292162
A critical discourse analysis of national policy agendas for the elimination of asthma disparities
Tuesday, November 5, 2013
: 5:10 p.m. - 5:30 p.m.
Background and Issues: Asthma management inequities (AMI) between African and White Americans are significant and alarming. AMI policy agendas impacting the delivery of public health and primary care have been suggested with little success. A recent IOM framework on integrating public health and primary care proposes five principles: population health, community engagement, aligned leadership, infrastructural sustainability, and sharing of data. It is unknown how this framework is reflected amongst discourses - the structured systems of text, talk, and action - contained within AMI policy agendas. This study presents a critical discourse analysis of five national AMI policy agendas using this IOM framework. Description: Using a Foucauldian critical discourse analysis, AMI policy agendas were analyzed for discourses which included persons, actions, and events that promoted or omitted aspects on the IOM integration framework. Lessons learned: Individual health discourses (n=9) were emphasized over population health focused discourses (n=5). Community engagement discourses were only promoted in relation to indoor/outdoor air pollution (n=3). Of the documents aligned leadership; MD's (32%), MPH (24%), and PhD's (19%) predominated, and only 4% were PHN's. Infrastructural sustainability discourses (n=10) were the most detailed, but omitted discourses on bias. Discourses on the sharing of data (n=2) were omitted from 3 of the 5 documents. Recommendations: Public health nurses should 1) promote population health agendas, 2) mobilize for air pollution advocacy, 3) mobilize for PHN leadership in policy development, 4) promote anti-bias policies, and 5) introduce discourses on data sharing. Critical discourse analysis provides powerful equity tools for policy analysis.
Learning Areas:
Chronic disease management and prevention
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Systems thinking models (conceptual and theoretical models), applications related to public health
Learning Objectives:
Identify strategies for public health nursing advocacy in asthma management inequity policy development
Describe opportunities for public health nursing and primary care integration for asthma management equity
Discuss power-relations in the construction of policies concerning national asthma management inequity
Keyword(s): Asthma, Policy/Policy Development
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I am assistant Professor at the University of Washington Nursing and Healthcare Leadership program (2012). I have completed my dissertation research on asthma management disparity policy, I am on the steering committee of the Washington Asthma Initiative, and I have conducted translational policy research using a health equity lens in Tacoma, WA (2012). I received my PhD (2011) and MN (1989) from the University of Washington and his BSN (1994) from Johns Hopkins University.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
