Is public support of policy, system, and environmental-change strategies to combat chronic disease higher among low socio-economic status residents in Los Angeles County? Results from a random-digit dial telephone survey, Los Angeles County, 2013

Introduction: Since 2010 a variety of federally-funded and locally supported policy, system, and environmental-change (PSE) initiatives in Los Angeles County have sought to address the physical and social determinants of health of its residents. Nutrition interventions have ranged from adoption of healthy food standards to breastfeeding policies. While these interventions have heavily targeted populations at-risk for cardiovascular disease, little is known about their receptivity to such efforts. We examine predictors of public support of nutrition-focused PSE efforts in two socio-economically diverse regions of Los Angeles County.

Methods: A socio-economically diverse sample of voters (n=1007) were randomly selected to participate in a 7-page, 35 item RDD-telephone survey. Questions pertained to attitudes towards obesity epidemic, public opinions about changing business practices/government policies, nutrition knowledge and behaviors, and socio-demographics. Using factor analysis to inform outcome variable selection (i.e., index of level of public support for PSE efforts), we conducted a multivariable regression analysis to examine support among low and high socio-economic status (SES) residents.

Results: Results suggest that there is no difference in level of PSE support across SES. However, being female and having higher perceived access to healthy eating resources is associated with stronger level of public support (p<.05). In contrast, higher soda consumption is associated with lower support. 

Discussion: An examination of local health data is essential to ensuring that forthcoming PSE efforts are better tailored to target populations. Local health data serves as the basis for continual efforts to improve health promotion and protection in the county population.