G. E. Alan Dever

An epidemiological model for health policy analysis

Health programs needing health and other related data have failed in their solutions because they have lacked a rational framework for analysis. A cursory analysis of present disease patterns reveals chronic conditions for which the present system of organized health care has no immediate cures. On the other hand, infectious diseases of decades past have been all but eliminated by vaccines and antibiotics. Before we are able either to prevent or to arrest current disease processes, we must dissect the health field into more manageable elements that reflect a creative area for epidemiological models.An epidemiological model that supports health policy analysis and decisiveness must be broad, comprehensive, and must include all matters affecting health. Consequently, four primary divisions have been identified: (1) System of Health Care Organization; (2) Life Style (self-created risks); (3) Environment; and (4) Human Biology.An application of the epidemiological model involves four steps: (1) the selection of diseases that are of high risk and that contribute substantially to the overall morbidity and mortality; (2) to proportionately allocate the contributing factors of the disease to the four elements of the epidemiological model; (3) to proportionately allocate total health expenditures to the four elements of the epidemiological model; and (4) to determine the difference in proportions between (2) and (3) above.Five tables illustrate how the epidemiological model is applied, showing the diseases selected for analysis; the contributing factors of each disease to the four components of the epidemiological model; the distribution of Federal outlays for medical and health-related activities by category; the distribution of Federal outlays of health expenditures by category; and a comparison of Federal health expenditures to the allocation of mortality in accordance with the epidemiological model.The conclusion to be drawn from this study is that, based on current procedures for reducing mortality and morbidity, little or no change in our present disease patterns will be accomplished unless we dramatically shift our health policy.

The pursuit of health

This paper delineates health legislation through a review of the literature as it relates to the cost of medical care; it also demonstrates a death-coding system that would be compatible with the cause of death and not the disease. Three tables and ten figures depict the leading causes of death by number and rate for Georgia and the U.S., 1900–1973; infectious and chronic disease death rates, U.S., 1900–70; cycles of infectious and chronic disease patterns; health expenditures, U.S., 1930–75, per capita and percent of GNP; an epidemiological model for health policy analysis; and sample certificates of death.

Marketing and Quality of Life: A Model for Improving Perinatal Health Status

Introduction: A marketing/business model using non-traditional Quality of Life measures was developed to assess perinatal health status on a micro-geographic level. This perinatal health status needs assessment study for Georgia South Central Region was conducted for the years 1994–1999. The model may be applied to any geographic unit in the U.S. – from a block group level to a state or a region. Methodology: An Infant Health Risk Score was created for each county and census tract by calculating the Z-scores of various Medical, Lifestyle, and Access variables so as to construct a Quality of Life Index. The scores identified the areas in the region that were at high risk for certain medical, lifestyle, and access variables (i.e., high risk for preterm births, low education levels, and poor access to perinatal services). A marketing tool, Claritas PRIZM Clusters, was used to identify a specific cluster and associated marketing information for each census tract within the region. Results: The Infant Health Quality of Life Risk Scores were linked with the PRIZM cluster marketing data to target areas in the region that exhibit high risk medical, lifestyle, and access scores. Health promotion and disease prevention strategies were developed using a marketing/business model. Specifically, media usage and consumer behavior purchasing patterns were identified and processed for every high risk area in the region. The categories for media usage were television, radio, and magazines and the categories for consumer behavior included restaurants, food items, and shopping locations. Discussion: The Perinatal Region is developing strategies to implement the media usage and consumer behavior marketing information to focus their prevention efforts to the high risk areas in the region based on the Quality of Life Measurements. Linking marketing business tools with a Quality of Life health status needs assessment has significant potential for improving the planning, the evaluation, and the focus of prevention efforts.

Reproductive mortality in Georgia: a lifestyle and environmental analysis.

Frequencies and rates of maternal mortality in the United States have declined sharply since the turn of the century. During this decline, researchers have closely examined maternal mortality relative to various risk factors. However, maternal death as currently defined and coded on death certificates may not reveal the true extent of the problem of reproductive mortality. In Georgia, an analysis of death certificates of females ages 10 to 49 indicates that deaths due to pregnancy related conditions are not being discovered by traditional underlying cause-of-death maternal mortality classification. Frequencies and rates were calculated showing the difference between the traditional International Classification of Disease codes for maternal deaths (ICD 630–676) and the reproductive mortality definition used in this paper (which emphasizes the Health Field Concept classification of Lifestyle, Environment, Biology and Health Care Delivery System) (Lalonde, M., 1974 and Laframboise, H. L., 1973). The analysis suggests that a revised definition of maternal mortality be employed to take into consideration all risk factors related to reproductive mortality.

Practical computer graphics for planning health policy

Computer-generated graphics have been successfully employed in various disciplines. However, computer graphics are just beginning to be utilized in the health field. In this paper, the authors contend that health information can be better understood by health program managers and decision-makers through the use of versatile, rapid, computer-generated graphics.

An epidemiological model applied to planning and evaluation of local health department services

Utilizing epidemiological methods in the planning process, the Georgia Department of Human Resources, Division of Public Health, focuses on community-based and patient-based standards. These standards are identified and applied in the evaluation of local health department programs.Emphasis is first on prevention, taking into consideration life style, environment, health systems, and biological factors, in developing objectives from which these standards are derived. The evaluation process is based on sampling techniques to obtain patient data and vital statistics for community data.The success of this model is a function of decentralization.