Table 2.
Results of multivariate regression models examining factors associated with accountability for health challenges among 110 US mayors participating in the 2018 Menino Survey of Mayorsa
| Perceived accountability for . . .b | Effect estimate (SD) [95% CI] | P valuec |
|---|---|---|
| Traffic accidents | ||
| Sex (male vs female) | −0.008 (0.018) [−0.044 to 0.028] | .67 |
| Race/ethnicity (non-White vs White) | 0.078 (0.102) [−0.124 to 0.281] | .44 |
| Political affiliation (Republican vs Democratic) | 0.328 (0.255) [−0.179 to 0.835] | .20 |
| Type of health authority present in city (municipal vs county/regional) | 0.214 (0.213) [−0.210 to 0.638] | .32 |
| Population size (logarithm of continuous variable for population) | 0.020 (0.162) [−0.301 to 0.342] | .90 |
| Median housing value (logarithm of continuous variable for median housing value) | 0.563 (0.214) [0.137 to 0.989] | .01 |
| Incidence of traffic fatalities (rate per 100 000 population) | −0.006 (0.027) [−0.060 to 0.048] | .83 |
| Gun violence | ||
| Sex (male vs female) | 0.029 (0.021) [−0.014 to 0.072] | .18 |
| Race/ethnicity (non-White vs White) | −0.037 (0.101) [−0.238 to 0.164] | .72 |
| Political affiliation (Republican vs Democratic) | 0.785 (0.259) [0.270 to 1.299] | .003 |
| Type of health authority present in city (municipal vs county/regional) | 0.038 (0.208) [−0.378 to 0.454] | .86 |
| Population size (logarithm of continuous variable for population) | −0.028 (0.202) [−0.431 to 0.375] | .89 |
| Median housing value (logarithm of continuous variable for median housing value) | −0.309 (0.208) [−0.722 to 0.105] | .14 |
| Incidence of gun-related homicides (rate per 100 000 population) | 0.001 (0.005) [−0.008 to 0.010] | .86 |
| Lead and other toxins | ||
| Sex (male vs female) | 0.228 (0.018) [−0.041 to 0.030] | .47 |
| Race/ethnicity (non-White vs White) | 0.181 (0.105) [−0.029 to 0.390] | .09 |
| Political affiliation (Republican vs Democratic) | −0.006 (0.316) [−0.400 to 0.857] | .75 |
| Type of health authority present in city (municipal vs county/regional) | 0.229 (0.225) [−0.219 to 0.678] | .32 |
| Population size (logarithm of continuous variable for population) | 0.051 (0.165) [−0.278 to 0.379] | .76 |
| Median housing value (logarithm of continuous variable for median housing value) | −0.029 (0.241) [−0.509 to 0.449] | .90 |
| Incidence of lead exposure (1-10 index) | 0.064 (0.054) [−0.044 to 0.172] | .24 |
| Hunger/malnourishment | ||
| Sex (male vs female) | −0.029 (0.016) [−0.061 to 0.002] | .07 |
| Race/ethnicity (non-White vs White) | 0.038 (0.093) [−0.147 to 0.223] | .68 |
| Political affiliation (Republican vs Democratic) | 0.747 (0.247) [0.255 to 1.239] | .003 |
| Type of health authority present in city (municipal vs county/regional) | −0.055 (0.208) [−0.469 to 0.359] | .80 |
| Population size (logarithm of continuous variable for population) | 0.110 (0.150) [−0.188 to 0.409] | .47 |
| Median housing value (logarithm of continuous variable for median housing value) | −0.312 (0.218) [−0.745 to 0.121] | .16 |
| Prevalence of limited access to healthy foods (percentage) | 0.009 (0.008) [−0.008 to 0.025] | .31 |
| Substance abuse other than opioid abuse | ||
| Sex (male vs female) | −0.026 (0.015) [−0.056 to 0.003] | .08 |
| Race/ethnicity (non-White vs White) | −0.067 (0.086) [−0.239 to 0.104] | .44 |
| Political affiliation (Republican vs Democratic) | 0.083 (0.244) [−0.402 to 0.568] | .73 |
| Type of health authority present in city (municipal vs county/regional) | 0.021 (0.176) [−0.329 to 0.370] | .91 |
| Population size (logarithm of continuous variable for population) | 0.153 (0.133) [−0.112 to 0.419] | .25 |
| Median housing value (logarithm of continuous variable for median housing value) | −0.077 (0.294) [−0.662 to 0.508] | .80 |
| Prevalence of smoking (percentage) | 0.028 (0.043) [−0.059 to 0.114] | .53 |
