| Summary: | Legislation can be an effective public health tool, and understanding the
factors that influence legislative outcomes is advantageous for public health
practitioners who propose and advocate for legislation. The literature indicates that
the issues of personal freedoms, the presence or absence of strong coalition
leadership, and political conditions and ideology have significant influences on the
outcomes of public health legislation.
The existing literature includes information about the factors that influence
outcomes for legislation at the national level, and also discusses the factors that
influence initiatives (particularly tobacco-related initiatives) at the state level. Little
information is available, however, regarding the factors that influence the outcomes
of public health legislation initiated through the Legislature at the state level in
Oregon. The objective of the current research is to understand better which factors
influenced the outcomes of public health legislation in the 2001 Oregon legislative
session.
To answer this question, I used a cross-sectional case study design to
examine four pieces of public health legislation from the 2001 Oregon legislative
session. The legislation and outcomes examined included 1) Senate Bill 734 /
House Bill 2814, that would have allowed counties to opt out of providing family
planning services to county public health clinics (in committee upon adjournment);
2) Senate Bill 99, that would have required water suppliers serving over 10,000
people to fluoridate their water (in committee upon adjournment); 3) Senate Bill
608 / House Bill 3312, that would have required insurance to cover prescription
contraceptives at the same rate as are other prescriptions (in committee upon
adjournment) and 4) Senate Bill 965 / House Bill 3659, that implemented a
voluntary statewide health risk screening program for all firstborn children in
Oregon (passed by the Legislature). Data sources for this research included the
public legislative record, four Oregon newspapers (the Oregonian (Portland), the
Statesman-Journal (Salem), the Herald (Baker City) and the Mail-Tribune
(Medford), and tape-recorded telephone interviews with individuals involved with
at least one piece of legislation.
Two major and two minor factors were found to be influential in the
outcomes of the legislation included in this research. The two major findings
supported the existing literature, as major factors influencing outcomes were the
issue of personal freedoms (expressed as an individual or local entity's right to self-determination)
and the activities of effective political coalitions. Two minor factors
influencing outcomes in Oregon also emerged from the research; these were the
issues of economics (primarily in the State budget) and precedent (whether or not
other, similar legislation or programs already existed in Oregon).
The results of this research indicate that effective coalitions are necessary to
a successful legislative effort, and that such coalitions operate within a broad social
and political context. Future research should consider studying the development
and progression of legislative efforts and coalitions prospectively over time to
enable access to additional data sources such as radio and television coverage, and
to prevent errors related to less-than-perfect recall of past legislation in individuals
interviewed. === Graduation date: 2004
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