Patterns and predictors of state adult obesity prevention legislation enactment in US states: 2010-2013.
OBJECTIVE
This study examined bill- and state-level factors associated with enactment of adult obesity prevention legislation in US states.


METHODS
A review of bills in the Rudd Center for Food Policy and Obesity's legislative database identified 487 adult obesity prevention bills, or proposed legislation, introduced between 2010 and 2013. Multilevel models were constructed to examine bill- and state-level characteristics associated with enactment.


RESULTS
From 2010 to 2013, 81 (17%) of obesity prevention bills introduced were enacted across 35 states and the District of Columbia. Bills introduced in 2010 were more likely to be enacted than in 2013 (OR=9.49; 95% CI: 2.61-34.5). Bills focused on access to healthy food, physical activity, general and educational programs, as well as modifying rules and procedures (e.g., preemption) had greater odds of enactment relative to food and beverage taxes (OR=8.18; 95% CI: 2.85-23.4 healthy food; OR=17.3; 95% CI: 4.55-65.7 physical activity; OR=15.2; 95% CI: 4.80-47.9 general; OR=13.7; 95% CI: 3.07-61.5 rules).


CONCLUSIONS
The year of bill introduction and overall bill enactment rate were related to adult obesity prevention legislation enactment in states. This study highlights the importance of a bill's topic area for enactment and provides insights for advocates and policymakers trying to address enactment barriers.
Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health Baltimore, MD, United States. Electronic address: edonalds@jhsph.edu.
Elisabeth A
EA
Donaldson
Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health Baltimore, MD, United States; Institute for Global Tobacco Control, Baltimore, MD, United States.
Joanna E
JE
Cohen
Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health Baltimore, MD, United States; Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC, United States.
Andrea C
AC
Villanti
Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
Norma F
NF
Kanarek
Department of Health, Policy, & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
Colleen L
CL
Barry
Department of Health, Policy, & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
Lainie
L
Rutkow
D000328:Adult; D006801:Humans; D007881:Legislation, Food / Q000706:statistics & numerical data* / Q000639:trends; D018673:Nutrition Policy / Q000331:legislation & jurisprudence*; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control*; D010806:Physical Education and Training / Q000331:legislation & jurisprudence*; D013219:State Government; D013660:Taxes / Q000331:legislation & jurisprudence; D014481:United States / Q000453:epidemiology
Legislation; Obesity; Policy