Public Policy Update

Although the adverse effects of behaviors such as limited physical activity, poor nutrition and alcohol and tobacco consumption are widely recognized as precipitators of stroke, lung disease, diabetes and other such diseases, the rising prevalence of these behaviors is still cause for national concern. As a result, psychologists have been developing effective evidence-based interventions to help modify these behavioral risk factors. APA's Public Policy Office (PPO) has been working to inform Congress and key federal health agencies of these interventions and emerging best practices in hopes that they reach more citizens to improve the nation's health status and lower the cost that unhealthy behavior inflicts on society.

United against disparities

The recently launched National Coalition on Health and Behavior, through a group effort led by APA's PPO and including the National Association of Social Workers (NASW) and the Society for Public Health Education (SOPHE), is focused on recognizing the role of behavior in federal legislation aimed at eliminating racial, ethnic and other health disparities. Racial and ethnic minorities, individuals with low English proficiency, impoverished and working-poor families, people living in rural communities and those without health insurance, among other populations, experience obstacles in accessing critically needed, timely health care.

In 2000, six of the 10 leading causes of death were behaviorally based--factors that are known to increase an individual's risk of disease, physical disability and early death. APA, in collaboration with NASW, has been working since 1999 to ensure that legislation introduced to eliminate health disparities recognizes the critical role of behavioral factors in research and training. In due course, the words "behavior" and "psychology" were included in key research and training sections of the Minority Health and Health Disparities Research and Education Act. This act was signed into law in November 2000 at a White House Oval Office ceremony that included then-APA CEO Raymond Fowler, PhD, in recognition of APA's contribution to the passage of the legislation. However, the bill introduced in the last Congress to reauthorize the 2000 law lacked this critical language. No action was taken on this legislation; similar legislation is expected to be reintroduced in this session of Congress.

Historic and contemporary discrimination, segregation and inequality are found in many aspects of American life, including employment, education and housing. The Institute of Medicine's 2002 report "Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare" shows these problems are compounded for some racial and ethnic-minority groups. These factors negatively affect the health and well-being of many in communities of color, and the report concludes that they should be at the center of the federal government's efforts to reduce health disparities.

New support

The American Public Health Association has now joined APA and NASW on the executive committee of the National Coalition on Health and Behavior. Fifteen organizations, which include the National Association of Community Health Centers, the Association of Teachers of Preventive Medicine, the Association of Maternal and Child Health Programs, the American Association for Marriage and Family Therapy and the American Sociological Association, have also joined the coalition.

More recently, the Democratic leadership of the House of Representatives and Senate held a joint press conference to unveil a set of principles for any legislation that addresses health disparities. These principles aim to:

  • Expand the health-care safety net.

  • Diversify the health-care work force.

  • Combat diseases that disproportionately affect racial and ethnic minorities.

  • Emphasize prevention and behavioral health.

  • Promote the collection and dissemination of data and enhance medical research.

  • Provide interpreters and translation services in the delivery of health care.

APA's PPO and the National Coalition on Health and Behavior are advocating for the inclusion of these principles in health-disparities legislation, while targeting much needed attention to the critical role of behavioral factors and behavioral research. They continue to meet with congressional offices of both parties in the House and Senate.

Further Reading

Lori Valencia Greene is the senior legislative and federal affairs officer for public interest policy in APA's Public Policy Office. For more information, contact her via e-mail.