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The relationship between impairment, disability, and labor force participation is investigated longitudinally through disability determinations using objective medical evaluations. The sensitivity and specificity concepts are used to study the disability determination standards and their ability to predict capacity to work. Approximately one of every eight men in the study had a physical impairment that met or equaled the medical listings of impairment sometime through age 65; for the women the figure was slightly less than one-half that size. Many of these people were seriously ill; within four years of the disabling condition being established, about two of every five people were dead, suggesting the listings of impairment are indeed sensitive to serious health problems. The majority of the men who did meet or equal the medical listings of impairment were alive four years after the disabling condition was determined, and most of these survivors were in the labor force despite the disabling impairment. The study shows that withdrawal from the labor force is based on age in combination with any level of impairment; and the disabled are a unique subset of the impaired, distinguishable not by health but demographic and socioeconomic characteristics.

Rising welfare rolls have led some students and practitioners to suggest that more efficient administration will curb welfare costs and provide greater uniformity in decisions concerning eligibility. In order to insure strict standards in the administration, the disability insurance program enacted in 1956 relegated the responsibility of determining eligibility to the states, expecting that they would expend benefits less liberally than the national government. This article shows that the administration by states has had at best a nominal impact upon rising costs and uniformity of eligibility decisions. Moreover, their analysis leads the authors to conclude, first, that the states continue to be a potent force in American federalism and, second, that people in need will apply for and receive benefits regardless of the program's nature or its administering agency.

SINCE the publication in 1964 of the Surgeon General's report, Smoking and Health, an increasing number of studies related to the behavior of the public have been reported (1,2). Some of these studies have been economic in orientation, describing fluctuations in the sale of cigarettes and other tobacco products; others have been reports of clinical trials describing the effects of nicotine, tars, and smoke on man and animals; still others have been concerned with the attitudes of the public toward smoking. More recently, physicians have become the target population in studies of smoking behavior (3) and atti