Ladenheim Kala, Groman Rachel
J Health Polit Policy Law. 2006 Feb;31(1):153-83. doi: 10.1215/03616878-31-1-153.
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.
各州立法机构如何采取行动解决医疗保健中的种族和族裔差异问题？本文考察了与医疗保健差异和可及性相关的州立法随时间的趋势、一个两年期会议期间的提案立法，以及当代立法机构对该问题的态度和认识。各州采取的策略组合反映了各州理解少数族裔健康差距的不同方式以及随时间变化的策略。从历史上看，加利福尼亚州、佛罗里达州和路易斯安那州（均为少数族裔人口众多的州）一直最积极地通过法规来处理少数族裔健康问题。在我们研究的2001 - 2002年立法会议的18个月中，最常见的法案要求对差异进行研究，并为可确定的少数族裔健康倡议拨款。成功通过立法机构审议的措施包括与文化能力和少数族裔健康意识月相关的措施。最后，本文讨论了利用立法行动来衡量州政府在健康差异方面的政策活动水平时存在的问题和局限性。为了对差异立法的趋势描述提供依据，作者将州立法者的评论与对解释立法活动中存在的问题的讨论结合起来。
