Abstract
A major issue for health reform is the equitable distribution of health services. Equity in the use of services depends in large part on the distribution of need for services, in addition to availability, accessibility, affordability, and acceptability of the services. The present paper focuses on one set of indicators of need, the disability data reported in the 1990 U.S. Census of Population and Housing for 14 southern states. The Census data on work limitation, inability to work, physical mobility, and ability to perform routine personal care show differentials for subpopulations defined by rural versus urban areas within levels of poverty, age, sex, education, and ethnic group. Highest rates of work disability are found for rural, female, elderly, less educated, African-American, and below poverty level populations. The implications of such findings for health care reform suggest that there should be greater access to services by populations of greater identified need. Historically, the opposite has been true, perhaps exacerbating the observed differentials in need.
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Census of Population and Housing, 1990: Public Use Microdata Samples U.S. [Machine readable data files]/prepared by Bureau of the Census. Washington, D.C., 1992.
Census of Population and Housing, 1990: Public Use Microdata Sample U.S. Technical Documentation/prepared by the Bureau of the Census. Washington, D.C. 1992.
German, P.S., Shapiro, S., & Skinner, E.A. (1987). Detection and management of mental health problems of older patients by primary care providers.Journal of American Medical Association, 257, 489–493.
Hispanic Health and Nutrition Examination Survey (1991). U.S. Department of Health and Human Services. Hyattsville, MD: National Center for Health Statistics.
Kessler, R.C., McGonagle, K.A., Shanyang, Z., Nelson, C.B., Hughes, M., Eshleman, S., Wittchen, H.B, & Kendler, K.S. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States.Archives of General Psychiatry, 51, 8–19.
Leeper, J.D., Badger, L.W., & Milo, T. (1985). Mental disorders among physical disability determination patients.American Journal of Public Health, 75, 78–79.
Manderscheid, R.W., Witkin, M.J., & Rosenstein, M.J. (1986). The national reporting program for mental health statistics: History and findings.Public Health Reports, 101, 532–539.
National Health Interview Survey (1989). U.S. Department of Health and Human Services. Hyattsville, MD: National Center for Health Statistics.
National Health and Nutrition Examination Survey (1991). US. Department of Health and Human Services. Hyattsville, MD. National Center for Health Statistics.
Nichols, J., Wright, L.K., Murphy, J.F. (1986). A proposal for tracking health care for the homeless.Journal of Community Health, 11, 204–209.
Robins & Regier (1991).Psychiatric disorders in America: The Epidemiologic Catchment Area Study. New York, NY: The Free Press.
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Dr. Holzer is Professor at the Department of Psychiatry, University of Texas Medical Branch and Faculty Associate of the Southeastern Rural Mental Health Research Center at the University of Virginia. Mr. Nguyen is a research associate at the Department of Psychiatry, University of Texas Medical Branch. Dr. Goldsmith is a Research Sociologist, with the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. Dr. Thompson is a research associate at the Southeastern Rural Mental Health Research Center at the University of Virginia.
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Holzer, C.E., Nguyen, H.T., Goldsmith, H.F. et al. The demographics of disability in the south. Community Ment Health J 32, 431–443 (1996). https://doi.org/10.1007/BF02251044
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DOI: https://doi.org/10.1007/BF02251044