Abstract
Legislation and regulation at the state and local level can often have a greater impact on the public's health than individual-based approaches. Elected and appointed officials have an essential role in protecting and improving public health. Despite this important role, little systematic research has been done to assess the relative importance of public health issues compared to other policy issues in times of economic hardship. This study assessed attitudes of elected and appointed decision makers in Hawaii in 2007 and 2013 to determine if priorities differed before and after the economic recession. Elected and appointed state and county officials were mailed surveys at both time points. Respondents rated the importance of 23 specified problems, of which 9 asked about specific public health issues. The survey was completed by 126 (70.4%) respondents in 2007 and 117 (60.9%) in 2013. Among the public health issues, five saw significant mean decreases. These variables included climate change, pedestrian safety, government response to natural disasters, access to healthcare, and pandemic influenza. Obesity was the only public health issue to increase in importance across the two time points. In terms of relative ranking across the time points, only drug abuse and obesity were among the top 10 priorities. Lack of public health training, pandemic influenza, and government response to natural disasters were among the bottom five priorities. After the economic recession, many public health issues have a lower priority among Hawaii's policy makers than before the downturn. Additional education and advocacy is needed to keep public health issues on the minds of decision makers during tough economic times.
Highlights
Legislation and regulation at the state and local level can often have a greater impact on the public’s health than individual-based approaches
Research in the area has been limited, with
Our results showed that drug abuse, climate change, and pedestrian safety were rated as high priorities, while pandemic influenza, access to healthy groceries, and poor nutrition were not seen as priorities [11]
Summary
Legislation and regulation at the state and local level can often have a greater impact on the public’s health than individual-based approaches. Elected and appointed officials have an essential role in protecting and improving public health. Despite this important role, little systematic research has been done to assess the relative importance of public health issues compared to other policy issues in times of economic hardship. This study assessed attitudes of elected and appointed decision makers in Hawaii in 2007 and 2013 to determine if priorities differed before and after the economic recession. The social-ecological model postulates that behavior is influenced by a variety of factors including interpersonal, intrapersonal, organizational, community, and public policy [7]. The model proposes that policy has the potential to reach the highest number of people in the population of interest and is an essential part of multicomponent interventions to change behavior and reduce premature morbidity and mortality [7]
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