Despite dramatic increases in the number of Indian Health Service alcoholism programs and total expenditures, alcoholism mortality for American Indians and Alaska Natives increased 40%, 1986-90. Data analysis reveals little relationship of mortality rate with allocations, number of service components available, or per capita expenditures. Includes…

This document summarizes some of the major developments now underway in health promotion and disease prevention and reviews the federal contribution to achievement of prevention objectives. The first chapter focuses on opportunities in health promotion which offer the key to many potential improvements in the national health status profile and…

Health needs and health services in rural America are key issues directly related to education as well as community well-being. This report examines rural America's access to basic health care services and discusses options for congressional consideration. The focus is on trends in availability of primary and acute rural health care and on factors…

The 'rural' definitions applied by the Federal Government, especially by two data-gathering agencies, the Bureau of the Census and the Office of Management and Budget (OMB), emphasize different dimensions of the concept, and delineate the rural-urban continuum in different ways. This report discusses the inconsistency of curent "rural"…

This document is part of a five-volume nationwide study of Nutrition Services operations and elderly citizens participating in congregate dining and home delivery services authorized by Title III-C of the Older Americans' Act. This volume contains all technical appendices and is intended as a resource document. The Methodology Appendix is included…

Between 1979 and 1983 the noninstitutionalized Medicaid population grew by 210,000 people, or one percent. In comparison, because of a severe economic recession, there was a 37 percent increase in the number of people in poverty during the same period. The Medicaid population growth rate is relatively small for the following reasons: (1) Congress…

Despite claims that benefits for the needy have not been reduced, the Reagan Administration's final budget for fiscal year 1990 is marked by substantial reductions in programs for the poor. Actual spending for low-income programs would be sliced $6.75 billion below current levels. Medicaid, which provides health care coverage for poor families…