RESUMEN
CONTEXT: Kentucky leads the nation in adult and teen smoking prevalence. Even though Kentucky is one of the most tobacco-dependent states, tobacco policy is subject to change in light of possible national tobacco legislation. OBJECTIVE: To describe the degree of agreement among Kentucky legislators regarding tobacco control and tobacco farming policy, and to discover whether use of the policy Delphi method produces a shift toward consensus on tobacco policy. DESIGN: A two-round policy Delphi study was conducted using in-person interviews. SETTING: Legislators' offices in Frankfort, Kentucky. PARTICIPANTS: Volunteer sample of 116 Kentucky legislators (84% response rate). MAIN OUTCOME MEASURES: Degree of agreement on tobacco control and tobacco farming policies. RESULTS: Lawmakers were highly supportive of policies to lessen the state's dependence on tobacco, and were favorable toward stronger tobacco control policies. There were discrepancies, however, between what policies legislators thought were desirable and what policies were realistic. Tobacco interests were identified as possible explanations for this disparity. Tobacco allotment ownership was associated with less support for tobacco control and tobacco farming policies. A shift toward consensus on tobacco policy was achieved in the second round for 45% of the interview items common to both rounds. CONCLUSIONS: Kentucky legislators were highly supportive of reducing the state's dependence on tobacco and more supportive of tobacco control policies than expected. The policy Delphi method has the potential for shifting opinions about tobacco policies among state legislators. The findings of this study identify opportunities for public health policy change in one of the most tobacco-dependent states in the United States.
Asunto(s)
Agricultura/legislación & jurisprudencia , Actitud Frente a la Salud , Gobierno , Política de Salud/legislación & jurisprudencia , Nicotiana , Plantas Tóxicas , Prevención del Hábito de Fumar , Adulto , Técnica Delphi , Femenino , Humanos , Kentucky/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Fumar/epidemiología , Fumar/legislación & jurisprudencia , Encuestas y CuestionariosRESUMEN
Medical science occupies a peculiar status in American life. On the one hand, people often view medical science as a privileged and authoritative body of knowledge that transcends other kinds of knowledge. On the other hand, medical-scientific authority can be easily conjured from the popular symbols of science, e.g., credentials, technical terms, and white lab coats. This problem can be converted into an anthropological question of meanings and symbols, based on Geertz's interpretive anthropology and Baudrillard's sociology of hyperreality. This article uses these frameworks to explore the cultural construction of medical-scientific authority in the case of a 1986 referendum on AIDS/HIV policy in California. The interpretation of that construction raises some difficult problems concerning anthropology's treatment of medical science.