Essay on politics, public health law, and health outcomes in the United States and sub-Saharan Africa

This dissertation examines the political dimensions of health policymaking and the relationship between laws and population health. The first paper explores the politics of HPV policy formation in California, Indiana, New Hampshire, New York, Texas, and Virginia. Utilizing thematic content analysis of semi-structured key informant interviews, I identify critical moments and influences through the lens of the Multiple Streams (MS) framework. Policymakers seeking to encourage uptake of new adolescent vaccines such as the HPV vaccine should engage conservative family values and anti-vaccine advocacy groups early in the process to foster consensus-building.;The second paper examines how exposure to state-level obesity prevention laws is associated with an individual's body mass index (BMI) and classification as overweight or obese. Multivariate regression analyses with fixed effects using data from the Behavioral Risk Factor Surveillance System (BRFSS) suggests that individuals who live in states with laws designed to increase access to healthier foods through farmers' markets are significantly less likely to be overweight or obese. Greater state-level legislative activity around obesity prevention or reduction is also associated with lower self-reported BMI.;The third paper extends previous exploration of citizens' views of health services in twenty sub-Saharan African countries. Unmet need for medical care in the previous year was a significant predictor of less favorable views of government performance with health services in thirteen countries. Individual access to health care, personal living conditions, and perceptions of national leadership play a significant role in shaping public attitudes towards health services in the majority of countries. Social identity indicators are also important, though in fewer countries and to a lesser extent.