Community and minority group relations.

Community and minority group relations is currently one of the central issues in Health Services Organization. Dick Weinerman came to grips with aspects of this problem area throughout his career. He advocated a significant role for unionized plantation workers in the administration of a proposed health services plan for Hawaii in 1952. (25)t In 1960, he discussed and strongly encouraged Labor's interest in both occupational health and medical care. (36) He was frequently concerned with patients' perceptions of their attitudes towards group practice.' In one of his last works, a position paper for the Committee for National Health Insurance, Dick spoke of the importance of involving consumers in quality control.! One of the most important current topics in this area is that of community control of health facilities. Dick did not publish any of his views of this issue. He did leave behind a completed grant proposal to study it, but expressed no position besides his usual scientific one of attempting an objective analysis and evaluation.! Because of its currency and urgency, it seems to me most appropriate to discuss the community control problem tonight, even in the absence of a clear statement from Dick on it. Dick did leave for us a number of very concise descriptions of the theoretical approach that he used in dealing with any medico-social problem. In this paper I will attempt an analysis of the community control issue using methods that I learned from Dick. However, I am not attempting to put words in his mouth or to say, "This is what Dick would have said." The method may be Weinerman's, adapted by me, but the opinions expressed are pure Jonas. In 1964, Dick wrote: "No understanding of health, its disorders and its protection is possible in a social vacuum . . . An examination of current developments in medical care . . . must, therefore, consider the major social and scientific trends which provide the decisive context." (44) And in 1965 he said: "Social change and scientific advance determine the course of human endeavor in every country and in every era." (53) Therefore, the issue