Insights into How HIAs are Characterized in the Press: Findings from a Media Analysis of Widely Circulated United States Newspapers

Background: Health impact assessments (HIAs) are burgeoning tools in the policy process, where the media plays a critical role by focusing attention on issues, informing consumers, and influencing positions. Examining how media portrays HIAs is critical to understanding HIAs in the policy context. Methods: This study considered how widely circulated, U.S. newspapers represent HIAs. After searching newspaper databases, we used a qualitative document analysis method consisting of open and axial coding to examine specific phrases of HIA depictions. Results: In coding over 1,000 unique phrases from the 62 documents generated in our search, we found an uptick in HIA-related publications since 2010. Coding these documents identified 46 distinct codes across 10 different themes. The two most prominent HIA-centered themes focused on HIA engagement and the HIA setting. While themes of policy and science, health determinants, and explanations of HIAs were also frequently featured, specific mentions of projected impacts, HIA processes, HIA values, and health outcomes were less prevalent. Conclusions: HIA media portrayals warrant further inquiry from researchers and practitioners. Focusing on how media portrays HIAs is consistent with several HIA steps. It is also important for a broader strategy to educate stakeholders about HIAs and to understand HIAs’ utility. HIA practitioners should develop and implement guidelines for media interaction and tracking that encourage practitioners to seek additional media attention and to focus such attention on health impacts and outcomes, HIA recommendations, and HIA values. Building on our work, researchers should examine HIA media portrayals beyond the context of this study

How Have States Used Executive Orders to Address Public Health?

Gubernatorial executive orders (GEOs) are important, yet poorly understood, public health tools. We analyzed health-related GEOs nationwide using a modified legal mapping approach. We searched Westlaw\u27s Netscan Executive Orders database for orders issued between 2008 and 2014. Search terms were generated from the Healthy People 2020 Leading Health Indicators (LHIs). GEOs were screened with data abstracted and analyzed on the basis of LHIs, states, years, and characteristics identified in previous literature. We found differences in GEOs issued per LHI. Of the 303 unique orders, they ranged from 32 to 53 issued per year and 0 to 45 issued per state. Most GEOs managed governmental public health functions, required collaboration, and mandated studying problems. Fewer directly addressed health equity, chronic disease, and resource deployment. Gubernatorial authority and political and institutional factors appear relevant to GEO issuance. GEOs offer means to institute public health policies and should be considered by public health professionals

A State of Uncertainty: An Analysis of Recent State Legislative Proposals to Regulate Preventive Services in the United States

This policy brief examines preventive services state legislation trends in the United States during uncertainty regarding the Affordable Care Act (ACA), which requires certain coverage of 4 evidence-based preventive services categories without additional patient costs under §2713. We used a legal mapping approach to search for and analyze state legislation related to preventive services proposed or enacted over a 25-month period of ACA uncertainty. We screened 1231 bills and coded the 76 screened-in bills. Next, we determined their characteristics and examined trends. Bills originated in 28 states, and 69.7% were not enacted. Only 3.9% contained requirements contingent on ACA modifications. About 56.6% referenced services covered by §2713, but usually not entire §2713 categories. Bills also mentioned preventive services in general (53.9%) and services outside §2713’s scope (21.1%). About 55.3% applied to private insurance, and 75.0% only to one patient group. Bills generally promoted access, and 51.3% specifically prohibited cost-sharing. But 26.3% of the bills limited access to preventive services. State-level legislation targets preventive services, usually expanding, but sometimes limiting, access. Most bills single out specific services without fully incorporating evidence-based recommendations. State legislation may therefore promote access to preventive services but can favor certain services, deviate from experts’ recommendations, and increase nationwide variability. State legislation can function as an important lever for access to preventive services across patient groups. This may be especially important during uncertainty about federal policy. However, the design of state-level proposals is critical for maximizing access to preventive services

A Qualitative Study on Parental and Community Stakeholder Views of the Link between Full-Day Kindergarten and Health in Southern Nevada

Studies show that children who attend full-day kindergarten (FDK) experience both academic and developmental benefits compared to children who attend half-day programs. Sectors outside of health, such as education, can have important intended and unintended impacts on health. The purpose of this qualitative study was to understand perceptions of parental and other stakeholders in Southern Nevada (USA) about the education–health link, and to understand priorities regarding how FDK access could affect health. Two 90-minute focus groups were conducted with 14 adult stakeholder participants representing parents, current and former teachers, and community members. Transcripts were analyzed using conventional content analysis. Eight major themes and several subthemes emerged; findings related to each are discussed. ‘Access’ was mentioned most frequently (n = 43), followed by ‘Time’ (n = 25), and ‘Lifetime educational attainment’ (n = 17). Participants were overall in favor of expanding access to FDK and felt that FDK could improve social skills, increase the amount of physical activity, and provide additional time for educators to detect additional learning disabilities when compared to half-day programs. Although the purpose was to understand priorities related to the education–health link, participants spent little time discussing this, suggesting this association is not inherently considered. Health and education stakeholders should collaborate to increase awareness, as this link may serve as an upstream approach to downstream effects on population health outcomes