| This study uses a systems theory approach in analyzing how health services facilities and utilization affect individuals' health status, and how these and other community characteristics affect poverty in the southern United States. Community resources and community resource allocation are depicted as system inputs. Health service availability and health service utilization are seen as system throughputs. They serve to translate system resources to individuals in the form of health status. Health status is hypothesized to be an important although often overlooked determinant of poverty.;The results obtained in all five instances (regional and four county groups) are suggestive of the importance of health status on poverty in these counties. Yet, the relationship between health status and its antecedent variables is not as apparent. In all tests, community resources were found to impact upon health status. This finding is supportive of the Miller and Stokes (1978) thesis that a community's aggregate socioeconomic characteristics are a more important determinant of health status than is the provision of health services. These results, however, are tempered by finding that in more urbanized southern counties (i.e., those classified as Mixed-Mixed and Urban-Urban) health service availability and utilization exhibit a significant impact on health status. The latter finding points to the importance of the health sector in affecting the aggregate physical well-being of system members.;Through the utilization of multiple indicators taken to represent community resources, community resource allocation, health service availability, health service utilization, health status and poverty, a series of multiple partial coefficients adjusted for degrees of freedom (MPCA) are calculated. This approach allows for direct comparison of coefficients obtained when all counties are simultaneously analyzed (N = 1217) with those obtained when the counties are more homogeneously grouped. These groups are based on a four-fold typology predicated upon changes in urbanization during the 1960-1970 decade. The four county types--Rural-Rural (N = 425), Rural-Mixed (N = 162), Mixed-Mixed (N = 548), and Urban-Urban (N = 82)--are found to exhibit differences when compared to all counties in the southern region. |
