Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Department of Pediatrics, Emory University School of Medicine, Emory University, Atlanta, Georgia.
JAMA Health Forum. 2024 Sep 6;5(9):e243305. doi: 10.1001/jamahealthforum.2024.3305.
Policies that are associated with child health are rarely included in platforms of candidates for national political office. Candidates may underrecognize voter support for such priorities or perceive that such policy issues are not sufficiently divisive to appeal to partisan voters. Key policy questions associated with child health may be considered by the next Congress, including the consistency of Medicaid coverage across states and restoring the recently lapsed refundable child tax credit.
To examine voter support for candidates regarding policies that are associated with child health.
DESIGN, SETTING, AND PARTICIPANTS: This nationally representative survey of registered US voters 18 years or older was conducted from March to April 2024 and included a survey-based randomized experiment to evaluate the association of message framing with voter support.
Messages conveying distinct rationales for Medicaid reform and refundable child tax credit.
Likely or definite support for candidates.
In this sample (unweighted N = 2014; 1015 women [51.0%]), most respondents indicated they would likely or definitely vote for candidates who expressed strong support for all tested policies: extreme risk protection order (79.5%), school threat assessment (73.1%), expanded childcare (69.6%), refundable child tax credit (66.6%), federalization of Medicaid (66.0%), paid parental leave (65.5%), free school meals (65.6%), safe firearm storage and enforcement (62.9%), preventing Medicaid disenrollment for children younger than 6 years (61.9%), universal free preschool (61.6%), and summer nutrition programs (57.9%). More women than men expressed support for all tested policies. Strong majorities of Democrat and Independent voters would support candidates who endorsed child-focused policies; fewer than 50% of Republican voters expressed such support, except for the extreme risk protection order and school threat assessment. Variations in framing language regarding consistent Medicaid coverage across states were not associated with amplified or diminished voter support. Framing the refundable child tax credit as benefiting "hard-working" vs "low-income" families garnered significantly more support among men (67.0% vs 59.0%), privately insured individuals (72.0% vs 64.4%), and Republicans (54.6% vs 43.0%; all P < .05).
The study results suggest that most voters favor candidates who strongly support policies that are associated with child health. Voter support differs substantively by gender and political party affiliation and may be associated with language choices in messaging about policy change.
与儿童健康相关的政策很少被纳入国家政治职位候选人的竞选纲领中。候选人可能没有意识到选民对这些优先事项的支持，或者认为这些政策问题没有足够的分歧，不足以吸引党派选民。与儿童健康相关的关键政策问题可能会被下一届国会审议，其中包括各州之间医疗补助覆盖范围的一致性以及恢复最近失效的可退还儿童税收抵免。
研究选民对与儿童健康相关政策的候选人的支持情况。
设计、地点和参与者：这是一项针对美国注册选民（18 岁及以上）的全国代表性调查，于 2024 年 3 月至 4 月进行，其中包括一项基于调查的随机实验，以评估信息传递与选民支持之间的关联。
传达医疗补助改革和可退还儿童税收抵免的不同理由的信息。
对候选人的支持程度。
在该样本中（未经加权 n=2014；女性 1015 人[51.0%]），大多数受访者表示他们可能或肯定会投票给表达对所有测试政策强烈支持的候选人：极端风险保护令（79.5%）、学校威胁评估（73.1%）、扩大儿童保育（69.6%）、可退还儿童税收抵免（66.6%）、医疗补助联邦化（66.0%）、带薪育儿假（65.5%）、免费学校餐食（65.6%）、安全枪支储存和执法（62.9%）、防止 6 岁以下儿童被医疗补助除名（61.9%）、普及免费学前教育（61.6%）和暑期营养计划（57.9%）。女性比男性更支持所有测试政策。民主党和独立选民的绝大多数人将支持关注儿童的政策的候选人；只有不到 50%的共和党选民表示支持，除了极端风险保护令和学校威胁评估。关于各州之间医疗补助覆盖范围一致性的语言框架变化并没有导致选民支持的放大或减弱。将可退还儿童税收抵免描述为惠及“努力工作”的家庭与“低收入”家庭的说法在男性（67.0%对 59.0%）、私人保险个人（72.0%对 64.4%）和共和党人（54.6%对 43.0%；所有 P<0.05）中获得了更多支持。
研究结果表明，大多数选民支持强烈支持与儿童健康相关政策的候选人。选民的支持程度在性别和政党归属方面有实质性差异，并且可能与政策变革信息传递中的语言选择有关。
