We conducted a legal mapping study of state bills related to racial/ethnic health disparities in all 50 states between 2002 and 2011. Forty-five states introduced at least 1 bill that specifically targeted racial/ethnic health disparities; we analyzed 607 total bills. Of these 607 bills, 330 were passed into law (54.4%). These bills approached eliminating racial/ethnic health disparities by developing governmental infrastructure, providing appropriations, and focusing on specific diseases and data collection. In addition, states tackled emerging topics that were previously lacking laws, particularly Hispanic health. Legislation is an important policy tool for states to advance the elimination of racial/ethnic health disparities. Despite decades of research and awareness, 1–3 and increasing federal attention and action, 4–7 racial/ethnic health disparities persist throughout US society. It is well documented that some racial/ethnic groups are more likely to live shorter and sicker lives. 8–10 Health disparities also vary geographically. For example, research suggests that there are more severe racial/ethnic health disparities among rural populations compared with urban dwelling populations. 11 These health disparities are the result of myriad social, individual, and political factors, including health behaviors, housing, education, income, and access to health care. 12–15 Because of the complex nature of the drivers of health disparities, eliminating racial/ethnic health disparities requires integrating science, practice, and policy at all levels of government. 16 States are well positioned to use their policymaking powers toward eliminating racial/ethnic health disparities, and have done so in the past. 17 State legislative activities related to racial/ethnic health disparities have focused on developing governmental infrastructure focused on racial/ethnic health disparities, disease-specific approaches (e.g., lupus task forces), race-specific activities (e.g., African American oral health programs), and increasing awareness of health disparities through special commissions. 17 Few researchers have devoted attention to mapping state legislative activity regarding racial/ethnic health disparities. By not doing so, we miss opportunities to further our understanding of how states have used legislation to eliminate racial/ethnic health disparities, and to support advocacy and monitoring efforts related to racial/ethnic health disparities. To our knowledge, Ladenheim and Groman published the first study in this area, by reviewing state legislation that specifically targeted racial/ethnic disparities in health care and access from 1975 to 2001. 17 We furthered the understanding of the recent state legislative environment related to eliminating racial/ethnic health disparities. Our analysis examined proposed and enacted state legislation from 2002 to 2011 to identify legislative approaches to eliminating racial/ethnic health disparities. Our research, which considered state bills that were proposed and failed along with those that were passed into law, offered insights into states’ legislative agendas related to health disparities, including emerging trends and challenges.
展开▼
