. This situation is further aggravated by economic problems and the high unemployment rate of the Navajo Indians.

The relevance of socio-demographic and resource factors in the use of acute psychiatric in-patient care in the Atlantic Provinces of Canada

This study assessed the inter-relations of socio-demographic, resource and policy factors with standardized measures of short-term psychiatric bed-use in 42 counties of Atlantic Canada. The policy factor made up two-thirds of the total variability (61%) accounted for among males, and nearly one-half of the 47% accounted for among females. An accurate assessment of in-patient resource needs is seen as resulting from intertwining morbidity surveys with utilization studies.

Unmet needs as sociomedical indicators

This paper discusses the Meharry Medical College Study of Unmet Needs designed to measure the effectiveness of alternative health care delivery systems: (a) comprehensive care with broad outreach, (b) comprehensive care with limited outreach, and (c) traditional care. Unmet needs are defined as the differences between services judged necessary to deal appropriately with health problems and services actually received. The central hypothesis is that comprehensive health programs will be more effective than traditional care in reducing unmet needs. Unmet needs are viewed as measures of program outcome and are one of several types of sociomedical indicators which use factors other than biomedical or biological states as measures of outcome. The distinction is made between unmet needs are discussed and the relatively limited focus of these is contrasted with the more comprehensive Meharry approach. Household interviews and clinical examinations provide the data base for deriving professional judgements of unmet needs in the medical, dental, nursing, and social services areas. The Meharry work suggests several areas in which further work on unmet needs would be useful.