Changes in the distribution of physicians in rural areas of Minnesota, 1965-85.

Abstract

PUBLIC HEALTH BRIEFS posttest counseling in this study, diverse forms of information and social support were given by the nurses who maintained contact with the participants. Testing was voluntary, with informed consent and under the strict condition of confidentiality. Because ethical and practical considerations prohibit experimenting with the factors mentioned above, their individual contribution to the effect of testing cannot be distinguished. ACKNOWLEDGMENTSThe authors wish to acknowledge with appreciation the helpful assistance APPENDIXThe relative importance of a sexual technique was determined by the computation of so called deviation contrasts, or deviations from the grand means.'02 A practical description of this procedure is found in the SPSSX Users Guide,'2 pp 494-495. New variables were computed for each individual and each sexual technique on pretest, posttest, and follow-up, by subtracting from the number of partners on a specific technique, the mean of the number of partners with whom the remaining techniques were performed. An example may clarify this procedure: if an individual performs masturbation with two partners, orogenital intercourse with six partners, and anogenital intercourse with eight partners, the relative importance of masturbation is 2-(6+8)/2= -5, of orogenital intercourse 6-(8+2)/2= 1, and of anogenital intercourse 8422+6)/ 2=4. Twelve months later, if this individual practices masturbation with eight partners, orogenital intercourse with two partners, and anogenital intercourse with zero partners, the relative importance of masturbation has increased to 8-(2+0)/2=7, of orogenital intercourse has decreased to 2-(8+0)/2=-2, and of anogenital intercourse has decreased to 0-(8+2)/2= -5. It is concluded that a shift has occurred in the pattern of practiced sexual techniques from orogenital and anogenital intercourse in the direction of masturbation. Sexual techniques included in this procedure were : oral, manual, orogenital, anogenital, oroanal, anobrachial, anodigital, dildo use, rectal

A Descriptive Analysis of Health Insurance Coverage Among Farm Families in Minnesota

“…As health care costs continue to escalate, many farm families and rural employers are finding health insurance premium costs to be prohibitive (Baldwin, 1986). Efforts to reduce costs are causing some rural hospitals to close or reduce their services, and many rural communities are finding it difficult to attract physicians, in part because of economic factors, but also because it is increasingly difficult to practice medicine in solo practices (Dennis, 1988;Cordes, 1989). This article reports the findings of a study designed to evaluate the magnitude of this problem in Minnesota.…”

Medical Practice and Satisfaction of Physicians in Sparsely Populated Rural Counties of the United States: Results of a 1988 Survey*

“…As the pool of physicians continues to expand, they maintained, the competitive pressures force the newcomers to increasingly locate outside metropolitan areas (Newhouse et al, 1982). Several recent studies have acknowledged the general predictions of "diffusion theorists" but have disagreed that these forces will alleviate all geographic imbalances (Cordes & Eiseles, 1986;Dennis, 1988;Fruen & Cantwell, 1982;Hynes & Givner, 1983;Kindig & Movassaghi, 198% Wright, 1985).…”

Rural Health Care: The Future of the Hospital

“…In 1987, a National Governors' Association survey found that access to maternal and child health services was a problem in rural areas in 35 states, compared to urban/suburban areas, for which only three states reported a problem (Bernstein, Kolimaga, and Neuschler 1988b). The physician-population ratio decreased by 2 percent for primary care physicians and by 11 percent for family practitioners in non-MSA counties in Minnesota between 1965 and (Dennis 1988). This occurred despite an overall increase in the number of physicians in Minnesota.…”