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State Legislators' Work on Public Health-Related Issues: What Influences Priorities?

Dodson, Elizabeth A. PhD, MPH; Stamatakis, Katherine A. PhD, MPH; Chalifour, Stephanie BA; Haire-Joshu, Debra PhD, MS; McBride, Timothy PhD, MS; Brownson, Ross C. PhD

Journal of Public Health Management and Practice: January/February 2013 - Volume 19 - Issue 1 - p 25–29
doi: 10.1097/PHH.0b013e318246475c
Original Articles

Context: Policies are an effective way to influence population health and prevent disease. Unfortunately, public health research is often not well translated for policy audiences. Furthermore, researchers seeking to influence policy face an incomplete understanding of what influences legislators' decisions regarding which issues will receive their limited time and focus.

Objective: The objective of this analysis was to examine various factors that may influence state legislators' decisions about which health issues they address.

Design: Cross-sectional analysis of data collected from a randomized trial.

Setting: State legislatures.

Participants: State-level legislators.

Main Outcome Measure(s): Measures included a rating of the influence of various factors on health policy priorities. A 7-point scale was used to measure political ideology on social and fiscal issues. Standard demographic questions were included on age, gender, and level of education.

Results: Seventy-five legislators completed surveys. Sixty-three percent were aged 55 years or older, and 76% male. When they were asked to rate factors according to importance in determining what health issues to work on, the top-rated factor was constituents' needs or opinions followed by evidence of scientific effectiveness. Ratings were also examined by subgroups.

Conclusions: These findings point to several important applications for public health practitioners and researchers. Because legislators value constituents' opinions, it is critical to inform and educate constituents about public health issues as well as policy options that may be effective in addressing problems. The results also highlight the importance of public health researchers and practitioners improving dissemination efforts to ensure that evidence-based scientific information is shared with policymakers in an effective and timely manner.

This study examines various factors that may influence state legislators decisions about which health issues they address.

Prevention Research Center in St. Louis (Drs Dodson, McBride, and Brownson and Ms Chalifour), Brown School, Washington University in St. Louis (Drs Dodson, Haire-Joshu, and Brownson), Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine (Drs Stamatakis and Brownson), Center for Obesity Prevention and Policy Research, Washington University in St. Louis (Dr Haire-Joshu), and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis (Dr Brownson), St Louis, Missouri.

Correspondence: Elizabeth A. Dodson, PhD, MPH, Brown School, Washington University in St. Louis, 660 S Euclid Ave, Campus Box 8109, St Louis, MO 63110 (

This work was supported by the National Cancer Institute at the National Institutes of Health (grant 1R01CA124404-01) and Cooperative Agreement Number U48/DP001903 from the Centers for Disease Control and Prevention, Prevention Research Centers Program.

The authors declare no conflict of interest.

© 2013 Lippincott Williams & Wilkins, Inc.