Journal of Health Politics Policy and Law最新文献

The relationship between people's attitudes about abortion acceptability and the Supreme Court decision in Roe v. Wade-two distinct but related issues-has not been rigorously explored. The authors used a mixed-methods approach for analyzing in-depth interviews to better understand how participants' feelings toward abortion acceptability are related to perceptions of whether abortion should be legal. The authors then assessed (1) correlations between abortion acceptability and different measures of support for Roe v. Wade, and (2) how the phrasing of survey items related to Roe v. Wade may evoke different responses via an online survey fielded in 2018. The study's qualitative results highlight that there is a disjuncture between people's moral feelings toward abortion and their attitudes toward abortion legality. The study's quantitative results further demonstrate that correlations between abortion acceptability and support for Roe v. Wade are moderate, and the differences in responses to the phrasing of survey items related to Roe v. Wade are moderated by knowledge. The authors recommend that when researchers develop survey items, they avoid ambiguities of abortion as a general construct, especially when public opinion measures on abortion are employed for research and the design of social and health policy and practice.

State laws have influenced access to abortion in the 50 years since Roe v. Wade. The 2022 Dobbs decision returned questions about the legality of abortion to the states, which increased the importance of state laws for abortion access. The objective of this study is to illustrate trends in abortion-restrictive and abortion-supportive state laws using a unique longitudinal database of reproductive health laws across the United States from 1994 to 2022. This study offers a descriptive analysis of historical trends in state-level pre-viability abortion bans, abortion method bans, efforts to dissuade abortion, TRAP (targeted regulation of abortion providers) laws, other laws that restrict reproductive choice, and laws that expand abortion access and support reproductive health. Data sources include state statutes (from Nexis Uni) and secondary sources. The data reveal that pre-viability bans, including gestation-based bans and total bans, became significantly more prevalent over time. Other abortion-restrictive laws increased from 1994 to 2022, but states also passed a growing number of laws that support reproductive health. Increasing polarization into abortion-restrictive and abortion-supportive states characterized the 1994-2022 period. These trends have implications for maternal and infant health and for racial/ethnic and income disparities.

Previous research has assessed the impact of state regulations on abortion clinics and patients, but how bureaucrats implement them is less understood and is increasingly important as states arbitrate abortion regulation. The authors conducted a case study of how bureaucrats use discretion to implement state regulations on abortion, focusing on two abortion facilities in southwest Ohio from 2010 to 2022. Ohio abortion facilities are required to obtain a written transfer agreement, despite it offering no demonstrable health or safety benefits. The authors find that state requirements for obtaining variances-a process that allows abortion facilities to operate without a written transfer agreement-have become exceedingly difficult to comply with. The authors show how state statutes and administrative law have enabled bureaucrats to wield unlimited discretion and enforce arbitrary requirements. This unlimited bureaucratic discretion and accompanying administrative burden exacerbated clinic instability and threatened abortion availability in southwest Ohio for almost a decade. As implementation and interpretation of abortion policy is increasingly left to state bureaucrats and civil servants following the Supreme Court's Dobbs decision, how bureaucrats use discretion will influence clinic stability and abortion availability. The authors posit that unlimited bureaucratic discretion may exert greater influence on abortion availability across the nation as states scramble to clarify and implement policies after Dobbs.

This article examines the decades-long campaign to increase access to abortion pills in the United States, including advocates' work to win US Food and Drug Administration approval of mifepristone and misoprostol for abortion, the continuing restrictions on mifepristone, and the multiple strategies advocates have pursued to challenge these restrictions, including lobbying the FDA to remove the restrictions, obtaining a limited research exemption from FDA restrictions, and suing the FDA during the COVID-19 pandemic. The article pays particular attention to the influence of research conducted on the safety and efficacy of medication abortion as well as research on the impact of increased availability of abortion pills through telemedicine during the pandemic. The article also addresses self-managed abortion, wherein people obtain and use mifepristone and/or misoprostol outside the formal health care system, and it documents the growing network of organizations providing logistical, medical, and legal support to people self-managing abortion. The article concludes with reflections on the role abortion pills might play in the post-Roe era amid increasingly divergent abortion access trends across different regions of the United States.

While the US Supreme Court's 1973 ruling in Roe v. Wade guaranteed a legal right to abortion, universal access to legal abortion has never been achieved in the United States. At the same time, the Helms Amendment, a US foreign-assistance policy, is keeping millions of people around the world, particularly Black and Brown people, from receiving abortion-related information and services. As abortion-rights advocates in the United States look for ways to move forward in the post-Roe era, two sources can offer insights and inspiration: the inclusive, human rights-based reproductive justice framework, and some of the strategies and approaches being used to expand access in countries around the world with restrictive abortion laws.

Abortion is central to the American political landscape and a common pregnancy outcome, yet research on abortion has been siloed and marginalized in the social sciences. In an empirical analysis, the authors found only 22 articles published in this century in the top economics, political science, and sociology journals. This special issue aims to bring abortion research into a more generalist space, challenging what the authors term "the abortion research paradox," wherein abortion research is largely absent from prominent disciplinary social science journals but flourishes in interdisciplinary and specialized journals. After discussing the misconceptions that likely contribute to abortion research siloization and the implications of this siloization for abortion research as well as social science knowledge more generally, the authors introduce the articles in this special issue. Then, in a call for continued and expanded research on abortion, the introduction to this special issue closes by offering three guiding practices for abortion scholars-both those new to the topic and those deeply familiar with it-in the hopes of building an ever-richer body of literature on abortion politics, policy, and law. The need for such a robust literature is especially acute following the US Supreme Court's June 2022 overturning of the constitutional right to abortion.

Context: Although the COVID-19 pandemic has affected all Americans, its effects have been unequally distributed across geographic areas. These variations in the pandemic's severity-and public perceptions thereof-likely have political consequences. This study examines the factors that shape perceptions of COVID-19 at the local level and assesses the consequences of these perceptions for public opinion and political behaviors.

Methods: The authors use questions from the 2020 Cooperative Election Study linked with county-level COVID-19 rates to examine predictors of respondents' perceptions of the pandemic's severity in their county, including demographic, political, and informational characteristics. The study also examines whether these perceptions are associated with public opinion and voter behavior.

Findings: Respondents' perceptions are correlated with case rates. Liberals and Democrats estimate the pandemic to be more severe than Republicans and conservatives do, as do CNN viewers compared to Fox News viewers. The study found only limited evidence of a relationship between perceptions of the pandemic in a respondent's county and political outcomes.

Conclusions: The results add to the accumulating evidence that both news media and political predispositions shape perceptions of COVID-19, and they raise important questions about whether and how the pandemic has shaped-and will continue to shape-political outcomes.

Context: Although community health centers (CHCs) arose in the 1960s as part of a Democratic policy push committed to social justice, subsequent support has been shaped by paradoxical politics wherein Republican and Democratic support for CHCs continually morphed in response to changes in the health policy landscape.

Methods: Drawing on the CHC literature and empirical examples from firsthand accounts and reporting, this article explains CHCs' curious historical development from 1965 to the present.

Findings: Both Republicans and Democrats have calibrated their support for CHCs in response to a broader set of political considerations, from antiwelfare policy commitments to aspirations of establishing a national health care plan.

Conclusions: CHCs have proven to be a politically malleable policy tool within the broader context of American health care policy. The COVID-19 pandemic raised new questions about CHCs' sustainability and future, but CHCs will continue to play a critical role in providing health care access to underserved populations. They also will continue to be an attractive bipartisan policy option within the larger framework of US health policy.