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Health Policy Responsiveness: Lessons Learned from Maryland and Prince George’s County

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Journal of Racial and Ethnic Health Disparities Aims and scope Submit manuscript

Abstract

Effective, timely, and intentional policy efforts can significantly impact and improve the public’s health and reduce racial and ethnic health disparities across the nation. Creating and implementing responsive policies at the state and county level is essential to supporting community efforts to improve health behaviors and health outcomes, particularly for communities of color who bear the brunt of disease risk and negative health outcomes. Using policy examples from the State of Maryland and Prince George’s County, the largest and wealthiest predominately African-American county in the USA, this case study highlights the importance of state and county policy action when presented with opportunities to affect long-lasting, positive change. We examine each jurisdiction’s policy response through the lens of timeliness, intentionality, and effectiveness. At first glance, it would appear that Maryland responded effectively to the rise in tobacco use. Similarly, at face value, it appears that Prince George’s County’s unchecked rise in obesity rates among African-Americans is an example of nonresponsiveness among local policymakers in the face of an obesity epidemic. However—guided by a more nuanced understanding of “policy responsiveness”—this analysis uncovers a more revealing picture, with important strengths and limitations seen in both policy situations. This analysis raises critical questions about the determinants of jurisdictions’ health policy capacity and how policymakers might best be supported in their efforts to build an arsenal of health policies that are timely, effective, and intentional in meeting the needs of vulnerable communities.

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References

  1. King ML Jr. Stride toward freedom: the Montgomery story. Boston: Beacon Press; 2010.

    Google Scholar 

  2. Centers for Disease Control and Prevention. Ten great public health achievements—United States, 1900–1999. MMWR Morb Mortal Wkly Rep. 1999;48(12):241–3.

    Google Scholar 

  3. Smith DB. Health care divided: race and healing a nation. 1st ed. Detroit: University of Michigan Press; 1999.

    Book  Google Scholar 

  4. Sankofa J, Sogie-Thomas B. 50 years later: Medicare’s pathway to racial integration. In: HPRC Publications. 2015. http://hprc.info/wp-content/uploads/2016/05/Medicare-50-Years-Later-7.28.15-JS.pdf. Accessed 9 Dec 2016.

  5. Adepoju OE, Preston MA, Gonzales G. Health care disparities in the post-Affordable Care Act era. Am J Public Health. 2015;105(Suppl 5):S665–7.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Sogie-Thomas B, Sankofa J. Health equity and the ACA: the effect of the affordable care act on racial and ethnic disparities in healthcare access. In: HPRC Publications. 2015. http://hprc.info/wp-content/uploads/2015/09/HPRC-health-policy-march.pdf. Accessed 9 Dec 2016.

  7. U.S. Census Bureau. QuickFacts. Prince George’s County, Maryland. http://www.census.gov/quickfacts/table/PST045215/24033. Accessed 12 Dec 2016.

  8. Prince George’s County Health Department. Office of assessment and planning. Health report 2015. http://www.princegeorgescountymd.gov/ArchiveCenter/ViewFile/Item/1557. Accessed 29 Nov 2016.

  9. Jones C. An introduction to the study of public policy. Belmont: Wadsworth; 1984.

    Google Scholar 

  10. Kingdon JW. Agendas, alternatives, and public policies. 2nd ed. New York: Longman; 1995.

    Google Scholar 

  11. Samet JM. Tobacco smoking: the leading cause of preventable disease worldwide. Thor Surg Clin. 2013;23(2):103–12.

    Article  Google Scholar 

  12. U.S. Department of Health and Human Services. Public health service. Center for disease control. Center for chronic disease prevention and health promotion. Office on smoking and health. DHHS Publication No. (CDC) YO-K-116. 1990.

  13. Godtfredsen NS, Lam TH, Hansel TT, Leon ME, Gray N, Dresler C, Burns DM, Prescott E, Vestbo J. COPD-related morbidity and mortality after smoking cessation: status of the evidence. Eur Respir J. 2008;32(4):844–53.

    Article  CAS  PubMed  Google Scholar 

  14. Schoenborn CA, Adams PF, Peregoy JA. Health behaviors of adults: United States, 2008–2010 [PDF–3.21 MB]. National Center for Health Statistics. Vital Health Stat. 10(257):1–184.

  15. Heron M. Deaths: leading causes for 2010. National vital statistics reports, vol 62 no 6. Hyattsville: National Center for Health Statistics; 2013.

  16. Centers for Disease Control and Prevention. Current cigarette smoking among adults—United States, 2005–2015. Morb Mortal Wkly Rep. 2016;65(44):1205–11.

