The Persisting Importance of Rhetoric and Equity in Health Policy and Outcomes.

This editorial considers the persisting importance of rhetoric and equity in health policy analysis, implementation, and outcomes. It argues that employing social determinants of health, and intersectional and rhetorical frames, can improve life and health outcomes, as measured by morbidity and mortality. The pertinence of these frames with regard to the crises brought on by the COVID-19 pandemic is discussed, and the plan for a special issue on disparties and COVID-19 is announced.

Mothers' beliefs about indigenous and traditional food affordability, availability and taste are significant predictors of indigenous and traditional food consumption among mothers and young children in rural Kenya.

OBJECTIVE: To examine mothers' and young children's consumption of indigenous and traditional foods (ITF), assess mothers' perception of factors that influence ITF consumption, and examine the relationship between perceived factors and ITF consumption. DESIGN: Longitudinal study design across two agricultural seasons. Seven-day FFQ utilized to assess dietary intake. Mothers interviewed to assess their beliefs about amounts of ITF that they or their young children consumed and on factors that influence ITF consumption levels. SETTING: Seme sub-County, Kenya. PARTICIPANTS: Mothers with young children. RESULTS: Less than 60 % of mothers and children consumed ITF at time of assessment. Over 50 % of the mothers reported that their ITF consumption amounts and those of their children were below levels that mothers would have liked for themselves or for their young children. High cost, non-availability and poor taste were top three reasons for low ITF consumption levels. Mothers who identified high cost or non-availability as a reason for low levels of ITF consumption had significantly lower odds of consuming all ITF except amaranth leaves. Mothers who identified poor taste had significantly lower odds of consuming all ITF except green grams and groundnuts. Similar relationships were noted for young children's ITF consumption levels. CONCLUSIONS: A majority of the mothers reported that they and their children did not consume as much ITF as the mothers would have liked. Further studies should examine strategies to improve availability and affordability of ITF, as well as develop recipes that are acceptable to mothers and children.

How do we die?

Within the next two decades, the elderly population in the United States will reach its zenith, comprising 73 million individuals, 20 percent of the nation, the baby boomers' final surge. The process of their dying may become contentious. Should policymakers and bioethicists be satisfied with our current approach to dying, or should they begin now to reconceptualize it? We distill end-of-life discussions in the bioethics literature and popular press, paying particular attention to physician-assisted suicide and its uptake where legal. Evidence so far indicates that few of the dying opt for this alternative, suggesting that its role in assuring "death with dignity" cannot be, as may have been hoped, a leading one. The end-of-life literature on the whole lends credence to the fear that most of the dying, along with their families and physicians, will muddle through a morass of uncoordinated options, with futile medical intervention the most prominent outcome ­ despite more palliative strategies, such as home hospice care, being favorably described. We found no reason to recommend persistence in our current approach to dying and found good reason to urge early, conscientious, and thoroughgoing reconceptualization in policy and practice as well as in theory.

What's the matter with Kansas? Legislative debates over stem cell research in Kansas and Massachusetts.

This paper examines the contextual factors shaping legislative debates affecting stem cell research in two states, Kansas and Massachusetts, which both permit therapeutic cloning for stem cell research but markedly vary in their legislative approach to the issue. In Kansas, restrictive legislation was proposed but effectively blocked by research proponents, while in Massachusetts permissive legislation was successfully implemented under the auspices of an act to promote stem cell research. The importance of university and industry involvement is highlighted in each case, as are the roles of enterprising and persistent policy entrepreneurs. Providing a close examination of the policy process attending the cloning debate in these states is intended to contribute to an enhanced understanding of the cloning-policy process as it has played out at the state level, with an eye toward informing legislative debates over related biotechnical advances in the future.

Demographic profile of states with human cloning laws: morality policy meets political economy.

This analysis seeks to identify factors that may shape the policy stance - whether restrictive or permissive - that each state in the United States with a human cloning law in place takes toward human therapeutic cloning. The investigation also considers if cloning policy is more the product of morality politics or political economy. Results show that among states with human cloning policies in place, those with a greater biotechnological capacity, more permissive abortion laws, fewer Evangelical Protestants, and higher political liberalism rankings are more likely to have permissive cloning laws. A higher Roman Catholic population is strongly associated with permissive cloning laws, rather than restrictive cloning laws as originally supposed. Factors with morality policy and economic bases were both found to be associated with cloning policy outcomes. Results suggest that morality policies, though distinct in some ways, do share determinants with public policies based on political economy.