Providing appropriate health services to the elderly is emerging as one of the major challenges of this decade. Using the theoretical framework developed by Andersen and Aday, this study attempts to improve our understanding of those factors which inhibit or facilitate elders' use of health services. The data come from a 1974 statewide random probability sample of 1,625 noninstitutionalized elders 65 years of age or older living in Massachusetts. Regression analysis is used to study the effects of predisposing, enabling, and need characteristics on the use of five health services: hospitals, physicians, dentists, home care, and ambulatory care. The model explains from 5% to 27% of the variance in health service utilization. Need characteristics, in general, account for most of the explained variance.

Dramatic public health advances in the 20th century have improved quality of life-an increase in life expectancy, worldwide reduction in infant and child mortality, and the elimination or reduction of numerous life-threatening communicable diseases. These achievements could not have occurred without the research, practice, and service of professionals who comprise the public health workforce. This multidisciplinary workforce includes public health clinicians, occupational and environmental health specialists, epidemiologists, biostatisticians, health program administrators and educators, health economists, planners, and policy analysts. Employed by governmental public health agencies, community-based service organizations, academic and research institutions, private organizations, hospitals, health plans, and medical groups, these professionals function broadly, with activities including health surveillance, protection, promotion, planning, regulation, and health services organization, delivery, and evaluation. 1 The world increasingly relies upon the public health workforce to confront emerging communicable diseases (e.g., Ebola and avian influenza), prevent environmental hazards (e.g., protect food security and combat climate change) and chronic disease (e.g., obesity and

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A household interview survey of 883 persons age 62 and older residing in Seattle, Washington, asked about a broad range of health care and social service issues, including the need for and use of dental care. The Andersen model of health services utilization was used to identify predisposing, enabling, and need characteristics hypothesized to affect the use of dental services. A path analysis was conducted to distinguish the direct and indirect effects of the variables. The results showed that none of the predisposing variables, including age, was a significant factor in explaining the use of dental services. Education had

Sustaining a successful program over times is critical in today's rapidly changing health care environment. This study sought to identify the characteristics of organizations that implemented innovative health programs for older adults and sustained those programs over time. The Gerontological Health Section of the American Public Health Association created an award in 1998, endowed by the Archstone Foundation, to recognize innovative programs providing health and related social support services to older adults. The 20 award winners were interviewed in Fall 2002, using a structured questionnaire based on the conceptual model for sustainability articulated by Shediac-Rizkallah and Bone. The findings provided insights into the importance of leadership, financing, organizational structure, governance, marketing, and evaluation/research.