State epidemiology programs and state epidemiologists: results of a national survey

In 1983, the State Epidemiologists in 46 States completed a survey questionnaire describing the professional qualifications, training, and experience of State health department epidemiologists and the scope of participation by the State Epidemiologists and their staffs in public health programs. The survey identified 224 State health department epidemiologists (estimated U.S. ratio 1.1 per million population). A State health department epidemiologist was most often male (80 percent), frequently (57 percent) was a physician, had an average age of 41 years, and had worked as an epidemiologist for 9 years. Participation in public health programs (either by supervising or providing consultation) by the State Epidemiologists and their staffs focused mainly on general epidemiology and communicable disease programs; fewer than half had participated in programs relating to the health of women and children, chronic diseases, injuries, or in other programs directed towards preventing premature mortality. Recently, the State Epidemiologists have been trying to broaden their activities into these areas; however, the demands created by the acquired immunodeficiency syndrome (AIDS) will mostly likely slow this process. Based on the overall findings and collective experience, it was concluded that State health departments have too few epidemiologists to address the wide variety of important public health problems facing our communities. It was proposed that each State health department have at least four epidemiologists (including one or more physician epidemiologists) and at least one master's level biostatistician and that the epidemiologists-per-population ratio not be less than 1 per million.     

Health promotion programs in small worksites: results of a national survey

PURPOSE: This study documents the prevalence of workplace health promotion activities at small worksites with 15 to 99 employees. DESIGN: A random sample of U.S. worksites stratified by size and industry (n = 3628) was drawn using American Business Lists. MEASURES: Each worksite was surveyed using a computer-assisted telephone interview system to document activities related to health promotion and related programs, worksite policies regarding health and safety, health insurance, and philanthropic activities. SUBJECTS: Participation varied by industry and size, with an overall response rate for eligible worksites of 78% for a total sample of 2680 worksites. DATA ANALYSIS: Data were analyzed using SUDAAN statistical software. RESULTS: Approximately 25% of worksites with 15 to 99 employees offered health promotion programs to their employees, compared with 44% of worksites with 100+ employees. As with the larger worksites, the most common programs for worksites with 15 to 99 employees were those related to occupational safety and health, back injury prevention, and CPR. The majority of worksites in both size categories had alcohol, illegal drug, smoking, and occupant protection policies. The majority of both small and large worksites also offered group health insurance to their employees (92% and 98%, respectively), with many of the worksites also extending benefits to family members and dependents (approximately 80% for both business sizes). CONCLUSIONS: The results indicated that small worksites are providing programs to their employees, with a primary focus on job-related hazards. Small worksites also have formal policies regarding alcohol, drug use, smoking, and seatbelt use and offer health insurance to their employees at a rate only slightly lower than that of large worksites.     

Employee assistance programs: a worldwide perspective

Once limited to U.S. corporations, employee assistance programs (EAPs) are now spreading around the world. The authors review global EAP trends and identify similarities and differences among EAPs in North America, Europe, Central and South America, the Asia-Pacific region, and the Caribbean. Through affiliations between international professional associations and services to multinational corporations, the EAP field is quietly creating globalized behavioral health services.     

Worksite smoking cessation programs: a potential for national impact.

Data from three pilot studies of small worksite smoking cessation programs demonstrate that programs which appeal to all smokers in an organization, not just those who have stated an interest in achieving cessation, will attract a high per cent of smokers and assist an unusually high per cent of them to achieve and maintain abstinence.     

Cost of employee assistance programs: Comparison of national estimates from 1993 and 1995

The cost and financing of mental health services is gaining increasing importance with the spread of managed care and cost-cutting measures throughout the health care system. The delivery of mental health services through structured employee assistance programs (EAPs) could be undermined by revised health insurance contracts and cutbacks in employer-provided benefits at the workplace. This study uses two recently completed national surveys of EAPs to estimate the costs of providing EAP services during 1993 and 1995. EAP costs are determined by program type, worksite size, industry, and region. In addition, information on program services is reported to determine the most common types and categories of services and whether service delivery changes have occurred between 1993 and 1995. The results of this study will be useful to EAP managers, mental health administrators, and mental health services researchers who are interested in the delivery and costs of EAP services.     

