Advancing New Standards in Reproductive Health, University of California San Francisco, Oakland, California.
J Public Health Manag Pract. 2018 May/Jun;24(3):255-262. doi: 10.1097/PHH.0000000000000647.
Recent legislation in states across the United States has required governmental health agencies to take on new and different roles in relation to abortion. While there has been media attention to health department roles in regulating abortion providers, there has been no systematic investigation of the range of activities in which state and local health departments are engaged.
To systematically investigate health department activities related to abortion.
We searched state health department Web sites of the 50 states and District of Columbia using key words such as "abortion" and "pregnancy termination". Two trained coders categorized 6093 documents using the 10 Essential Public Health Services (EPHS) framework. We then applied these methods to 671 local health department documents.
State and local health department Web sites.
N/A.
On average, states engaged in 5.1 of 10 Essential Services related to abortion. Most (76%-98%) state health departments engaged in activities to Monitor Health Status (EPHS1), Enforce Laws (EPHS6), and Evaluate Effectiveness, Accessibility, and Quality (EPHS9). Many (47%-69%) engaged in activities to Inform and Educate (EPHS3), Develop Policies (EPHS5), and Link to Services (EPHS7). A minority (4%-29%) engaged in activities to Diagnose and Investigate Health Problems (EPHS2), Mobilize Community Partnerships (EPHS4), and Assure Competent Workforce (EPHS8). No state engaged in Innovative Research (EPHS10). Few local health departments engaged in abortion-related activities.
While most state health departments engage in abortion-related activities, they appear to reflect what the law requires rather than the range of core public health activities. Additional research is needed to assess whether these services meet quality standards for public health services and determine how best to support governmental health agencies in their growing tasks. These findings raise important questions about the role of public health agencies and professionals in defining how health departments should be engaging with abortion.
美国各州的最近立法要求政府卫生机构在堕胎问题上承担新的和不同的角色。虽然媒体关注了卫生部门在监管堕胎提供者方面的作用，但没有系统地调查州和地方卫生部门从事的各种活动。
系统地调查卫生部门与堕胎相关的活动。
我们使用“堕胎”和“妊娠终止”等关键词，在 50 个州和哥伦比亚特区的州卫生部门网站上进行搜索。两名训练有素的编码员使用 10 项基本公共卫生服务（EPHS）框架对 6093 份文件进行分类。然后，我们将这些方法应用于 671 份地方卫生部门文件。
州和地方卫生部门网站。
无。
平均而言，各州参与了 10 项与堕胎相关的基本服务中的 5.1 项。大多数（76%-98%）州卫生部门参与了监测健康状况（EPHS1）、执行法律（EPHS6）以及评估效果、可及性和质量（EPHS9）的活动。许多（47%-69%）参与了信息和教育（EPHS3）、制定政策（EPHS5）和链接服务（EPHS7）的活动。少数（4%-29%）参与了诊断和调查健康问题（EPHS2）、动员社区伙伴关系（EPHS4）和确保有能力的劳动力（EPHS8）的活动。没有州参与创新研究（EPHS10）。很少有地方卫生部门参与堕胎相关活动。
虽然大多数州卫生部门都参与了与堕胎相关的活动，但这些活动似乎反映了法律要求，而不是核心公共卫生活动的范围。需要进一步研究，以评估这些服务是否符合公共卫生服务的质量标准，并确定如何最好地支持政府卫生机构承担日益增长的任务。这些发现提出了关于公共卫生机构和专业人员在界定卫生部门应如何参与堕胎问题上的作用的重要问题。