    Google Scholar 

  17. Albano JD, Ward E, Jemal A, Anderson R, Cikkinides VE, Murray T, et al. Cancer mortality in the United States by education level and race. J Natl Cancer Inst. 2007;99:1384–94.

    Article  PubMed  Google Scholar 

  18. Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, et al. SEER cancer statistics review, 1975–2011. Bethesda: National Cancer Institute; 2014. http://seer.cancer.gov/csr/1975_2011/. Accessed 12 Dec 2016

    Google Scholar 

  19. U.S. Department of Health and Human Services. 2014. The health consequences of smoking—50 years of progress: a report of the surgeon general. http://www.surgeongeneral.gov/library/reports/50-years-of-progress/sgr50-chap-2.pdf. Accessed 29 Nov 2016.

  20. Daynard RA, Bates C, Francey N. Tobacco litigation worldwide. Br Med J. 2000;320(7227):111–3.

    Article  CAS  Google Scholar 

  21. Maryland Department of Health and Mental Hygiene. Cigarette restitution fund. Maryland.gov. http://crf.dhmh.maryland.gov/pages/home.aspx. Accessed 1 Feb 2017.

  22. Public health Law Center, Mitchell Hamline School of Law. Master settlement agreement. http://www.publichealthlawcenter.org/topics/tobacco-control/tobacco-control-litigation/master-settlement-agreement. Accessed 1 Feb 2017.

  23. Proctor RN. The shameful past. The history of the discovery of the cigarette-lung cancer link: evidentiary traditions, corporate denial, global toll. Tob Control. 2012;21:87–91. http://tobaccocontrol.bmj.com/content/tobaccocontrol/21/2/87.full.pdf. Accessed 1 Feb 2017

    Article  PubMed  Google Scholar 

  24. Robert Wood Johnson Foundation. Smoking and health. http://www.rwjf.org/maketobaccohistory. Accessed 1 Feb 2017.

  25. Smoking and Health. Report of the advisory committee to the surgeon general of the public health service. United States Department of health, education and welfare, public health service. https://www.scribd.com/document/199073624/Smoking-and-Health. Accessed 1 Feb 2017.

  26. Robert Wood Johnson Foundation. 50 years of tobacco control. https://www.cancer.org/healthy/stay-away-from-tobacco/great-american-smokeout.html. Accessed 1 Feb 2017.

  27. American Cancer Society. The great American smokeout. https://www.cancer.org/healthy/stay-away-from-tobacco/great-american-smokeout.html. Accessed 1 Feb 2017.

  28. Maryland Department of Health and Mental Hygiene. Monitoring changing tobacco use behaviors: 2000–2014. Baltimore: Maryland Department of Health and Mental Hygiene, Prevention and Health Promotion Administration, Primary Care and Community Health Bureau, Center for Tobacco Prevention and Control; 2016.

    Google Scholar 

  29. Maryland Department of Information Technology. Open data portal. https://data.maryland.gov/Health-and-Human-Services/Maryland-Adult-Cigarette-Smoking-Status-1995-2010/ycny-6riz. Accessed 2 Dec 2016.

  30. Maryland Department of Health and Mental Hygiene. Monitoring changing tobacco use behaviors 2000–2010. Baltimore: Maryland Department of Health and Mental Hygiene, Prevention and Health Promotion Administration, Primary Care and Community Health Bureau, Center for Tobacco Prevention and Control; 2011. http://mdquit.org/sites/default/files/pdf_files/2010%20BiennialTobaccoReport%5B1%5D.pdf. Accessed 6 Dec 2016

    Google Scholar 

  31. Maryland’s alcohol and tobacco tax annual report. http://finances.marylandtaxes.com/static_files/revenue/alcoholtobacco/annual/AnnualReportFY2015.pdf. Accessed 6 Dec 2016.

  32. Maryland’s Citizen Health Initiative. 2012. Maryland’s cigarette pack sales decline dramatically with each cigarette tax increase. http://healthcareforall.com/wp-content/uploads/2012/01/Vinnys-favorite-chart1.pdf. Accessed 2 June 2015.

  33. Office of Minority Health and Health Disparities. Maryland plan to eliminate minority health disparities: plan of action 2010–2014. March 2010. http://dhmh.maryland.gov/mhhd/Documents/Maryland_Health_Disparities_Plan_of_Action_6.10.10.pdf. Accessed 15 Feb 2017.

  34. Centers for Disease Control and Prevention (CDC)'s Behavioral Risk Factor Surveillance System (BRFSS) 2006–2007 Survey results. State Tobacco Activities Tracking and Evaluation (STATE) system.

