able populations worsened in several states (Lurie et al., 1984; Mandinger, 1985). What influence on health differences was actually exerted by national policy, by economic gains, or by the empowerment and increasing social acceptance of blacks are obviously research questions of interest.
When considering public health measures targeted at reducing racial or ethnic health disadvantage, therefore, one should keep in mind the ways in which other government actions, taken for a variety of extraneous reasons, can also affect racial and ethnic differences, supporting or possibly undermining measures directed at improving health.
Much is obviously not known about the policy possibilities for dealing with racial and ethnic differences in late-life health. There is a need to examine the effects of broad social policies on a wide variety of health behaviors among older people of different racial and ethnic groups. The effects of specific policies, such as taxation, also require corraboration for various population groups, such as recent immigrants (Jasso et al., 2004). A simple distinction between whites and minority groups is clearly insufficient in assessing differential effects. More broadly, there appears to be little analysis of the differential effects of interventions at the individual, community, or national levels by age and race or ethnicity (Emmons, 2001). There may be large cohort or period influences that would make public policies more or less effective for different groups at different times (Warner, 2001). Analysis should use as much existing data as possible, but it may be hampered by the lack of good, representative data, especially for older adults and recent immigrants.
Research Need 18: Characterize long-term trends (and possible lags) in the effects of changing social policy—federal, state, and local—on health differences and on public health.
For instance, popular expectations may have been too high that the 1964 civil rights laws, which marked a significant public policy change, would have large and immediate effects on the health and well-being of that generation of blacks. Much time was required to prepare regulations to implement legislation—to change the nature of segregated health care facilities, to improve the availability of good prenatal care and well-baby check-ups, to expand the possibilities for better jobs, and to improve environmental and housing conditions. Overcoming long-term neglect and lack of access are long-term projects that are still in process. How lags in the effects of public policy differentially affect racial and ethnic groups at different points in the life course requires sustained scrutiny (Hudson, 2002; Warner, 2001).