Health Policy Center, Institute for Health Research and Policy, University of Illinois at Chicago, USA.
Am J Prev Med. 2011 Oct;41(4):407-14. doi: 10.1016/j.amepre.2011.06.043.
States and school districts nationwide have enacted policies targeting youth obesity, but many policies lack specific requirements or enforcement language. Geographic disparities in youth obesity could worsen if policies are weaker in areas with higher obesity prevalence.
To determine if state or district policy strength varies with youth obesity prevalence across Census divisions.
Policies in five domains related to nutrition and physical activity in schools were obtained from all states and nationally representative samples of 578 and 592 public school districts in the 2006-2007 and 2008-2009 school years, respectively. Policy language strength was rated on a 0-100 scale on both the state and district level. Regression models were used to determine if mean 2006-2007 strength scores, and changes in mean scores from 2006-2007 to 2008-2009, were associated with youth obesity prevalence across Census divisions. Analyses were conducted in 2010.
State and district policies governing foods sold outside of school meal programs ("competitive foods") were stronger in 2006-2007 in the two divisions with the highest youth obesity prevalence (East South Central, West South Central). Furthermore, mean competitive food policy strength increased the most from 2006-2007 to 2008-2009 in these divisions. The West South Central had the weakest district physical education policies in 2006-2007, however, and was the only division in which average strength of district school meal policies decreased.
State and districts in Census divisions with the highest youth obesity prevalence are taking steps to restrict competitive foods in schools, but many have not targeted other policy domains as aggressively.
全美各州和学区都制定了针对青少年肥胖问题的政策，但许多政策缺乏具体的要求或执行语言。如果在肥胖率较高的地区政策较弱，那么青少年肥胖的地域差异可能会恶化。
确定各州或地区的政策力度是否因各普查区的青少年肥胖率而异。
从所有州以及 2006-2007 学年和 2008-2009 学年分别代表全国 578 个和 592 个公立学区的样本中获取了与学校营养和体育活动相关的五个领域的政策。州和地区层面的政策语言力度均按 0-100 分制进行评级。使用回归模型来确定 2006-2007 年平均力度得分，以及 2006-2007 年至 2008-2009 年的平均得分变化，是否与各普查区的青少年肥胖率相关。分析于 2010 年进行。
在青少年肥胖率最高的两个普查区（东中南部、西南中部），2006-2007 年管理学校午餐计划以外食品（“竞争食品”）销售的州和地区政策较为严格。此外，这些分区的竞争食品政策力度平均增幅最大，从 2006-2007 年到 2008-2009 年。然而，在 2006-2007 年，西南中部地区的地区性体育教育政策最为薄弱，也是唯一一个地区性学校午餐政策力度平均下降的分区。
在青少年肥胖率最高的普查区，州和地区正在采取措施限制学校的竞争食品，但许多地区并未如此积极地针对其他政策领域。
