U.S. policy on health inequities: the interplay of politics and research

What is the relationship between scientific research and government action in addressing health inequalities in the United States? What factors increase the impact of scientific research on public policy? To answer these questions, we focus on racial and ethnic disparities in health status and health care in the United States. We first review the history of the disparities issue to elucidate how the continual and persistent interplay between political action and scientific research drives government policy. We then analyze two recent government-sponsored reports about racial and ethnic disparities to understand the strategic consequences of issue framing. We draw lessons about how disparities research can have a greater impact on public policy.     

Reframing the racial disparities issue for state governments

Although racial and ethnic disparities in health have been on the federal government's agenda since 1985, no policy reforms have significantly reduced disparities. The question arises whether states can effectively address this issue without waiting for solutions from the national government. The purpose of this article is to propose ways of reframing the disparities issue that might give state policy makers more leverage and might strengthen political will to address the issue. I suggest a moral frame based on a concept of distributive justice in which medical care must be distributed according to need. I explain the rationales for such a frame and consider its strategic advantages and disadvantages. In the last section, I suggest some policies based on this framing that are within the power of state legislatures.     

Gunshot wounds: visual and analytical procedures.

Visual examination of clothing and tissue from gunshot wounds provides information pertaining to the range of discharge of a firearm. Identification of powder grains or soot is evidence of close range discharge by a handgun. Analyses of tissue by EDX and FAAS technics are shown to supply corroborating data to visual examination in estimation of range. These methods are of particular value in differentiating contact and distant wounds when decomposed bodies are examined and when multiple layers of clothing are present.