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Doctors, county team up to offer free health care.

A public/private partnership in North Carolina has resulted in free health care for 13,000 indigent patients a year. 85% of the physicians in the county's medical society volunteer to take patients into their practice for free. The county government pays $250,000 a year for medications and administrative costs, leveraging $3.5 million in free care.

Community Health Centers↗

Mental health services. Poor relations.

The case for London requiring greater resources for mental health services than other parts of the country has not been proved. Liverpool, Birmingham and Manchester are among the six most deprived areas in England. Spending per capita on mental health services in inner London is double that in Birmingham and Liverpool and 40 per cent higher than in Manchester. A national strategy is needed to address inequities in funding.

Age Factors↗

The Kaiser Family Foundation Community Health Promotion Grants Program: findings from an outcome evaluation.

OBJECTIVES: To present results from an outcome evaluation of the Henry J. Kaiser Family Foundation's Community Health Promotion Grants Program (CHPGP) in the West, which represented a major community-based initiative designed to promote improved health by changing community norms, environmental conditions, and individual behavior in 11 western communities. METHODS: The evaluation design: 14 randomly assigned intervention and control communities, 4 intervention communities selected on special merit, and 4 matched controls. Data for the outcome evaluation were obtained from surveys, administered every two years at three points in time, of community leaders and representative adults and adolescents, and from specially designed surveys of grocery stores. Outcomes for each of the 11 intervention communities were compared with outcomes in control communities. RESULTS: With the exception of two intervention communities-a largely Hispanic community and a Native American reservation-we found little evidence of positive changes in the outcomes targeted by the 11 intervention communities. The programs that demonstrated positive outcomes targeted dietary behavior and adolescent substance abuse. CONCLUSIONS: Improvement of health through community-based interventions remains a critical public health challenge. The CHPGP, like other prominent community-based initiatives, generally failed to produce measurable changes in the targeted health outcomes. Efforts should focus on developing theories and methods that can improve the design and evaluation of community-based interventions.

Adolescent↗