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Americans want government to promote good health -- sometimes

In a survey, smokers were less likely than others to support restrictions on tobacco use in the name of public health, according to a new report in Health Affairs.
(Misha Japaridze / Associated Press)
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Does the government have a role to play in preventing childhood obesity, helping smokers quit and heading off chronic diseases such as cancer and heart disease? Yes, according to survey results published Monday by the journal Health Affairs.

Two health policy experts from Harvard University wanted to find out how the public was responding to what they called “new frontier” public health initiatives aimed at changing consumer behavior, such as New York City’s ban on super-sized sodas. After all, they noted, the three leading causes of death among Americans in 2000 were all behavior-related (tobacco use contributed to 18.1% of deaths that year, poor diet and exercise habits played a role in 16.6% of deaths, and alcohol was a factor in 3.5% of deaths, according to data from the Centers for Disease Control and Prevention.

Stephanie Morain and Michelle M. Mello conducted an online survey of 1,817 Americans and asked them about a variety of policy options.

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Overall, 75% said the CDC was doing a “good” or “excellent” job, and more than half gave the same ratings to their state and local public health agencies. When it came to assessing the government’s public health agenda, there was broad support for preventing cancer (89% were in favor), preventing heart disease (86%), preventing obesity in children (81%) and adults (76%), preventing and reducing tobacco use (76%) and reducing alcohol consumption (70%). In addition, 84% agreed that the government should help people with diabetes control their disease.

But the government should not use coercive policies or punitive measures in pursuit of these goals, survey respondents said. For instance, 84% said the government should help make fruits and vegetables more affordable, 81% liked the idea of requiring restaurants to post the calorie counts for food they serve and 73% said the government should make nicotine patches available at no cost. In schools, 89% agreed that children should be taught more about the health risks of obesity and 88% believe kids should get at least 45 minutes of physical education each day.

On the other hand, 62% of people were opposed to allowing health insurers to charge a $50 annual penalty to people who are obese, 62% did not want to see smoking bans in private spaces, 68% said it would be a bad idea to “make possession of soda and other junk foods a disciplinary offense” for kids and 48% don’t want schools to measure the body-mass index of their students.

As expected, smokers were less likely than nonsmokers to support restrictions on tobacco use and people who were overweight were less likely to support the idea of charging higher insurance premiums for people who are obese. But the researchers were surprised to discover that people with diabetes were more likely than others to back government efforts designed to improve their health.

You can read a summary of the study online here (the full text is behind a pay wall).

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