Fighting obesity at the local level? An analysis of predictors of local health departments' policy involvement
Fighting obesity at the local level? An analysis of predictors of local health departments' policy involvement
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DOI：
10.1016/j.ypmed.2020.106006
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发表时间：
2020-04-01
影响因子：
5.1
通讯作者：
Martin, Erika G.
中科院分区：
文献类型：
--
作者：
Feng, Wenhui;Martin, Erika G.
肥胖在美国是一个严重的公共健康问题。地方卫生部门（lhd）可以在公共卫生政策中发挥关键作用，并且在解决社区肥胖问题方面处于有利地位。我们评估了美国各地高肥胖人群参与的肥胖政策，以及与参与增加相关的因素。数据来自2016年全国地方卫生部门调查的1803名lhd，并补充了县级肥胖患病率和政治意识形态。负二项回归检验了肥胖率和与肥胖率相关的肥胖政策数量相关的区域特征。几乎一半（46.1%）的高脂肪人群报告没有参与当地的肥胖政策。有几个因素与增加的政策参与有关：有地方卫生委员会提供咨询（IRR= 1.31, p < 0.05）或治理角色（IRR= 1.27, p < 0.01），更大的劳动力（IRR= 1.34, p < 0.001），认证（IRR= 1.40, p < 0.001），更高的肥胖率（IRR= 1.03, p < 0.01），以及政治上更自由（IRR= 1.01, p < 0.05）。总的来说，大量没有或有限参与肥胖政策的高脂肪国家错失了地方行动的机会。需要更好地了解地方卫生保健机构的政策参与，组织和政治因素如何使其行动成为可能或限制其行动，以及他们如何利用现有权力来帮助地方卫生保健机构满足当地需求。
Obesity is a critical public health issue in the United States. Local health departments (LHDs) can play a crucial role in public health policy, and are well-positioned to address obesity in their communities. We assess the obesity policy involvement among LHDs across the United States and the factors associated with increased involvement. Data come from 1803 LHDs in the 2016 National Profile of Local Health Department survey, supplemented with county-level obesity prevalence and political ideology. Negative binomial regressions examined LHD and regional characteristics associated with the number of obesity policies with which LHDs were involved. Almost half (46.1%) of LHDs reported no involvement with local obesity policies. Several factors were associated with increased policy involvement: having local boards of health with advisory (IRR= 1.31, p < 0.05) or governance roles (IRR= 1.27, p < 0.01), larger workforces (IRR= 1.34, p < 0.001), accreditation (IRR= 1.40, p < 0.001), higher obesity prevalence (IRR= 1.03, p < 0.01), and being politically more liberal (IRR= 1.01, p < 0.05). Overall, the large number of LHDs with no or limited involvement in obesity policies is a missed opportunity for local action. A better understanding of LHD policy involvement, how organizational and political factors enable or constrain their actions, and how they can leverage their current authority is needed to help LDHs serve local needs.