Dental visits by income and race in ten urban and two rural areas.

Household surveys in 12 low income areas found large differences in dental visit rates after control for income and race. The dental visit rate for Red Hook (NYC) exceeded the national rate whereas in seven of the areas the rate was below national averages by 40 per cent or more. The ranges in dental visit rate for low income Blacks was from two-thirds the national rate (in two areas of the South) to two to three times greater than the comparable national rate (in three areas of the Northeast). Lesser but nevertheless large variations among area dental visit rates existed for other race and income groups.

Access to usual source of care by race and income in ten urban areas.

In terms of less access to private sources of care (as distinguished from hospital-public clinics) and longer travel time to usual source of care, poverty areas are at a disadvantage. Within the ten areas studied, the poor have less access than the nonpoor, with access differences even greater between the races than between income groups. Blacks generally have less than whites when income differences are taken into account. Both the type of usual source of care and travel time appear to be related to differential utilizations of ambulatory care resources: persons reporting private sources of care and persons with shorter travel time to their usual source of care tend to make more physician visits in a year. Mechanisms for public financing of health care will not likely alleviate the problems of inaccessibility presented by poverty areas. It is in these areas of low access that public responsibility to organize and locate facilities will continue even after the advent of a fairly comprehensive payment mechanism for health care among the poor.

Need for publicly financed family planning services as measured by seven area surveys.

PIP: Data collected in 1972 from 7 diverse communities in the United States were used to determine the impact of federally assisted family planning programs. On the average 56% of low income women were at risk of an unwanted pregnancy. Of these, 40% were receiving family planning services from organized family planning programs and 22% from private physicians. More than 1/2 the women were using either the IUD or pill, and 15% were not using any contraceptive method. Fertility rates were higher for low-income than for high-income women, although the use of effective methods was similar. Because of the similarity of the findings to national estimates, it is suggested that national estimates can reliably be used for local programming.^ieng

Ethnic group and welfare status of women sterilized in federally funded family planning programs, 1972.

PIP: A statistical study to determine if women from minority groups and women receiving public assistance were more likely to be sterilized than other women in federally assisted family planning projects is presented. The data used was provided by the National Reporting System for Family Planning Services. When the data was controlled for age and parity among welfare recipients and by minority, it was learned that Anglo women appeared to have a higher sterilization rate than black women or women of Latin American descent. However, without the controlling factors, the opposite result appeared to be the case. Nonwhite welfare recipients of similar age and parity had a sterilization rate almost twice that of nonrecipients though the rate was about 35% higher when age and parity were taken into account. Nonwhite women receiving contraceptive sterilization were not disproportionately represented when age and parity were controlled. This was also the case among white welfare recipients and nonrecipients. The data did not indicate that women were coerced into sterilization nor could it be determined that individual projects abused program guidelines.^ieng

How much do family planning programs cost?

PIP: The results of 2 cost studies on family planning programs are compared. National Analysts, Inc. studied 45 family planning programs for the program years 1968-1969. Westinghouse Population Center studied 27 family planning projects of 25 agencies for the program year 1970-1971. The Westinghouse projects were considerably larger in terms of operating costs than the National Analysts programs. Comparisons are made by way of multiple graphs and statistical tables. Per patient costs and the distribution of costs between direct medical services and indirect costs are consistent between the 2 studies. The results emphasize economies of scale and diseconomies of very large scale. From a cost basis, the ideal family planning project characteristics are: 1) a patient volume of approximately 3000; 2) a budget size of about $175,000; and 3) an institutional base. Programs with 1-site services were less costly than those with multiple sites or those using private physicians to provide the primary medical services.^ieng