The author explores findings from the 1986 Longitudinal Supplement on Aging to determine the appropriateness of using proxy variables, including urban/rural location, as indicators of need among elderly residents. The application of regression models using proxies typical for distributional decisions against seven measures of need indicates that biasing in favor of rural elders may be an ineffective strategy. Reliance on proxy measures may result in inefficient and inequitable methods for distribution of funds within states. An expanded definition of need is recommended for distributional decisions.
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References
1.
Aday, L. , R. Andersen, and G. Fleming. 1980. Health care in the U.S.: Equitable for whom?Beverly Hills, CA: Sage.
2.
Andersen, R.1968. A behavioral model of families' use of health services. Chicago: Center for Health Administration Studies.
3.
Assistant Secretary for Planning and Evaluation/Health Care Finance Administration . 1982. National Long Term Care Survey. Washington, DC: National Technical Information Service.
4.
Centers for Disease Control , National Center for Health Statistics. 1984. Supplement on aging. Washington, DC: National Technical Information Service.
5.
Cutler, S. , and R. Coward. 1988. Residence differences in the health status of elders. Journal of Rural Health4 (3): 11-26.
6.
Dwyer, J. , G. Lee, and R. Coward. (1990). The health status, health services utilization, and support networks of the rural elderly: A decade's review. Journal of Rural Health6 (4): 379-398.
7.
General Accounting Office . 1990. Older Americans Act: Administration on Aging does not approve intrastate funding formulas. Washington, DC: Author.
8.
Golant, S.1990. The metropolitanization and suburbanization of the U.S. elderly population: 1970-1988. The Gerontologist30 (1): 80-85.
9.
Harlow, K. , and J. Turner. 1993. State units and convergence models: Needs assessment revisited. The Gerontologist33 (2): 190-199.
10.
Katz, S. , A. Ford, R. Moskowitz, B. Jackson, and M. Jaffe. 1963. Studies of illness in the aged—The index of ADL: A standardized measure of biological and psychosocial function. Journal of the American Medical Association185:914-919.
11.
Lawton, P. , and E. Brody. 1969. Assessments of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist9:179-186.
12.
Leinbach, R.1988. Differences in need among the rural and urban aged: Statistical versus practical significance. Journal of Rural Health4 (3): 27-34.
13.
Massey, D. , and N. Denton. 1987. Trends in the residential segregation of blacks, Hispanics, and Asians, 1970-1980. American Sociological Review52:802-824.
14.
National Resource Center on Minority Aging Populations . 1989. Intrastate funding formulas. San Diego: Center on Aging, University of Southern California and University of California, Los Angeles.
15.
Nelson, G.1980. Social services to the urban and rural aged: The experience of area agencies on aging. The Gerontologist20 (2): 200-207.
16.
Verbrugge, L.1991. Physical and social disability in adults. In Primary care research: Theory and methods, edited by M. Grady. Washington, DC: Department of Health and Human Services.
17.
Weiher, G.1989. Rumors of the demise of the urban crisis are greatly exaggerated. Journal of Urban Affairs11 (3): 225-242.
18.
Wolinsky, F.1990. Health and health behavior among elderly Americans. An age-stratification perspective. New York: Springer.