Interfaculty Initiative in Health Policy, Harvard University, Cambridge, Massachusetts, USA.
Health Aff (Millwood). 2013 Mar;32(3):486-96. doi: 10.1377/hlthaff.2012.0609.
The high prevalence of chronic diseases in the United States with lifestyle-related risk factors, such as obesity and tobacco use, has sparked interest in legal strategies to influence health behavior. However, little is known about the public's willingness to accept these policies as legitimate, which in turn may affect compliance. We present results from a national survey of 1,817 US adults concerning the acceptability of different public health legal interventions that address noncommunicable, or chronic, diseases. We found that support for these new interventions is high overall; substantially greater among African Americans and Hispanics than among whites; and tied to perceptions of democratic representation in policy making. There was much support for strategies that enable people to exercise healthful choices--for example, menu labeling and improving access to nicotine patches--but considerably less for more coercive measures, such as insurance premium surcharges. These findings suggest that the least coercive path will be the smoothest and that support for interventions may be widespread among different social groups. In addition, the findings underscore the need for policy makers to involve the public in decision making, understand the public's values, and communicate how policy decisions reflect this understanding.
美国慢性疾病高发与生活方式相关的风险因素有关，如肥胖和吸烟，这引发了人们对法律策略的兴趣，以影响健康行为。然而，人们对这些政策是否合法的接受程度知之甚少，而这反过来又可能影响合规性。我们展示了一项针对 1817 名美国成年人的全国性调查结果，该调查涉及不同公共卫生法律干预措施的可接受性，这些干预措施针对的是非传染性或慢性疾病。我们发现，总体而言，人们对这些新干预措施的支持度很高；非裔美国人和西班牙裔人比白人更支持这些新干预措施；并且与政策制定中的民主代表性观念有关。人们非常支持能够使人们做出健康选择的策略，例如菜单标签和改善尼古丁贴片的获取途径，但对更具强制性的措施的支持度要低得多，例如保险费附加费。这些发现表明，最不具强制性的途径将是最顺利的，并且干预措施可能会在不同的社会群体中得到广泛支持。此外，这些发现强调了政策制定者需要让公众参与决策，了解公众的价值观，并传达政策决策如何反映这种理解。
