Perceptions of Public Health Priorities and Accountability Among US Mayors

Abstract

Objective Mayors have considerable and often direct influence over health policy in their cities, yet little is known about mayors’ general perceptions of current public health challenges. The objective of this study was to assess perceptions, attitudes, and priorities related to public health among US mayors. Methods We collected survey data from a nationally representative sample of US mayors (N = 110) in 2018 and matched survey responses with city-level health surveillance data. We conducted descriptive analyses and multivariable regression modeling to estimate associations of interest. Results Mayors in our sample most frequently cited obesity/chronic diseases (23.6%; 26 of 110), opioid abuse/drug addiction (22.7%; 25 of 110), and health care access (13.6%; 15 of 110) as the top health challenges facing their cities. However, mayors identified a different set of health issues for which they believed constituents hold them accountable. With the exception of opioid-related deaths, prevalence of a health concern was not associated with perceived accountability for that particular issue, whereas partisanship and sex predicted patterns in perceived accountability. Conclusions Mayors recognized critical health challenges at the city level but varied widely in their perceived accountability for such challenges. Findings can inform strategies to engage local policy makers in cross-sector collaborations to improve the health and overall well-being of people in cities across the United States.

Perceived Healthcare Priorities, Barriers, and Preferences When Selecting Private or Governmental Healthcare Services Among a Sample of University Affiliates from Saudi Arabia

“…22 However, in another study that assessed the perception of mayors in the United States, it was reported that the mayors viewed obesity, chronic diseases, drug addiction, and healthcare access as critical health issues in their cities. 23 When the participants of the current study were asked about the most vital medical conditions, the condition perceived as most important was diabetes, followed by cancer, hypertension, and obesity. It is possible to argue that the perception of the current sample about the burden of chronic noncommunicable diseases in the country can be associated with the raised prevalence of these conditions, and the effort of the governmental establishments in raising awareness about prevention through lifestyle modification.…”

“… 22 However, in another study that assessed the perception of mayors in the United States, it was reported that the mayors viewed obesity, chronic diseases, drug addiction, and healthcare access as critical health issues in their cities. 23 …”

On the Relationship Between Stakeholder Affiliation and Attitudes Toward Behavioral Health Reform in Kansas

“…Other studies generally have found that among elected officials, factors such as gender, political party affiliation, and political ideology can influence attitudes toward social determinants of health. 33,36,58 These studies may explain why significant differences were observed between elected officials and members of health advocacy groups on the perceived benefit of social determinants of health policies.…”

“…Several studies have examined the attitudes of elected officials toward social determinants of health. 33,36,58 Notably, per Purtle et al 36 , a smaller proportion of mayors strongly agreed that health disparities exist in their city and that city policies could impact health disparities when compared to health commissioners. Other studies generally have found that among elected officials, factors such as gender, political party affiliation, and political ideology can influence attitudes toward social determinants of health.…”

Microbiome First Approaches to Rescue Public Health and Reduce Human Suffering

“…For example, food emulsifiers are clearly obesogens via their capacity to destroy the keystone gut bacteria, Akkermansia mucinophila, compromise the gut barrier, allow pathobionts to gain predominance, and produce underlying immune-inflammatory dysregulation [64,65]. Yet, the FDA has not acted to protect consumers from this pervasive food additive hazard despite the fact that reducing the prevalence of obesity is among the highest public health priorities [66,67]. When the WHO directs people to eat healthier foods to reduce obesity, are they considering elimination of most emulsifier-containing foods or at least replacing emulsifiers with a microbiome friendly alternative?…”