Background:
Rates of overweight and obesity in children are rapidly increasing in the United States. As these rates climb, public health practitioners and policymakers seek effective means of reducing the prevalence of obesity in American youth. In recent years, many state laws and regulations, focusing on childhood obesity, have been introduced. Understanding determinants of such legislation may inform the development and passing of future policies.
Objectives:
This study examined factors that support and oppose state-level childhood obesity prevention legislation.
Methods:
As part of a study of proposed and enacted state legislation, key informant telephone interviews were conducted with 16 legislators and staffers from 11 states. Trained interviewers sought information about specific bills recently sponsored, factors that promote or inhibit the introduction and adoption of childhood obesity legislation, and components of “model” legislation regarding childhood obesity prevention. Interviews were tape-recorded and transcribed verbatim. Focused coding qualitative techniques were used to systematically analyze the transcripts.
Results:
The most often-cited factors positively influencing the passing of childhood obesity prevention legislation included national media exposure of the issue, introduction of the policy by senior legislators, and gaining the support or involvement of key players including parents, physicians, schools, community members, and health departments. Additional facilitating factors included favorable political climate, introducing legislation proposing incremental rather than major policy changes, and legislators having strong personal interest in childhood obesity issues.
Several noteworthy barriers to passing and adopting childhood obesity prevention legislation were named in a majority of interviews. These barriers include powerful lobbyists of companies producing unhealthy foods, and misconceptions about negative outcomes of legislating school foods. Finally, interviewees noted the importance of educating constituents about the benefits of legislation designed to prevent or reduce childhood obesity.
Conclusions:
Childhood obesity is a significant public health challenge in the United States. State-level policy holds promise in its prevention. This study provides policymakers and practitioners with a set of enablers and barriers that should be considered when pursuing state-level policy enactment. Further research is needed to understand how these qualitative factors apply across all states.
Support:
Funding for this project was provided by the Robert Wood Johnson Foundation via Active Living Research.
