abstract: 'In public health care, needs assessments are a common practice, often

  done once a year or every couple of years, to determine arenas on which

  providers should focus their prime attention. The structure of needs

  assessments varies between political boundaries, but within political

  boundaries (e.g. state, county, etc.) they are generally standardized so

  that organizations offering similar types of care may compare results

  and streamline strategies. Public health providers, however, often see

  needs assessments as bureaucratic mazes through which providers must

  navigate to gain state and federal dollars. Despite this image, needs

  assessments play an integral role in how governmentally subsidized

  health care services are provided and delivered. Equally important,

  needs assessment design may at once reinforce and be reinforced by

  existing geographies of inequality and associated social policy

  regarding subsidized populations. The purpose of this paper is to

  examine this mutually constitutive relationship between social policy

  and spatiality using an empirical example in the public health arena,

  specifically, the needs assessment process for federally subsidized

  women''s health care clinics in Butler County, Ohio, where I worked as an

  intern on a three year needs assessment in 1993. The paper focuses on

  how the problem definition process (the use of indicators of need)

  constitutes and is constituted by a dualistic conception of health care

  provision which views health care as either preventive or sick care and

  the provision of care as either site specific or individual specific. I

  criticize this binary conception and then analyze it in terms of the

  geographical implications for low income women and children seeking

  subsidized health care. The paper has three sections. The first section

  lays out a theoretical framework through which social policy analysis

  may be understood. The second section offers an introduction to the

  study area and the needs assessment methodology for subsidized women''s

  health care clinics in Ohio. The third and final section examines the

  geographical implications of the needs assessment process in Ohio.'
affiliation: Gallaher, C (Corresponding Author), UNIV KENTUCKY,DEPT GEOG,LEXINGTON,KY
  40506, USA.
author: Gallaher, C
author_list:
- family: Gallaher
  given: C
da: '2023-09-28'
doi: 10.1016/0016-7185(95)00033-X
files: []
issn: 0016-7185
journal: GEOFORUM
language: English
month: AUG
number: '3'
number-of-cited-references: '15'
pages: 287-295
papis_id: 11fbbee37a01b74655d2beee4b133cde
ref: Gallaher1995socialpolicy
times-cited: '0'
title: 'Social policy and the construction of need: A critical examination of the
  geography of needs assessments for low-income women''s health'
type: Article
unique-id: WOS:A1995TM33200005
usage-count-last-180-days: '0'
usage-count-since-2013: '0'
volume: '26'
web-of-science-categories: Geography
year: '1995'