Department of Public Health Policy and Management, College of Global Public Health, New York University, 715 Broadway, 10th Floor, New York, NY 10003, United States.
Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Prev Med. 2017 Dec;105:397-403. doi: 10.1016/j.ypmed.2017.08.028. Epub 2017 Sep 1.
States play a key role in addressing obesity and its risk factors through policymaking, but there is variation in state activity nationally. The goal of this study was to examine whether the presence of a consolidated Democratic or Republican "trifecta" - when a state's governorship and both houses of the legislature are dominated by the same political party - or divided government (i.e., without a trifecta) is associated with obesity-related policy content and enactment. In 2016 and 2017, we gathered state bills and laws utilizing the CDC Chronic Disease State Policy Tracking System, and examined the association between state-level political party control and the enactment of state-level obesity-related policies in all states during 2009-2015. The three areas of interest included: policies specifically addressing obesity, nutrition, or physical activity in communities, schools, or workplaces using a public health framework; neutral policies, such as creating government task forces; and policies that employed a business-interest framework (e.g., Commonsense Consumption Acts that prohibit consumer lawsuits against restaurant establishments). Using divided governments as the reference group, we found that states with Democratic trifectas enacted significantly more laws, and more laws with a public health framework. Republican trifecta states enacted more laws related to physical activity, and in some states like Texas, Republican trifectas were exceptionally active in passing policies with a public health framework. States with Republican trifectas enacted a statistically similar amount of laws as states with divided governments. These findings suggest promise across states for obesity-related public health policymaking under a variety of political regimes.
各州在通过政策制定来解决肥胖及其风险因素方面发挥着关键作用，但各州在国家层面的活动存在差异。本研究的目的是检验一个州的州长和州议会两院都由同一政党主导的统一民主党或共和党“三权分立”（trifecta）的存在，还是分裂政府（即没有三权分立）是否与肥胖相关政策的内容和实施有关。在 2016 年和 2017 年，我们利用疾病控制与预防中心（CDC）慢性病州政策跟踪系统收集了州法案和法律，并研究了 2009 年至 2015 年期间所有州的州级政党控制与州级肥胖相关政策的颁布之间的关联。三个关注领域包括：在社区、学校或工作场所使用公共卫生框架专门解决肥胖、营养或身体活动的政策；中立政策，例如创建政府特别工作组；以及采用商业利益框架的政策（例如，禁止消费者对餐馆提起诉讼的常识消费法案）。以分裂政府为参照组，我们发现，拥有民主党三权分立的州颁布了更多的法律，并且更多的法律采用了公共卫生框架。共和党三权分立的州颁布了更多与身体活动相关的法律，在德克萨斯州等一些州，共和党三权分立在通过具有公共卫生框架的政策方面异常活跃。拥有共和党三权分立的州颁布的法律数量与拥有分裂政府的州大致相同。这些发现表明，在各种政治体制下，各州在肥胖相关公共卫生政策制定方面都有希望取得成功。
