Edgar A. Schuler

Measurement of Health Needs and Health Care

SOCIOLOGISTS are generally aware of the presence of ill health, but the extent to which it prevails in any given population group such as a local community or a county is not generally known. Morbidity and mortality rates provide a measure of only the number of persons who have been reported to have had specified diseases or who have died. They do not indicate how many individuals are suffering from ailments which have not been reported or the number having health problems that need the attention of a physician at least to the extent of diagnosis and possible treatment. There is need for a relatively simple and economical way of measuring health needs and health care so that sociologists and other research workers may appraise in an objective manner the health status of the population. To be sure, examinations by a medical doctor would provide the necessarry information but they are expensive in terms of medical personnel and involve considerable time and effort on the part of the people. It seems unlikely, therefore, that medical examinations for even representative samples of the population can be made in the foreseeable future. As has been indicated above, morbidity rates are useful but they are limited to those illnesses and medical needs which are related to specific diseases. Other medical and health needs would not be reported. A second possible method of measuring health and health needs, expenditures for medical care by a family, likewise proves to be inadequate. At most, expenditures for health services indicate what the effective demand is for such services

The Relationship of Birth Order and Fraternal Position to Incidence of Insanity

This study is an attempt to discover the relationship between the position of a child in his sibship and the development of certain personality traits. Some abnormal behavior traits, when exhibited by adults, result in the diagnosis of insanity. Hence, a statistical analysis of the birth order and fraternity position of individuals committed as insane should reveal a relationship between these two factors, if such a relationship exists. It is very difficult to secure a sufficient number of complete and unequivocal records of the insane so far as birth-order data are concerned. Using certain methodological rules, however, data on about 1,200 cases are obtained. Analysis of these records leads to the conclusion that among the insane there is no very reliable or significant relation between incidence of insanity and position of the patient in his sibship when the sibship is larger than two. In fraternities of two, however, the insane individual is much more frequently the elder than the younger.