Public and Opinion Leader Willingness to Fund Obesity-Focused Policies in Kansas

Abstract

Obesity increases the risk for leading causes of death, including cardiovascular disease and some cancers. Midwestern and southern states have the highest obesity rates—in Kansas, one in every three adults is obese. We compared the willingness of Kansas adults and opinion leaders to pay more in taxes to fund obesity prevention policies. In 2014, we asked a representative sample of 2,203 Kansas adults (response rate 15.7%) and 912 opinion leaders (response rate 55%) drawn from elected office and other sectors, including business and health, whether they would pay an additional $50 in annual taxes to support five policies that improve access to healthy foods and opportunities for physical activity. We used adjusted Wald tests to compare public and opinion leaders’ responses, and regression analysis to assess whether differences in respondents’ gender, age, location (urban/rural), race/ethnicity, and political stance affected results. Adjusting for demographic differences, Kansas adults were more willing than opinion leaders to pay $50 in taxes for each of the five policy interventions. This study demonstrates a willingness among residents of a fiscally conservative state to pay increased taxes for policies that could reduce population obesity rates. Health professionals, including nurses, can use these findings to educate policy makers in Kansas and geopolitically similar states about widespread public support for obesity prevention policies. Public health and other nurses could also apply our methods to assess support for obesity prevention policies in their jurisdictions.

Keywords

obesity state policy political action public policy rural health public health

Get full access to this article

View all access options for this article.

References

AAPOR Cell Phone Task Force. (2010). New considerations for survey researchers when planning and conducting RDD telephone surveys in the U.S. with respondents reached via cell phone numbers. Retrieved from https://www.aapor.org/AAPOR_Main/media/MainSiteFiles/2010AAPORCellPhoneTFReport.pdf.

American Association for Public Opinion Research. (2015). Response rates—An overview. Retrieved from http://www.aapor.org/AAPORKentico/Education-Resources/For-Researchers/Poll-Survey-FAQ/Response-Rates-An-Overview.aspx.

American Association for Public Opinion Research. (2016). Standard definitions: Final dispositions of case codes and outcome rates for surveys. Retrieved from http://www.aapor.org/AAPOR_Main/media/publications/Standard-Definitions20169theditionfinal.pdf.

American Public Health Association, Public Health Nursing Section. (2013). The definition and practice of public health nursing: A statement of the public health nursing section. Retrieved from https://www.apha.org/∼/media/files/pdf/membergroups/phn/nursingdefinition.ashx.

Bell, J., Mora, G., Hagan, E., Rubin, V., & Karpyn, A. (2013). Access to healthy food and why it matters: A review of the research. Retrieved from http://www.policylink.org/sites/default/files/GROCERYGAP_FINAL_NOV2013.pdf.

Blumberg, S. J., & Luke, J. (2017). Wireless substitution: Early release of estimates from the National Health Interview Survey, July-December 2016. Retrieved from https://www.cdc.gov/nchs/data/nhis/earlyrelease/wireless201705.pdf.

Boehmer, T. K., Brownson, R. C., Haire-Joshu, D., & Dreisinger, M. L. (2007, July). Patterns of childhood obesity prevention legislation in the United States. Preventing Chronic Disease (serial online), 4(3). Retrieved from http://www.cdc.gov/pcd/issues/2007/.

Bosman, J., Smith, M., & Davey, M. (2017, June 7). Brownback tax cuts set off a revolt by Kansas Republicans. The New York Times. Retrieved from https://www.nytimes.com/2017/06/07/us/sam-brownback-kansas-budget-override.html.

Bowen

P. G.

Bryant

P. H.

Hess

McCarty

K. H.

Ivey

J. B.

(2014) Modifying public policies to combat obesity. The Journal for Nurse Practitioners 10(2): 100–106.

10.

Centers for Disease Control and Prevention. (2013). State indicator report on fruits and vegetables, 2013. Retrieved from http://www.cdc.gov/nutrition/downloads/State-Indicator-Report-Fruits-Vegetables-2013.pdf.

