State Legislative Activities Related to Elimination of Health Disparities

Abstract

How have state legislatures acted to address racial and ethnic disparities in health care? This article examines trends over time in state legislation related to disparities in care and access, proposed legislation during one biennial session, and contemporary legislative attitudes and awareness of the issue. The mix of strategies adopted across the states reflects the differing ways that states understand gaps in minority health and changing strategies over time. Historically, California, Florida, and Louisiana (all states with substantial minority populations) have been the most active in dealing with minority health issues through statutes. In the eighteen months of the 2001-2002 legislative session that we studied, the most common bills called for studies of disparities and appropriations for identifiable minority health initiatives. Measures that successfully cleared the legislature include measures related to cultural competence and minority health awareness month. Finally, the article discusses issues and limitations in using legislative action to measure the level of state policy activity with regard to health disparities. To ground the description of trends in disparity legislation, the authors integrated comments by state legislators with a discussion of problems in interpreting legislative activity.

Racial and Socioeconomic Disparities in Access to Primary Care Among People With Chronic Conditions

“…Developing targeted regulatory and health care policies to reduce deaths from chronic diseases and injuries would be a major step forward in eliminating health disparities in the United States. 35,36 This study is subject to the following limitations. First, because of the secondary nature of the data, measures of primary care attributes have to be based on availability of data.…”

Strategies for Targeting Health Care Disparities Among Hispanics

“…Moreover, insurance that covers primary health care services is less expensive over the course of an individual's life span. 3 The Small Employer Health Insurance Rating Act allows employers with 2 to 50 employees to purchase health insurance coverage with reduced premiums. However, insurers such as managed care plans and health maintenance organizations provide health insurance to employers with 2 to 50 employees only after they meet the minimum participation requirements as established by the insurer.…”

“…It can promote provision of culturally sensitive health care services. 64 By including cultural diversity and cultural competency in the academic curriculum, 3 and with community partnerships, schools could create opportunities for students to be exposed to the health care field. These experiences include arranging for job shadowing in a health care setting, offering classes to become certified nurses' aides or arranging for health care professionals as special speakers to introduce the health profession as an option to minority students.…”

“…45 Federal and state funds that are extended to include minorities' participation in assessing the contributors to health care disparities may lead to the evidence for its resolution. 3 Secondary data from studies with Hispanic participants could also be used to evaluate the strengths and weaknesses of the community's efforts and progress in dealing with the Hispanic health care disparities. 46 Community-based participatory research (CBPR)…”

“…1 Health care disparities are more frequent in minority groups, 2 of which Hispanics constitute the largest group. 3 According to the 2000 US census of 2000, approximately 13% of the US population is Hispanic, including MexicanAmericans, Puerto, Ricans, and Cubans. Since 1990, the Hispanic population in the United States has increased by approximately 58%.…”