Patterns of maternal desires for child health care

Mothers' health beliefs and use of well-baby services among a high-risk population

The relationship between mothers' health beliefs and use of well-baby services among a poor, minority, high-risk population is reported. Data were collected from 61 black mothers attending a maternal-child clinic by interviews at the first and sixth months after the birth of their infants. The analysis focused on four health beliefs (susceptibility, severity, benefits, and efficacy) and two health behaviors (clinic visits and immunizations during the first 6 months). Although mothers' health beliefs were not predictive of clinic visits, health beliefs at the sixth month accounted for 30% of the variance in the number of immunizations. This relationship was dominated by perceived efficacy of immunizations and perceived benefits of well-baby services. The findings indicate a need to consider the nature and extent of possible changes in relationships between health beliefs and health behaviors over time.

Health costs and benefits of economic policy

The purpose of this study is to translate research findings on pathological effects of unemployment and other forms of economic distress into a form that would be useful for national economic policy decisions. Economic indices considered by themselves are questionable because such data permit no inferences as to quantitive social implications. In the present report, we have brought together several of the scientific findings on the impact of economic distress in a policy relevant framework which would ultimately permit quantitive estimates of that impact on social pathology. Some success has been achieved in formulating models to explain how the various sources of national economic distress may be associated with pathology.

Overall, it is evident that significant relationships exist between economic policy and measures of national well-being. This study indicates that actions which influence national economic activity-especially the unemployment rate-have a substantial bearing on physical health, mental health, and criminal aggression. To the extent, therefore, that economic policy has acted to influence economic activity, it has always been related to the nation's social health. It would appear that on a day-today basis, nearly all political and deliberate economic policy decisions which affect the national, regional, and local economic situations also are associated with many aspects of the nation's well-being. Indeed, significant amelioration of many of our basic social problems may depend, in part, on national economic policy considerations.

Proteinuria and hematuria in schoolchildren: epidemiology and early natural history

Over the past several decades screening for disease in large asymptomatic populations has increased, culminating most recently with a federal mandate for early, periodic screening, diagnosis and treatment of all children from low-income families. The present study of five consecutive examinations in over 12,000 schoolchildren shows the cumulative occurrence of proteinuria and hematuria to be surprisingly high (greater than 6%). Comparison of this large number of children with the few individuals in whom death occurs from chronic renal disease annually (less than 0.03%) suggests that the vast majority of these children with urinary abnormalities have either no renal disease or at most a self-limited condition. Observation of 512 children with proteinuria and 78 with hematuria for one to five years after initial detection and referral to their physician or clinic provides a measure of both contemporary management and early natural history. These observations suggest that there is a need to question the overall effectiveness of urinary screening and that early inclusion of roentgenographic and urologic investigations in management seems unwarranted. Rather, these children should be followed for long periods of time. Additional investigations are indicated when worsening of the abnormal findings or other evidence of renal or systemic disease occurs. If routine urinary screening is performed, it should be as one aspect of a multiphasic program by the primary physician so that it can be coupled with a clearly defined plan for follow-up and management of subjects with abnormal findings.

Parents' experiences of child health centers. A study in the urban district of Uppsala

Improved techniques for counselling parents can be achieved through a knowledge of the parents' experience of existing child health care. The author has studied the parents' experience of child health centers with regard to contact with the staff, information received, and general organization. A questionnaire was sent to one-third, 478, of all parents in the urban district of Uppsala with children 1/2–1 1/2 years old. The children were registered at 14 separate child health centers. The results showed that the essential prerequisites for good contact with the staff were, a limited number of children registered, and the presence of a permanent physician at the health center. The level of information concerning measures undertaken in child health care was mainly related to social grouping. One or more behavior problems were noted to have existed in 21% of the cases. About 60% of all parents concerned had sought advice at the child health center with varying degrees of success for different kinds of problems. An important objective in the child health care system would be to study the clients' attitudes. This would be the method to identify information problems and conditions influencing the contact between parents and staff. A constructive parental attitude to the staff is in fact necessary for successful guidance and psycho-social care, tasks of great significance for child health care in our type of community.