Health Policy Advocacy in Local Health Departments: Importance of Public Opinion Surveys

Improving public health through policy-level change achieved by enacting local ordinances is increasingly recognized as a viable and cost-effective strategy. However, enacting local ordinances requires effective campaigns to influence elected officials and policy makers. High quality public opinion data is a critical component of an effective campaign. Using tobacco control as an example, this paper describes the practice of using public opinion surveys in successful campaigns. The Los Angeles County Health Survey (LACHS) is a biennial random-digit-dial health survey querying adults in approximately 8,000 households. Since 1999, the LACHS has included a module assessing public opinion regarding tobacco control policies. Questions are tailored to address specific tobacco control policy initiatives of current interest and are revised as new policy areas are pursued. Examples of policy areas in the 2007 LACHS include smoke-free housing, smoke-free outdoor areas, and tobacco retail licensure. Public opinion data from the LACHS has been used to inform local elected officials, decision makers, community-based organizations, and tobacco control coalitions. Data has been included in reports, fact sheets, newspaper articles, press releases, and presentations. LACHS data demonstrating public support for the adoption of tobacco control policy to ban smoking in outdoor areas has been used successfully in campaigns to ban smoking in parks, beaches and other outdoor areas throughout Los Angeles County. The success of these campaigns shows evidence of the usefulness of public opinion survey data and makes a case for their routine collection by local health departments.