The focus on the evidence is there all the time.... People are digging in the literature and asking, 'Ok, would this thing really have an impact on health?' It's got to meet that threshold first."—Project Director Kimberley Isett
Dates of Project: August 2010 to September 2012
Field of Work: Public health laws and regulations
Problem Synopsis: New York City health officials under the leadership of Mayor Michael Bloomberg have been unusually successful in passing public health regulations intended to lower the incidence of chronic disease. Such measures are often controversial, in part because they address personal behavior considered by many to be outside the purview of government.
Synopsis of the Work: Researchers affiliated with Columbia University and the Georgia Institute of Technology studied the strategies used in New York to move three measures through the political process—a ban on trans fats; limits on exhaust emissions; and excise taxes on sugar-sweetened beverages. The first two reforms passed; the third did not.
The goal was to determine whether New York's ability to introduce health reforms was unique to conditions there, or whether it might serve as a model for introducing similar measures elsewhere. The research team also developed case studies of attempts to pass similar measures in other cities and states, and made comparisons to determine what steps led to reforms.
Key Findings: Researchers concluded that the public health policies approved in New York did not depend solely on the city's unique circumstances. Many of the strategies offer models for health departments throughout the United States. These dynamics were consistent across the three public health proposals:
- Although the mayor's strong support was key, leadership in the health department provided the "driving force" necessary to steer reforms through the political process.
- Public health officials employed creative administrative and regulatory mechanisms to secure passage of reforms.
- City officials used empirical evidence to support their efforts.
- Health officials changed the department's internal structure (such as by creating a bureau dedicated to chronic disease and an in-house legal team).
In their multiple-city analyses, the research team concluded:
- Cities that successfully banned trans fats had the support of a government champion and both local and national advocates, and used empirical evidence and expert testimony.
- Cities that limited exhaust emissions promoted their image as environmentally progressive and saw regulations as an opportunity to increase demand for cleaner vehicles and comply with existing clean air standards.
- Ideological and economic objections were common barriers to levying excise taxes on sugar-sweetened beverages.
How to pass progressive health policies: RWJF study finds lessons in political process from New York and other cities.
While the need to address disparities in care is well known, few strategies for reducing disparities have been studied systematically.
RWJF examines the types of competitive foods - foods and beverages schools offer outside of meal programs - available in our nation's school...
Recent studies have demonstrated a connection between low-socioeconomic status and poor health in children. This study builds upon previous ...
This study examined the impact that race has on the prevalence of self-reported diabetes for Hispanic and non-Hispanic people. Data from the...
In this article, the authors consider the social, structural and symbolic effects of the recent and rapid spread of legal gambling in the Un...
Immigrants and their children are one of the fastest growing components of the U.S. population. One in five Americans under the age of 18 is...
Most studies investigating links between social capital and health have relied on work by Robert Putnam who conceptualized social capital as...
The present article considered cardiovascular patients' adherence to physicians' medication recommendations. Nonadherence was defined as fol...
This study examined the prevalence of attention-deficit/hyperactivity disorder (ADHD) among children in the United States. Also of interest ...
The current article explored risk factors for iron deficiency for toddlers in the United States with a focus on Hispanic toddlers. Data from...
The research presented in this article compared the density and concentration of pro-tobacco media messages in African-American and White ma...
This article describes efforts to use information on influenza burden and vaccine efficacy to estimate how influenza vaccine recommendations...