State and county level legislative approaches to address racial/ethnic health inequities in Maryland (2012–2021)

IntroductionPublic policies and legislative approaches are used to address racial health inequities. While most recent studies examine federal and state-level legislative activity, a paucity of analyses characterize policies enacted in a single state and across local jurisdictions. To address this g...

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Main Authors: Makeda Walelo, Kellee White Whilby
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1473971/full
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author Makeda Walelo
Kellee White Whilby
author_facet Makeda Walelo
Kellee White Whilby
author_sort Makeda Walelo
collection DOAJ
description IntroductionPublic policies and legislative approaches are used to address racial health inequities. While most recent studies examine federal and state-level legislative activity, a paucity of analyses characterize policies enacted in a single state and across local jurisdictions. To address this gap, we identify racial health equity policies in the state of Maryland and describe key features and themes.MethodsA legal mapping study and content analysis was conducted. Maryland policies and legislative activity adopted at the state or county level (2012–2021) were identified by systematically searching Westlaw and state and county government legislative databases. Information for each policy was ascertained and analyzed to identify content domains.ResultsWe identified 22 state-level policies and 10 county-level policies and actions that explicitly addressed racial health inequities. Six domains were identified: healthcare and public health cultural competence; disease-specific care and outcomes; access to healthcare services; social determinants of health; collection action and research infrastructure; and structural racism. At the state- and county- level, most policies pertained to the healthcare and public health cultural competence domain. Of Maryland’s 24 counties, only 8 (33%) passed health equity policies and implemented equity-specific policy priorities.ConclusionThis study provides a snapshot of the Maryland policy landscape and suggests an increasing prioritization of equity policy at the state and county levels. While policies address issues ranging from cultural competence to structural racism, policy content differed by level of jurisdiction. Future efforts to critically evaluate the impact of specific policies on health inequities are needed.
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spelling doaj-art-4d65d8a785ed452eb9d77c83fd46cab02025-01-23T06:56:16ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-01-011310.3389/fpubh.2025.14739711473971State and county level legislative approaches to address racial/ethnic health inequities in Maryland (2012–2021)Makeda WaleloKellee White WhilbyIntroductionPublic policies and legislative approaches are used to address racial health inequities. While most recent studies examine federal and state-level legislative activity, a paucity of analyses characterize policies enacted in a single state and across local jurisdictions. To address this gap, we identify racial health equity policies in the state of Maryland and describe key features and themes.MethodsA legal mapping study and content analysis was conducted. Maryland policies and legislative activity adopted at the state or county level (2012–2021) were identified by systematically searching Westlaw and state and county government legislative databases. Information for each policy was ascertained and analyzed to identify content domains.ResultsWe identified 22 state-level policies and 10 county-level policies and actions that explicitly addressed racial health inequities. Six domains were identified: healthcare and public health cultural competence; disease-specific care and outcomes; access to healthcare services; social determinants of health; collection action and research infrastructure; and structural racism. At the state- and county- level, most policies pertained to the healthcare and public health cultural competence domain. Of Maryland’s 24 counties, only 8 (33%) passed health equity policies and implemented equity-specific policy priorities.ConclusionThis study provides a snapshot of the Maryland policy landscape and suggests an increasing prioritization of equity policy at the state and county levels. While policies address issues ranging from cultural competence to structural racism, policy content differed by level of jurisdiction. Future efforts to critically evaluate the impact of specific policies on health inequities are needed.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1473971/fullracial health inequitiesstructural racismracial disparitiesstate policylocal level policylegislative approaches
spellingShingle Makeda Walelo
Kellee White Whilby
State and county level legislative approaches to address racial/ethnic health inequities in Maryland (2012–2021)
Frontiers in Public Health
racial health inequities
structural racism
racial disparities
state policy
local level policy
legislative approaches
title State and county level legislative approaches to address racial/ethnic health inequities in Maryland (2012–2021)
title_full State and county level legislative approaches to address racial/ethnic health inequities in Maryland (2012–2021)
title_fullStr State and county level legislative approaches to address racial/ethnic health inequities in Maryland (2012–2021)
title_full_unstemmed State and county level legislative approaches to address racial/ethnic health inequities in Maryland (2012–2021)
title_short State and county level legislative approaches to address racial/ethnic health inequities in Maryland (2012–2021)
title_sort state and county level legislative approaches to address racial ethnic health inequities in maryland 2012 2021
topic racial health inequities
structural racism
racial disparities
state policy
local level policy
legislative approaches
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1473971/full
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