Gregory J. Tung is with the Pediatric Injury Prevention, Education, and Research Program and the Department of Health Systems, Management, and Policy at the Colorado School of Public Health, Aurora. Jon S. Vernick and Daniel W. Webster are with the Department of Health Policy and Management, and Elizabeth A. Stuart is with the departments of Mental Health and Biostatistics at the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Am J Public Health. 2014 Jun;104(6):e92-7. doi: 10.2105/AJPH.2013.301689. Epub 2014 Apr 17.
We examined the effects of key political institutional factors on the advancement of state-level clean indoor air laws.
We performed an observational study of state-level clean indoor air law enactment among all 50 US states from 1993 to 2010 by using extended Cox hazard models to assess risk of enacting a relevant law.
During the 18-year period from 1993 to 2010, 28 states passed a law covering workplaces, 33 states passed a law covering restaurants, 29 states passed a law covering bars, and 16 states passed a law covering gaming facilities. States with term limits had a 2.15 times greater hazard (95% confidence interval [CI] = 1.27, 3.65; P = .005) of enacting clean indoor air laws. The presence of state-level preemption of local clean indoor air laws was associated with a 3.26 times greater hazard (95% CI = 1.11, 9.53; P = .031) of state-level policy enactment. In the presence of preemption, increased legislative professionalism was strongly associated (hazard ratio = 3.28; 95% CI = 1.10, 9.75; P = .033) with clean indoor air law enactment.
Political institutional factors do influence state-level clean indoor air law enactment and may be relevant to other public health policy areas.
我们考察了主要政治体制因素对州级清洁室内空气法推进的影响。
我们对 1993 年至 2010 年间全美 50 个州的清洁室内空气法制定情况进行了一项观察性研究，使用扩展的 Cox 风险模型来评估制定相关法律的风险。
在 1993 年至 2010 年的 18 年期间，28 个州通过了覆盖工作场所的法律，33 个州通过了覆盖餐馆的法律，29 个州通过了覆盖酒吧的法律，16 个州通过了覆盖博彩设施的法律。有任期限制的州制定清洁室内空气法的风险是其他州的 2.15 倍（95%置信区间[CI]：1.27，3.65；P =.005）。州级对地方清洁室内空气法的预先阻止的存在与州级政策制定的风险增加 3.26 倍相关（95%CI = 1.11，9.53；P =.031）。在存在预先阻止的情况下，立法专业性的提高与清洁室内空气法的制定密切相关（风险比=3.28；95%CI = 1.10，9.75；P =.033）。
政治体制因素确实会影响州级清洁室内空气法的制定，这可能与其他公共卫生政策领域有关。