  35. Centers for Disease Control and Prevention (CDC)'s Behavioral Risk Factor Surveillance System (BRFSS) 2013–2015 Survey results. State Tobacco Activities Tracking and Evaluation (STATE) system.

  36. Maryland chartbook of minority health and minority health disparities data with sections on gender-specific health and jurisdiction-specific health second edition: December 2009 http://dhmh.maryland.gov/mhhd/Documents/Health%20Disparities%20Data%20Chartbook_2009.pdf. Accessed 12 Dec 2016.

  37. Prince George’s County Health Department. Health report 2014. http://www.princegeorgescountymd.gov/sites/Health/PGCHI/Coalitions/Documents/LocalhealthPlanPrefinal.pdf Accessed 12 Dec 2016.

  38. Prince George’s County Health Department. 2011. Prince George’s county health improvement plan 2011 to 2014. http://www.princegeorgescountymd.gov/ArchiveCenter/ViewFile/Item/1521. Accessed 12 Dec 2016.

  39. USDA National Institute of Food and Agriculture. Supplemental Food and Nutrition Program–Education (SNAP-Ed). https://nifa.usda.gov/program/supplemental-nutrition-education-program-education-snap-ed. Accessed 15 Feb 2017.

  40. The Maryland-National Capital Park and Planning Commission. Approved general plan. October 2002. http://www.pgplanning.org/Resources/Publications/2002_General_Plan_Publication.htm. Accessed 15 Feb 2017.

  41. The Maryland-National Capital Park and Planning Commission. Envision Prince George’s. https://planning.maryland.gov/PDF/YourPart/MPCA/20111109/MPCA_SParkerSession_VisioningAndPlanning.pdf. Accessed 15 Feb 2017.

  42. Prince George’s County Planning Board. A discussion of community health and food access in Prince George’s County: Prince George’s County general plan update. November 2012. http://planpgc2035.com/sites/default/files/documents/Community%20Health%20and%20Food%20Access%20Policy%20Paper.pdf. Accessed 15 Feb 2017.

  43. The Maryland-National Capital Park and Planning Commission. Approved countywide master plan of transportation. November 2009. http://www.pgplanning.org/Resources/Publications/Mpot.htm. Accessed 15 Feb 2017.

  44. Let’s Move Cities Towns and Counties (LMCTC). A call to action for local elected officials. White House Archives. https://letsmove.obamawhitehouse.archives.gov/become-lets-move-city-or-town. Accessed 15 Feb 2017.

  45. Maryland General Assembly. House Bill 1135. Property tax credit–grocery stores–low income areas. February 17, 2010. http://mlis.state.md.us/2010rs/bills/hb/hb1135f.pdf. Accessed 15 Feb 2017.

  46. Prince George’s County, Maryland. Healthcare action coalition. 2014. http://www.princegeorgescountymd.gov/1631/Healthcare-Action-Coalition. Accessed 2 June 2015.

  47. M-NCPPC Prince George’s County Planning Department. 2014. Prince George’s county food system study. Presentation to the Prince George’s county planning board, http://www.pgplanning.org/Assets/Planning/Countywide+Planning/Food+System+Study/PB+presentation+on+FSS.pdf. Accessed 2 June 2015.

  48. Prince George’s County Health Department. Office of assessment and planning. Health report 2015. http://www.princegeorgescountymd.gov/ArchiveCenter/ViewFile/Item/1557. Accessed 4 Dec 2016.

  49. Prince George’s County Health Zone. Prince George’s county health department. http://www.pgchealthzone.org/. Accessed 30 Jan 2017.

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Acknowledgements

This work was supported by the National Institute on Minority Health and Health Disparities of the National Institute of Health under award number 5U54MD00860802. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Health or the National Institute on Minority Health and Health Disparities.

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Authors and Affiliations

  1. Health Policy Research Consortium, CTIS Inc., Greenbelt, MD, USA

    Byron Sogie-Thomas, John Sankofa, Crystal Reed, Kweisi Mfume & Lauren Abla Doamekpor

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  1. Byron Sogie-Thomas
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  2. John Sankofa
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  3. Crystal Reed
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  4. Kweisi Mfume
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  5. Lauren Abla Doamekpor
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Correspondence to Lauren Abla Doamekpor.

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Sogie-Thomas, B., Sankofa, J., Reed, C. et al. Health Policy Responsiveness: Lessons Learned from Maryland and Prince George’s County. J. Racial and Ethnic Health Disparities 5, 366–374 (2018). https://doi.org/10.1007/s40615-017-0379-4

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