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Discriminatory state laws have deleterious effects on the health of socially marginalized groups. Health care clinicians, institutions, researchers, and research funders have tended to view different discriminatory laws in isolation, focusing on particular issues or groups. In contrast, intersectionality calls attention to the overlapping and synergistic systems of oppression that discriminatory legislation promotes or upholds, warranting an integrated analysis of these laws.
In this analytic essay, we assess discriminatory state laws simultaneously and discuss their implications for health care clinicians, institutions, and researchers. We present a multifunctional model of law and population health that describes how discriminatory law affects health outcomes among marginalized groups. We then draw on publicly available legislation trackers to identify 30 states that have enacted legislation since 2020 that targets Black people and other people of color; lesbian, gay, bisexual, and queer people; transgender and nonbinary people; and women and other birthing people.
Finally, we call for a coordinated, multilateral, and forceful effort by health care professionals, institutions, researchers, and research funders to counter these laws and address their predictable health consequences. (Am J Public Health. 2024; 114(12): 1335-1343. https://doi.Org/10.2105/AJ PH.2024.307830)
State law in the United States has long played an active part- sometimes a starring role-in maintaining power imbalances by race, ethnicity, sexual orientation, gender identity, and sex. A new surge of discriminatory state legislation in the United States has diminished protections for marginalized social groups, including Black people and other people of color; lesbian, gay, bisexual, and queer (LGBQ) people; transgender people; and women and other people capable of pregnancy. Public health law theory posits that laws have direct and indirect consequences for population health,1 including the health of marginalized populations.2 A growing body of research has documented associations between laws that adversely target marginalized populations (i.e., discriminatory laws) and poorer health among members of those groups.3"5 Building on the legacies of early thinkers in intersectionality, such as bell hooks, Kimberle Crenshaw, Pauli Murray, W.E.B. Du Bois,James McCune Smith, and members of the Black feminist Combahee River Collective, health inequities research recognizes linkages between discriminatory policies and health of multiply marginalized groups. An intersectionality framework suggests that these laws stem from, and contribute to, overlapping and synergistic systems of marginalization, including but not limited to racism, sexism, heterosexism,...