Abstract
BackgroundMonitoring trends in community opinion can identify critical opportunities to implement upstream health policies or interventions. Our study examines change and demographic modifiers of change in community perceptions of government intervention for prevention of lifestyle-related chronic disease across two time points in Australia.MethodsData were drawn from the 2016 (n = 2052) and 2018 (n = 2601) waves of a nationally representative cross-sectional telephone survey, ‘AUSPOPS’. Survey questions gauged perceptions of government intervention for health in general, peoples’/organizations’ role in maintaining health (e.g., parents, government) and support for specific health interventions (e.g., taxing soft drink).Bivariate and multivariate regression models tested for change between the two surveys, adjusted for demographic characteristics. Models with interactions between survey wave and demographic variables tested for differential change. One-tailed variance ratio tests examined whether opinions had become more polarized in 2018 compared with 2016.ResultsThe large, significant increase observed in the perceived size of the role that government has in maintaining people’s health was uniform across demographic subpopulations. The role for employers and private health insurers was also perceived to be larger in 2018 compared with 2016, but the degree of change varied by gender, age and/or socioeconomic status. Support for some government interventions (e.g., taxing soft drinks) increased among specific demographic subgroups whilst exhibiting no overall change. Opinion was more polarized on general attitudes to government intervention for population health in 2018 compared to 2016, despite little change in central tendency.ConclusionsOpportunities may exist to implement government health-promoting policies (e.g., taxing soft drinks), although advocacy may be needed to address the concerns of less supportive subpopulations. Attitudes on government intervention in general may be becoming more polarized; future research examining the association of such changes with exposure to different information sources could inform communication strategies for future health policy change.
Highlights
Monitoring trends in community opinion can identify critical opportunities to implement upstream health policies or interventions
Despite the considerable effort to address the burden of non-communicable chronic diseases (NCDs) such as diabetes and cardiovascular disease, the prevalence of risk factors for NCDs, with the possible exception of tobacco use, have changed little over the past few decades and remain high [1]
The majority of strategies designed to reduce the lifestylerelated risks leading to NCDs, including overweight/obesity, have been directed towards the individual behavior change, many health promotion advocates [2, 3] and lead health agencies [4, 5] have emphasized the important role of policy and environmental-level change for greater impact
Summary
Monitoring trends in community opinion can identify critical opportunities to implement upstream health policies or interventions. The majority of strategies designed to reduce the lifestylerelated risks leading to NCDs, including overweight/obesity, have been directed towards the individual behavior change, many health promotion advocates [2, 3] and lead health agencies [4, 5] have emphasized the important role of policy and environmental-level change for greater impact Such actions include introducing fiscal interventions, such as taxes on unhealthy products and/or providing subsidies for healthier options; restricting advertising and promotions; reducing the availability of certain products; changing built environments to support physical activity; and mandatory reformulations of the food supply. Greater investment in active travel infrastructure and a national physical activity plan is prioritized as changes in urban design which support modal shift from motorized transport to public and active transport have been demonstrated to significantly increase walking [7] Other groups such as the World Health Organization have recommended similar interventions, which they argue are cost-effective ‘Best Buys’ for chronic disease prevention [8]. The evidence base in public health strongly favors descriptive correlational studies, rather than studies examining intervention effectiveness, sustainability and public support – evidence which could assist policymakers to build a case for population-level interventions [13]
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