Godinez Puig Luisa, Lusk Katharine, Glick David, Einstein Katherine L, Palmer Maxwell, Fox Stacy, Wang Monica L
1846 Boston University Initiative on Cities, Boston University, Boston, MA, USA.
1846 Department of Political Sciences, Boston University, Boston, MA, USA.
Public Health Rep. 2021 Mar-Apr;136(2):161-171. doi: 10.1177/0033354920966050. Epub 2020 Oct 27.
Mayors have considerable and often direct influence over health policy in their cities, yet little is known about mayors' general perceptions of current public health challenges. The objective of this study was to assess perceptions, attitudes, and priorities related to public health among US mayors.
We collected survey data from a nationally representative sample of US mayors (N = 110) in 2018 and matched survey responses with city-level health surveillance data. We conducted descriptive analyses and multivariable regression modeling to estimate associations of interest.
Mayors in our sample most frequently cited obesity/chronic diseases (23.6%; 26 of 110), opioid abuse/drug addiction (22.7%; 25 of 110), and health care access (13.6%; 15 of 110) as the top health challenges facing their cities. However, mayors identified a different set of health issues for which they believed constituents hold them accountable. With the exception of opioid-related deaths, prevalence of a health concern was not associated with perceived accountability for that particular issue, whereas partisanship and sex predicted patterns in perceived accountability.
Mayors recognized critical health challenges at the city level but varied widely in their perceived accountability for such challenges. Findings can inform strategies to engage local policy makers in cross-sector collaborations to improve the health and overall well-being of people in cities across the United States.
市长们对其所在城市的卫生政策有着相当大且往往是直接的影响力，但对于市长们对当前公共卫生挑战的总体看法却知之甚少。本研究的目的是评估美国市长们对公共卫生的看法、态度和优先事项。
我们于2018年从美国市长的全国代表性样本（N = 110）中收集了调查数据，并将调查回复与城市层面的健康监测数据进行匹配。我们进行了描述性分析和多变量回归建模，以估计相关的关联。
我们样本中的市长们最常将肥胖/慢性病（23.6%；110人中的26人）、阿片类药物滥用/药物成瘾（22.7%；110人中的25人）和医疗保健可及性（13.6%；110人中的15人）列为其所在城市面临的首要健康挑战。然而，市长们确定了另一组他们认为选民会要求他们负责的健康问题。除了与阿片类药物相关的死亡外，某一健康问题的患病率与对该特定问题的可感知问责性无关，而党派归属和性别预测了可感知问责性的模式。
市长们认识到城市层面的关键健康挑战，但他们对这些挑战的可感知问责性差异很大。研究结果可为促使地方政策制定者参与跨部门合作以改善美国各城市居民的健康和整体福祉的策略提供参考。