11.

Centers for Disease Control and Prevention. (2014). The 10 essential public health services: An overview. Retrieved from https://www.cdc.gov/stltpublichealth/publichealthservices/pdf/essential-phs.pdf.

12.

Chriqui

J. F.

(2013) Obesity prevention policies in U.S. states and localities: Lessons from the field. Current Obesity Reports 2(3): 200–210. doi:10.1007/s13679-013-0063-x.

13.

Coffman, J., & Beer, T. (2015). The advocacy strategy framework. Center for evaluation innovation. Retrieved from http://www.evaluationinnovation.org/sites/default/files/Adocacy%20Strategy%20Framework.pdf.

14.

Committee on Physical Activity Health Transportation and Land Use. (2005). Does the built environment influence physical activity? Examining the evidence (TRB Special Report 282, Vol. 282). Retrieved from http://www.trb.org/publications/sr/sr282.pdf.

15.

Community Commons. (2012a). Recreation and fitness facilities, rate (per 100,000 pop.) by county, CBP 2012. Retrieved from http://www.communitycommons.org/.

16.

Community Commons. (2012b). U.S. census bureau: County business patterns, 2012. Retrieved from http://assessment.communitycommons.org/CHNA.

17.

Community Commons. (2013). Population with park access (within 1/2 mile of a park), ESRI/OSM 2013. Retrieved from http://www.communitycommons.org/.

18.

Community Commons. (2014). Data from the Food Access Research Atlas (FARA), 2014. Retrieved from http://assessment.communitycommons.org/CHNA.

19.

Dodson

E. A.

Stamatakis

K. A.

Chalifour

Haire-Joshu

McBride

Brownson

R. C.

(2013) State legislators’ work on public health-related issues: What influences priorities? Journal of Public Health Management and Practice 19(1): 25–29. doi:10.1097/PHH.0b013e318246475c.

20.

Frieden

T. R.

(2010) A framework for public health action: The health impact pyramid. American Journal of Public Health 100(4): 590–595.

21.

García

M. C.

Bastian

Rossen

L. M.

Anderson

Miniño

Yoon

P. W.

Iademarco

M. F.

(2016) Potentially preventable deaths among the five leading causes of death—United States, 2010 and 2014. MMWR Morbidity and Mortality Weekly Report 65: 1245–1255. doi:10.15585/mmwr.mm6545a1.

22.

Glasgow

Adams

Joshi

Curry

Schmitt

C. L.

Rogers

Willett

Van Hersh

(2017) Using a theory of change to guide grant monitoring and grantmaking. Journal of Public Health Management Practice 23(2): 126–130. doi:10.1097/PHH.0000000000000421.

23.

Guide to Community Preventive Services. (n.d.). Environmental and policy approaches to increase physical activity: Creation of or enhanced access to places for physical activity combined with informational outreach. Retrieved from www.thecommunityguide.org/pa/environmental-policy/improvingaccess.html.

24.

Healthy Kansans 2020. (n.d.). Kansas demographics. Retrieved from http://www.healthykansans2020.com/KHAIP/Health-Assessment-Section-2.pdf?v=1.

25.

Howard

K. A.

Rogers

Howard-Pitney

Flora

J. A.

Norman

G. J.

Ribisl

K. M.

(2000) Opinion leaders’ support for tobacco control policy and participation in tobacco control activities. American Journal of Public Health 90: 1282–1287.

26.

Huang

T. T. K.

Cawley

J. H.

Ashe

Costa

S. A.

Frerichs

L. M.

Zwicker

Kumanyika

S. K.

(2015) Mobilisation of public support for policy actions to prevent obesity. The Lancet 385: 2422–2431. doi:10.1016/S0140-6736(14)61743-8.

27.

Ingram

D. D.

Franco

S. J.

(2014) 2013 NCHS urban-rural classification scheme for counties. Vital and Health Statistics 2(166): 1–73.

28.

Institute of Medicine. (2007). Progress in preventing childhood obesity: How do we measure up. Retrieved from https://doi.org/10.17226/11722.

