Use of a State-Level Pharmaceutical Assistance Program Among Urban and Rural Elders

A number of state-level pharmaceutical assistance programs have been established as a result of the growing recognition of the role of pharmaceuticals in the long-term care of the elderly. However, existing research does not provide a coherent expectation for patterns of use by rural and urban elderly. The data for this analysis are drawn from a larger study of the Pennsylvania Pharmaceutical Assistance Contract for the Elderly (PACE). PACE provides prescription medicines for elderly who meet income requirements. The research project was designed to assess the characteristics of PACE program participants and non-participants on a wide range of issues. Chi-square analysis and regression models were used to assess the association between rural and urban residence and access to the PACE Program. The results indicate that rural/urban status of the elderly is not a significant predictor of the use of PACE. Other traditional variables (e.g., health self-rating and physician visits) did predict difference in the pattern of use.

Complicating the Local: Defining the Aymara at Tiwanaku, Bolivia

The archaeological site of Tiwanaku, Bolivia, is commonly held to be the "Spiritual Capital of the Aymara People." But negotiating who qualifies as Aymara, and in what contexts, is decidedly more complicated. Local political divisions between residents of the village of Tiahuanacu (who are seen locally as less-Aymara but not as not-Aymara) and residents of the surrounding rural communities (who are considered to be unquestionably Aymara) structure discussions about who has the right to earn income at the Tiwanaku archaeological site, who manages major public events, and who is responsible for the site's maintenance and security. The situation is complicated further by national-level events such as the Winter Solstice, where urban Aymara travel to Tiwanaku to seek their roots, and Bolivian Presidents and politicians come to participate in national Aymara "culture." I focus on the intervencin ("Intervention") that took place in Tiahuanacu in August 2000, which resulted in the transfer of management of the Tiwanaku archaeological site from the Bolivian state to local municipal and indigenous authorities. Heritage researchers should take such local divisions into account, rather than assuming that "locals" are politically unified or easily delineated by geographical boundaries.