Suppose a neighborhood community center decides to start a new care service for older residents. The first question the person in charge runs into is surprisingly simple: who actually needs this service, and how many of them are there? The answer is not easy, because the people who look at risk to an expert, the people who say they are struggling, and the people who actually show up at the application desk are not all the same people.
The framework that sorted out this confusion is the Taxonomy of Social Need, published in 1972 by the British social policy scholar Jonathan Bradshaw. Put simply, it points out that saying “there is a need” is in practice used in four different ways: normative, felt, expressed and comparative need. It began as a short essay in a collection of papers on medical services, yet it is still among the first classics people cite in needs assessment for social welfare and public health.
This article first explains why measuring need in only one way goes wrong, then covers the meaning and examples of the four needs, and finally how to read the four together and where the framework has limits.
Seeing Need Through Four Lenses
Why One Meaning of “Need” Is Not Enough
In welfare services, the person who pays and the person who uses the service are usually not the same. In a market, demand arises when someone is willing to pay, but in welfare we have to look at need regardless of ability to pay, so “who needs it” has to be worked out separately. Bradshaw observed that, in practice, this sorting out is done through four different definitions.
The problem is that each definition points to different people. Someone who falls short of an expert’s standard may feel no discomfort, and someone who does feel discomfort may not know where to ask for help. So if need is measured with a single yardstick, some people are left out and others are over-counted. Going back to the care service example, it is common to see one older person living alone count as high-risk by expert standards while saying they are fine, and another older person in the same neighborhood feel anxious and call first. Separating the four is not meant to make need more complicated; it is a device for making clear which need we are talking about right now.
Normative Need Set by Experts and Felt Need Sensed by the Person
The first two differ in who judges the need. Normative need is a state judged to be lacking against a desirable standard set by experts, administrators or researchers, while felt need is a state in which the person themselves feels something is needed.
- Normative Need: The need that arises when experts set a desirable standard and the current state falls short of it.
- Felt Need: The need identified by treating need as want and asking the person directly whether they need something.
Examples of normative need include a meal that falls short of nutritional standards or a score on a scale that measures the ability to carry out daily activities. The standard looks objective, but it is not absolute. Experts may set different standards, standards change as knowledge and social values change, and it can easily slide into paternalism, applying the outlook of one social class to another.
Felt need has the strength of capturing the person’s own voice, but it is not enough on its own. People think of needs only in terms of the services they know and their own circumstances. A service you never knew existed is one you cannot even want.
Expressed Need Shown Through Action and Comparative Need Found by Comparing
The third and fourth are more about how a need becomes visible. Expressed need is felt need turned into action to seek help, and comparative need is a need discovered by comparing people with similar characteristics.
- Expressed Need: The need that shows up as a demand and an action, such as submitting an application or joining a waiting list.
- Comparative Need: The need revealed by a gap, when some people go without a service even though they are in a similar situation to those who receive it.
Expressed need can be counted, like the number of people on a waiting list, which makes it handy for planning, but people who cannot or do not ask for help never appear in the figures. A waiting list is also a number that only comes from people who know the service exists.
Comparative need starts from comparisons such as a facility that exists in the next town but not in ours. Still, whether the region or group used for comparison is itself at an adequate level has to be examined separately.
How to Read the Four Together, and the Limits
The four needs sometimes overlap and sometimes pull apart. If someone falls short of expert standards, also feels they are struggling, actually asked for help, and people in similar situations are already receiving the service, no one disagrees that a need exists. Conversely, when only one of the four applies, it is a signal to check the other three.
(1) Finding blind spots in the mismatches
If normative need is high but felt and expressed need are low, the person may not know about the service or may be reluctant to use it. In that case, look first at how the service is publicized and how easy it is to reach. Conversely, if felt and expressed need are high but the normative standard shows no shortfall, it is worth checking whether the standard has fallen behind reality.
(2) Using them together in a survey
Estimate the scale with basic statistics and expert standards, hear how people feel through interviews, confirm expression through application and waiting list data, and look at gaps through comparisons between regions. The key is not to rely on a single source of data.
(3) Knowing the framework’s limits
This taxonomy is not an answer sheet that tells you what need is; it is a pair of glasses for looking at need. Need changes with environment and time, and choosing a standard involves value judgments. Bradshaw himself held that no single definition gives a perfect answer.
Finding people who need care is both a matter of counting numbers and a matter of listening to voices. Asking first who is saying there is a need, and by what standard, and then setting the four perspectives side by side, is the first step toward using Bradshaw’s taxonomy properly.
