Date of Award

Summer 2017

Document Type


Degree Name

Doctor of Philosophy (PhD)


School of Public Service

Committee Director

Meagan M. Jordan

Committee Member

John C. Morris

Committee Member

John C. Morris

Committee Member

Tancy Vandecar-Burdin


Over the past several decades obesity rates in the United States have increased exponentially, reaching epidemic proportions and placing heavy financial and health-related burdens on states. States could reduce their obesity-related spending by billions of dollars, however, if they reduced their obesity prevalence by five percent by 2030, which would reduce medical costs, loss of productivity, and loss of life. Despite the incentive to improve obesity rates, not all states are taking advantage of obesity-related policy as a means to combat obesity. Using a multiple case study design and policy design as the theoretical foundation, this study explores whether or not state policy design stringency, reflecting policy design prescriptiveness, changes as states experience an increase in obesity prevalence. This study also seeks to identify the factors that contribute to variation in state obesity-related policy stringency.

The results of this study indicate that states enacting a large number of highly stringent obesity-related policies will experience an improvement in obesity prevalence over time. States making minimal improvements will experience consistent obesity rates over time, while states that take no significant obesity-reducing policy steps will experience worsening obesity prevalence over time. In terms of the factors that lead to variation in policy design stringency, party sponsorship of obesity-related policy plays a key role, as does state affluence, and party in control of the state legislature in some cases. Party of the governor and contributions from health interest groups were not consistently present in years of high obesity policy stringency. This dissertation also offers implications of the findings and plans for future research.


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