Julia Berenson (
Yan Li is a research scientist in the Center for Health Innovation, New York Academy of Medicine, and an assistant professor in the Department of Population Health Science and Policy at the Icahn School of Medicine at Mount Sinai, both in New York City.
Health Aff (Millwood). 2017 Jun 1;36(6):1048-1056. doi: 10.1377/hlthaff.2017.0004.
In the United States, steps to advance health equity often take place at the state and local levels rather than the national level. Using publicly available data sources, we developed a scorecard for all fifty states and the District of Columbia that measures indicators of the use of five evidence-based policies to address domains related to health equity. The indicators are the cigarette excise tax rate, a state's Medicaid expansion status and the size of its coverage gap, percentage of four-year olds enrolled in state-funded pre-kindergarten, minimum wage level, and the presence of state-funded housing subsidy programs and homelessness prevention and rapid rehousing programs. We found that states varied significantly in their implementation of the selected policies and concluded that a variety of approaches to encourage policy changes at the state level will be needed to create healthier and more equitable communities. We describe promising, feasible state-level approaches for states to "do something, do more, do better" when they take action on the five selected policies that can promote health equity.
在美国，推进健康公平的措施通常在州和地方一级实施，而不是在国家一级。我们利用公开的数据源，为全美五十个州和哥伦比亚特区开发了一个记分卡，用于衡量五个循证政策在与健康公平相关领域的使用情况。这些指标包括香烟消费税税率、各州的医疗补助计划扩展情况和覆盖缺口规模、入读州立学前教育的四岁儿童比例、最低工资水平，以及州级住房补贴计划和无家可归预防和快速安置计划的存在情况。我们发现，各州在实施这些选定政策方面存在显著差异，并得出结论，需要采取各种方法鼓励州一级的政策变革，以创建更健康、更公平的社区。我们描述了一些有前途、可行的州一级方法，以便各州在采取行动促进健康公平的五个选定政策时“有所作为、更有作为、做得更好”。
