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PubMedDate not supplied

A school-based smoking prevention program for adolescent girls in New York City.

Teenaged girls comprise the largest percentage of new cigarette smokers in the United States today. Factors contributing to smoking initiation include peer pressure, family and social influences, cigarette availability, and cigarette advertising. Because three-quarters of smokers become dependent on cigarettes by age 20, smoking prevention programs aimed at the adolescent population have great potential. The proposed program outlined is directed at girls 12 to 18 years of age in New York City. Among the objectives are increasing students' knowledge of the short- and long-term health effects of smoking and awareness of the social factors which lead to smoking. Participants would be taught social skills and behaviors which could help them to resist initiating smoking, by such activities as assertiveness training through role playing. Endurance sports activities would be emphasized while learning of the effects of smoking on physical conditioning. The costs of such a program are estimated, and classroom activities are outlined.

Adolescent↗
PubMed1977

Health care cost-containment regulation: prospects and an alternative.

Regulation of the health care system to achieve appropriate containment of overall costs is characterized by Professor Havighurst as requiring public officials to engage, directly or indirectly, in the rationing of medical services. This rationing function is seen by the author as peculiarly difficult for political institutions to perform, given the public's expectations and the symbolic importance of health care. An effort on the part of regulators to shift the rationing burden to providers is detected, as is a trend toward increasingly arbitrary regulation, designed to minimize regulators' confrontations with sensitive issues. Irrationality and ignorance are found to plague regulatory decision making on health-related issues, even though it is the consumer who is usually thought to suffer most from these disabilities. The author argues that consumer choice under some cost constraints is a preferable mechanism for allocating resources because it better reflects individuals' subjective preferences, has a greater capacity for facing trade-offs realistically, and can better contend with professional dominance of the resource allocation process. In view of the unlikelihood of regulation that is both sensitive and effective in containing costs, the author proposes that we rely primarily on consumer incentives to reform the system. A simple change in the tax treatment of health insurance or other health plan premiums, to strengthen consumers' interest in cost containment while also subsidizing needy consumers, is advocated. Steps to improve opportunities for innovation in cost containment by health insurers, HMOs, and other actors are outlined briefly.

Choice Behavior↗
PubMedDate not supplied

Child care cost and quality.

This article summarizes what is known about the cost and quality of full-time child care in centers and family child care homes, and about parents' attention to quality in making child care choices. It relies primarily upon two recent studies which are among the first to collect detailed information about child care operating costs: the Cost, Quality, and Child Outcomes in Child Care Centers study and the Economics of Family Child Care study. Results indicate that mediocre quality is the rule and that parents often do not choose quality settings for their children. At the present time, child care quality is only modestly related to the cost of providing services. In part, the modesty of this relationship reflects the low wages of child care staff, the availability of in-kind donations in the nonprofit sector, and the altruistic motivations of many providers that depress direct costs and the fees charged for child care. The article concludes with recommendations of future: (1) launch consumer education efforts; (2) implement higher standards for child care at the state level; (3) avoid public policies that encourage people to become child care providers if they have no interest in such a career; (4) increase public and private investments in child care; and (5) develop the means to compensate child care workers as is appropriate for their levels of training, experience, and responsibility.

Accreditation↗