Graduate Thesis Or Dissertation
 

Factors influencing the outcomes of public health legislation in the 2001 Oregon legislature

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  • 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.
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