Kemp Blakelee, Grumbach Jacob M, Montez Jennifer Karas
University of Nebraska-Lincoln, Lincoln, NE, USA.
University of Washington, Seattle, WA, USA.
Socius. 2022 Jan-Dec;8. doi: 10.1177/23780231221091324. Epub 2022 Apr 24.
This study examines how state policy contexts may have contributed to unfavorable adult health in recent decades. It merges individual-level data from the 1993-2016 Behavioral Risk Factor Surveillance System (n=2,166,835) with 15 state-level policy domains measured annually on a conservative to liberal continuum. We examined associations between policy domains and health among adults ages 45-64 years and assess how much of the associations is accounted by adults' socioeconomic, behavioral/lifestyle, and family factors. A more liberal version of the civil rights domain was associated with better health. It was disproportionately important for less-educated adults and women, and its association with adult health was partly accounted by educational attainment, employment, and income. Environment, gun safety, and marijuana policy domains were, to a lesser degree, predictors of health in some model specifications. In sum, health improvements require a greater focus on macro-level factors that shape the conditions in which people live.
本研究探讨了近几十年来州政策环境可能如何导致成年人健康状况不佳。它将1993 - 2016年行为风险因素监测系统的个体层面数据（n = 2,166,835）与每年在保守到自由连续体上衡量的15个州层面政策领域相结合。我们研究了45 - 64岁成年人中政策领域与健康之间的关联，并评估这些关联中有多少可由成年人的社会经济、行为/生活方式和家庭因素来解释。民权领域更自由的版本与更好的健康状况相关。这对受教育程度较低的成年人和女性尤为重要，其与成年人健康的关联部分可由教育程度、就业和收入来解释。在某些模型设定中，环境、枪支安全和大麻政策领域在较小程度上是健康的预测因素。总之，改善健康需要更关注塑造人们生活条件的宏观层面因素。
