Describes the economic and demographic changes experienced by rural communities over the past few years and how they have increased rural health professionals' responsibilities. Presents the Community Wellness program and four case histories illustrating how it has strengthened community infrastructure, developed human capital, and created rural…

Measured the impact of managed care on the utilization of preventive health-care services by 867 inner-city Los Angeles families and assessed the relationship between insurance type, source of care, and access to immunization services. Results show that, lacking financial incentives, managed care is unlikely to improve immunization rates among…

Examines elements of programs that have been successful at changing long-term outcomes among disadvantaged children and their families: delivering a wide array of services, building relationship of trust and respect, dealing with children as part of a family, and responding to those most at risk. Suggests ways to overcome barriers to multiplying…

Despite the effectiveness of vaccinations in preventing disease, preschool children, particularly in the inner cities, are not being adequately immunized. Inadequate clinic staff and hours, inconvenient locations, prohibitive policies, and missed opportunities within the health care system may contribute to this problem. Suggests policy changes…

Community-based medical education is key to training physicians to work in needy fields such as outpatient care and health care for the medically underserved. Describes the disadvantages of traditional medical school curricula and presents sample community health curricula now being used. Suggests ways to increase medical students' awareness of…

Although Blacks face a higher risk of hypertension than other Americans, a comparison between Blacks and Whites participating in a hypertension education series showed no significant differences. The program reduced by 68 percent the number of participants with high blood pressure. Proposes marketing and adherence strategies to attract and retain…

Traces academic medicine's historical opposition to community medicine and its emphasis on traditional hospital-cased curricula subspecialties, to the neglect of primary and preventive care, community-oriented medicine, and public health. Calls for reducing barriers to basic medical services for all, and for training physicians equipped to respond…

It is apparent that some children in the United States have not benefited from the improved oral health care available. These children tend to be poor and members of racial and ethnic minority groups. Policy recommendations are made to increase both self-care and access to dental care. (SLD)