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PubMed1976

Tuberculosis among urban black children: failure of comprehensive health care services to influence incidence rates.

Over a three-year period, in 2,700 children aged two weeks to 19 years in a South Philadelphia ghetto, the new case rate for tuberculosis was 177 per 100,000 per year and the rate for new conversions was 673 per 100,000 per year. Children with recent conversions or with active disease were, on the average, slightly older and had older mothers and more adults and siblings at home than the rest of the child population. Parents or other residents of the home were the contacts. Children 10 to 14 years of age were the most frequently affected. Children who had been receiving continuous comprehensive health care for more than three years had the same attack rates as new children in the program.

Adolescent↗
PubMedDate not supplied

Analysis of prevention benefits in comprehensive health care reform legislation in the 102nd Congress.

One of the most important factors affecting the use of preventive services is health insurance coverage; however, until recently, most public and private health plans have explicitly excluded coverage of most preventive care. As a result, preventive services are used less frequently than recommended guidelines suggest, which contributes to the high incidence of preventable morbidity and mortality in the United States. Recent congressional efforts to enact national health care reform legislation present an important opportunity to analyze coverage for preventive services. This article presents the results of an analysis of the prevention benefits in 23 comprehensive health care reform bills introduced in 1991 during the first session of the 102nd Congress. I classified each bill by type (employer-based, single payer, managed competition, tax credit, and insurance market reform) and through a content analysis identified benefits for immunization, screening, and counseling services (including cost-sharing provisions), as well as funding for community-based health promotion. I interviewed congressional staff members of the sponsors of each bill to discuss their rationale for including or excluding specific prevention benefits and their reliance on existing policy, guidelines, and health services research or on the involvement of interest groups in developing prevention benefits. I conclude that health care reform is likely to address prevention, particularly in covering specific clinical preventive services, such as well-child visits, prenatal care, immunizations, family planning, and cancer screening. The prevention benefits least likely to be included in health care reform are coverage for counseling services and funding for community-based health promotion.

Health Care Reform↗