| Prevalence of binge drinking (percentage) | 0.043 (0.035) [−0.027 to 0.113] | .23 |
| Opioid abuse | ||
| Sex (male vs female) | −0.008 (0.016) [−0.039 to 0.024] | .63 |
| Race/ethnicity (non-White vs White) | −0.011 (0.093) [−0.204 to 0.164] | .83 |
| Political affiliation (Republican vs Democratic) | 0.210 (0.230) [−0.248 to 0.668] | .36 |
| Type of health authority present in city (municipal vs county/regional) | 0.048 (0.189) [−0.328 to 0.424] | .80 |
| Population size (logarithm of continuous variable for population) | 0.106 (0.141) [−0.174 to 0.386] | .45 |
| Median housing value (logarithm of continuous variable for median housing value) | −0.110 (0.194) [−0.495 to 0.276] | .57 |
| Incidence of opioid-related overdose deaths (per 100 000 population) | 0.019 (0.010) [0.001 to 0.037] | .05 |
| Mental health | ||
| Sex (male vs female) | −0.033 (0.232) [−0.062 to −0.003] | .03 |
| Race/ethnicity (non-White vs White) | 0.005 (0.085) [−0.165 to 0.174] | .95 |
| Political affiliation (Republican vs Democratic) | 0.274 (0.232) [−0.186 to 0.735] | .24 |
| Type of health authority present in city (municipal vs county/regional) | 0.057 (0.184) [−0.310 to 0.425] | .76 |
| Population size (logarithm of continuous variable for population) | 0.113 (0.134) [−0.155 to 0.380] | .40 |
| Median housing value (logarithm of continuous variable for median housing value) | 0.326 (0.258) [−0.187 to 0.839] | .21 |
| Prevalence of frequent mental distress (percentage) | 0.095 (0.075) [−0.054 to 0.244] | .21 |
| Asthma | ||
| Sex (male vs female) | 0.003 (0.013) [−0.023 to 0.029] | .82 |
| Race/ethnicity (non-White vs White) | 0.057 (0.074) [−0.089 to 0.204] | .44 |
| Political affiliation (Republican vs Democratic) | 0.401 (0.183) [0.037 to 0.765] | .03 |
| Type of health authority present in city (municipal vs county/regional) | 0.001 (0.170) [−0.338 to 0.340] | .10 |
| Population size (logarithm of continuous variable for population) | 0.144 (0.116) [−0.085 to 0.375] | .22 |
| Median housing value (logarithm of continuous variable for median housing value) | 0.322 (0.157) [0.009 to 0.635] | .04 |
| Presence of air pollution (fine particulate matter during a year) | 0.016 (0.046) [−0.075 to 0.107] | .73 |
| Obesity | ||
| Sex (male vs female) | −0.022 (0.014) [−0.050 to 0.005] | .12 |
| Race/ethnicity (non-White vs White) | 0.036 (0.071) [−0.106 to 0.179] | .61 |
| Political affiliation (Republican vs Democratic) | 0.462 (0.181) [0.101 to 0.823] | .02 |
| Type of health authority present in city (municipal vs county/regional) | −0.161 (0.158) [−0.477 to 0.154] | .31 |
| Population size (logarithm of continuous variable for population) | 0.260 (0.112) [0.037 to 0.482] | .02 |
| Median housing value (logarithm of continuous variable for median housing value) | −0.088 (0.315) [−0.715 to 0.538] | .78 |
| Prevalence of adult obesity (percentage) | −0.018 (0.035) [−0.088 to 0.051] | .60 |
| Prevalence of physical inactivity (percentage) | −0.017 (0.030) [−0.078 to 0.043] | .57 |
| Prevalence of diabetes (percentage) | 0.072 (0.074) [−0.075 to 0.220] | .33 |
aData sources: 2018 Menino Survey of Mayors by Einstein et al,27 City Health Dashboard 500 Cities data set from New York University Langone Health,28 Multiple-Imputed Supplementary Homicide Reports File, 1976-2016 by Fox,29 and US Department of Transportation, National Highway Traffic Safety Administration Fatality and Injury Reporting System Tool.30
bClosed-ended survey question asked the following: “How much do you think constituents hold you accountable for each of the following health challenges in your city?” All items were measured on the following scale: 0 = not at all accountable, 1 = a little accountable, 2 = somewhat accountable, 3 = very accountable.
cDetermined by ordinary least squares multivariate regressions; P ≤ .05 considered significant.