Factors contributing to participation in food assistance programs in the elderly population

BACKGROUND/OBJECTIVES

The study objectives were to examine the participation rate in food assistance programs and explore the factors that contribute to such participation among the Korean elderly population.

SUBJECTS/METHODS

The study sample comprised 3,932 respondents aged 65 years or older who were selected from a secondary data set, the fourth Korean Welfare Panel Study (KoWePS). The factors, related to participation in programs were examined based on the predisposing, enabling and need factors of the help-seeking behavior model. Multiple logistic regression analysis was used to select the best contributors among the factors related to program participation.

RESULTS

The predisposing rate in food assistance programs was 8.5% (7.1% for men and 10.4% for women). When all variables were included in the model, living without spouse, no formal education, low income, having social security benefits and food insecurity in elderly men, and age, low income, having social security benefits and feeling poor in elderly women were significantly related to a higher tendency to program participation.

CONCLUSIONS

The predisposing and need factors, such as living without spouse, low education level, food insecurity and feeling poor were important for program participation, as well as enabling factors, such as household income and social security benefits. A comprehensive approach considering these factors to identify the target population for food assistance programs is needed to increase the effectiveness and target population penetration of these programs.     

Menstrual regulation training and service programs in Bangladesh: results from a national survey

Using nationally representative sample survey data collected in 1986, this study evaluates the training and service programs for menstrual regulation (MR), and estimates the number of MR procedures performed during 1986, in Bangladesh. The results show that most of the MR providers, who received either formal or informal training, were physicians and family welfare visitors (paramedics) employed by the government. They were trained in various aspects of MR performance, including contraindications and complications associated with MR, the techniques of MR performance and follow-up procedures, and maintenance and sterilization of MR equipment. Averages of 20.5 and 13.0 MR procedures were performed by formally and informally trained physicians, respectively, in the three-month period preceding the date of interview. The corresponding average numbers for formally and informally trained family welfare visitors were 11.6 and 9.1, respectively. A total of 241,442 MR cases were estimated to have been performed between August 1985 and July 1986.     

Correlating pharmaceutical data with a national health survey as a proxy for estimating rural population health

Background  

Chronic disease accounts for nearly three-quarters of US deaths, yet prevalence rates are not consistently reported at the state level and are not available at the sub-state level. This makes it difficult to assess trends in prevalence and impossible to measure sub-state differences. Such county-level differences could inform and direct the delivery of health services to those with the greatest need.     

Preventive medicine residents: a national survey.

Little is known about those physicians who pursue graduate medical education in preventive medicine, including aerospace medicine, general preventive medicine and public health, and occupational medicine. We surveyed resident physicians about their academic background, financial environment, clinical activities, and professional goals. A total of 147 residents (30%) responded from a population of 498 residents. The data suggest a lack of available information about preventive medicine training and careers among medical students who subsequently pursue such training. Their economic environment is extremely diverse, with a wide range of salary, "moonlighting" hours, educational loans, and service obligations. Although the median annual salary ($24,700) is similar to the national average resident salary, 32% of respondents earned less than $20,000, and 95% have educational debts averaging $30,900. Sixty-two percent of respondents perform clinical work in their residency, whereas 76% desire future clinical work as part of their practice. This gap is most pronounced in general preventive medicine and public health. The residents express a wide range of interests in future practice of preventive medicine; 54% are interested in government work, and 33% desire academic careers.     

Oral public health programs for the elderly: 1989.

Forty-eight of the 50 state dental directors, program managers, or state health officials were interviewed by telephone about the nature of current oral health programs for the elderly and factors that aided or hindered the development of such programs. Oral health programs for the elderly were reported in 30 states (63 percent of respondents). A majority of respondents indicated that a perceived or documented need for oral health programs for the elderly and lobbying by local advocacy groups were instrumental in implementing or planning such programs.