Am J Epidemiol. 2023 Jan 6;192(1):34-38. doi: 10.1093/aje/kwac184.
Despite a dramatic reduction in the prevalence of commercial cigarette smoking in the United States, children are still commonly exposed to secondhand smoke (SHS), which is a cause of various pediatric health problems. Further, SHS exposure is patterned by race and class, exacting an inequitable toll on children from families with lesser social and economic advantage. In this issue of the Journal, Titus et al. (Am J Epidemiol. 2023;192(1):25-33) use natural experiment evaluation methods (difference-in-differences) to test whether the recently implemented US Department of Housing and Urban Development policy that forbade smoking in and around New York City Housing Authority buildings affected child respiratory health. The results from their work remind us that policies do not always impact outcomes as we might expect. Given that policy is one of the most potent tools for population health promotion, this work underlines the need for epidemiologists to engage in policy evaluation at all stages of the policy life cycle, in order to discover comprehensive approaches to policy development and implementation that prioritize equity and address structural racism.
尽管美国商业香烟吸烟的流行率显著下降，但儿童仍经常接触二手烟（SHS），这是各种儿科健康问题的一个原因。此外，SHS 的暴露情况因种族和阶层而异，对来自社会和经济地位较低的家庭的儿童造成了不公平的影响。在本期《美国流行病学杂志》上，Titus 等人（Am J Epidemiol. 2023;192(1):25-33）使用自然实验评估方法（差异中的差异）来检验美国住房和城市发展部最近实施的一项政策是否影响了儿童的呼吸健康，该政策禁止在纽约市住房管理局大楼内及周围吸烟。他们的研究结果提醒我们，政策并不总是像我们预期的那样影响结果。鉴于政策是促进人口健康的最有力工具之一，这项工作强调了流行病学家在政策生命周期的各个阶段参与政策评估的必要性，以便发现全面的政策制定和实施方法，优先考虑公平性，并解决结构性种族主义问题。
