State Leadership Conference

In California, Hawaii and New Mexico, no single ethnic or racial group constitutes a majority of the population, according to the census of 2000. As America's demographics continue to change, that pattern is likely to spread to other parts of the country, bringing with it new challenges for health-care providers.

To ensure that those challenges are met, state leaders need to take an active role in the legislative process, fighting for the inclusion of psychologists in health-related bills and supporting attempts to reduce health disparities among different segments of society, said panelists at a session at the APA Practice Organization's State Leadership Conference in March.

The goal of the session was to help attendees "understand the thinking of legislators as they approach issues of diversity, both ethnic and otherwise," said Kathleen S. Brown, PhD, chair-elect of the Committee of State Leaders (CSL). The CSL's Diversity Subcommittee organized the session, with current CSL chair Josephine D. Johnson, PhD, serving as moderator.

The panel offered the following insights into the current legislative environment, along with suggestions for how psychologists can make their voices heard:

  • Advocating for funding. The 108th session of Congress will be considering a number of bills that are directly relevant to psychologists concerned about diversity and minority-health issues, said Brenda Pillors, PhD, chief of staff for Rep. Edolphus Towns (D-N.Y.).

The most important is the Health Professions Education Act, which, in addition to housing the new Graduate Psychology Education program, funds a center on minority health at the National Institutes of Health, supports education at historically black colleges and provides financial assistance to minority students in health professions, among other things, she said.

The Children's Health Act of 2000 is also due for reauthorization; Pillors praised APA for its work on the act and emphasized the importance of staying involved in the reauthorization process. Other bills that deserve attention include the Minority Health and Health Disparities Research and Education Act of 2000, which is up for reauthorization, and bills that address HIV/AIDS both domestically and internationally.

Concrete actions that psychologists can take to influence these bills--and other legislation at both state and federal levels--include providing psychology-friendly legislators with questions they can pose to opponents, suggesting language to be included in the bills and testifying before legislative committees, said psychologist and state Rep. Joyce Beatty, PhD (D-Ohio). "If you leave here today with only one thing," said Beatty, "I'd like it to be this: Go testify."

  • Creating synergy. The current legislative environment is a difficult one for those who would like to see the federal government maintain or expand social services, said Peter Newbould, director of congressional and political affairs at the APA Practice Organization. The weak economy and tax cuts are putting pressure on the budget, while alliances between the Republican Party and the insurance industry have slowed some health-care reform efforts, Newbould said. Procedural rules in the House of Representatives allow the majority party to control the legislative process, he noted, frustrating attempts by the minority party to bring alternative proposals--which often have bipartisan support--to a vote.

As a result, groups like the Congressional Black Caucus--all of its House members are democrats--may have to focus less on winning votes and more on reaching people outside the legislature, Newbould said. One way to do so is by working with individual states. The 1996 drive to pass the Domenici-Wellstone mental health parity bill, for example, inspired a flood of new parity laws at the state level.

Even without legislative success, advocacy can achieve the important goal of raising consciousness, Newbould said. When faced with a strong opposition, he noted, "Our goal is not necessarily to win a unanimous vote on an issue, but to lessen the opposition and to get people to come over toward our side."

  • Building coalitions. One of the best ways to raise consciousness and win votes is to build coalitions that extend beyond race and ethnicity, the panelists said. The Minority Health and Health Disparities Research and Education Act is a prime example: It gained support by addressing regional disparities--such as those between urban and rural communities--instead of focusing solely on race and ethnicity, Pillors said.

"The misunderstanding is that we are only fighting for black folks, but the truth is that everybody benefits," noted Beatty. "This is no longer only about African Americans--it's about all of us."

Further Reading

APA's Public Policy Office has been working to promote psychology's role in minority health issues. For instance, it advocated successfully for the enactment of the 2000 minority health disparities legislation, which included provisions for research and education in behavioral health. Further information about APA's legislative initiatives to promote minority health and its collaboration with congressional ethnic-minority caucuses can be found in Ethnic Minority Affairs.