29.

Institute of Medicine. (2011). Early childhood obesity prevention policies. Retrieved from https://www.nap.edu/catalog/13124/early-childhood-obesity-prevention-policies.

30.

Institute of Medicine. (2012). Accelerating progress in obesity prevention: Solving the weight of the nation. Retrieved from http://www.nationalacademies.org/hmd/Reports/2012/Accelerating-Progress-in-Obesity-Prevention.aspx.

31.

Iowa State University, Iowa Community Indicators Program. (n.d.). Urban percentage of the population for states, historical. Retrieved from http://www.icip.iastate.edu/tables/population/urban-pct-states.

32.

Khan, L. K., Sobush, K., Keener, D., Goodman, K., Lowry, A., Kakietek, J., & Zaro, S. (2009, July 24). Recommended community strategies and measurements to prevent obesity in the United States. MMWR, 58(RR07), 1–26.

33.

Judd

S. E.

Allison

D. B.

Oza-Frank

Affuso

Safford

M. M.

Howard

(2014) The geographic distribution of obesity in the US and the potential regional differences in misreporting of obesity. Obesity 22(1): 300–306. doi:10.1002/oby.20451.

34.

Mowen

A. J.

Baker

B. L.

(2009) Park, recreation, fitness, and sport sector recommendations for a more physically active America: A white paper for the United States national physical activity plan. Journal of Physical Activity & Health 6(Suppl 2): S236–S244. doi:10.1123/jpah.6.s2.s236.

35.

Novak

N. L.

Brownell

K. D.

(2012) Role of policy and government in the obesity epidemic. Circulation 126(19): 2345–2352. doi:10.1161/CIRCULATIONAHA.111.037929.

36.

O’Dougherty

Forster

Widome

(2010) Communicating with local elected officials: Lessons learned from clean indoor air ordinance campaigns. Health Promotion Practice 11(2): 275–281. doi:10.1177/1524839908324781.

37.

O’Grady

E. T.

(2016) Chapter 7: The policy process. In: Mason

D. J.

Gardner

D. B.

Outlaw

F. H.

O’Grady

E. T.

(eds) Policy and politic in nursing and health care, 7th ed. St. Louis, MO: Elsevier, pp. 61–72.

38.

Oliver

J. E.

Lee

(2005) Public opinion and the politics of obesity in America. Journal of Health Politics, Policy and Law 30(5): 923–954. doi:10.1215/03616878-30-5-923.

39.

Rails-to-Trails Conservancy. (2017). Kansas trails and maps. Retrieved from https://www.traillink.com/state/ks-trails/.

40.

Schmitt

C. L.

Juster

H. R.

Dench

Willett

Curry

L. E.

(2014) Public and policy maker support for point-of-sale tobacco policies in New York. American Journal of Health Promotion 28(3): 175–180. doi:10.4278/ajhp.121023-QUAN-514.

41.

Sheehan

Yin

(2006) Childhood obesity: Nursing policy implications. Journal of Pediatric Nursing 21: 308–310.

42.

State of Kansas Office of the Secretary of State. (n.d.). Voter registration statistics: 2015 August (OFFICIAL) voter registration numbers. Retrieved from http://www.kssos.org/elections/elections_registration_voterreg.asp.

43.

Tompson, T., Benz, J., Agiesta, J., Brewer, K. H., Bye, L., Reimer, R., & Junius, D. (2013). Obesity in the United States: Public perceptions. The Associated Press-NORC, Center for Public Affairs Research. Retrieved from http://apnorc.org/PDFs/Obesity/AP-NORC-Obesity-Research-Highlights.pdf.

44.

Trust for America’s Health. (2016). The state of obesity: Better policies for a healthier America. Retrieved from http://stateofobesity.org/files/stateofobesity2016.pdf.

45.

Welker

Lott

Story

(2016) The school food environment and obesity prevention: Progress over the last decade. Current Obesity Reports 5(2): 145–155. doi:10.1007/s13679-016-0204-0.