The New Jersey Department of Health and Senior Services commissioned the Eagleton Institute's Center for Public Interest Polling at Rutgers University to conduct a statewide survey of New Jersey residents to assess their views on important health issues. The survey is part of the Healthy New Jersey 2010 planning process.

The survey involved telephone interviews conducted between May 4 and 11, 1999 with a random probability sample of 804 New Jersey residents 18 years old and older. Percentages for the total sample of 804 have a sampling error of +/-3.5 percent. The 1999 survey was based on a series of questions asked in a 1991 Eagleton poll for the department.

Most Important Health Issue

Study participants were asked to rate 12 types of health issues in terms of their importance in New Jersey. After rating each of the 12 health issues on importance, study participants were asked to select one as the most important for New Jersey.

From this list cancer (24%) emerged as the top health issue facing New Jersey, followed by access to and ability to pay for care (16%) and AIDS/HIV (15%).

The remaining 9 issues were each chosen by 6 percent or fewer participants as the most important issue, including: alcohol/drug abuse (6%), heart disease (5%), worksite/ environmental hazards (4%), teen pregnancy (4%), sexually transmitted disease (3%), vaccine-preventable infectious disease (2%), racial/ethnic differences in health status (2%), infant deaths (1%), and injuries (<1%).

The rank order of these issues has changed since the 1991 study when AIDS/HIV was named as the most important issue by 35 percent of study participants. Access/ability to pay for care was ranked second at 15 percent (similar to the current standing for this health issue). Cancer as the most important issue is now ranked much higher than it was in 1991 when it was chosen by only 11 percent.

Alcohol/drug abuse (11% in 1991) and worksite/environmental hazards (7% in 1991) are now somewhat less likely to been seen as the most important health issue than they were eight years ago.

Among different demographic groups in the population, black residents are most likely to choose AIDS/HIV (40% to 25% Hispanic and 9% white) and Hispanic residents are more likely than others to choose sexually transmitted disease (12% to 5% black and 1% white) as the state's most important issue from among the 12 mentioned in the survey.

White residents are more likely than minority residents to name cancer (29% white to 14% Hispanic and 11% black) or access/ability to pay for care (19% white to 9% Hispanic and 7% black).

Role of Different Entities in Addressing Health Issues

The 1999 survey included a new set of questions asking study participants to assess the role of 11 different entities in addressing their most important health issue.

Among these choices, New Jerseyans feel that doctors (86%), hospitals (85%), families (83%), and individuals (82%) are the leading entities that have an "extremely" or "very" important role in addressing the state's most important health issue.

Two-thirds or more also say that federal government (72%), state government (71%), and schools (66%) have an extremely or very important role.

Six-in-ten say the same about local government (61%), and about half say the same about the role of the news media (56%), employers (55%), and churches (47%) in addressing the most important health issue.

Minority residents and urban residents are more likely than other New Jerseyans to say that each of these entities plays an extremely or very important role in addressing the health issue they name as most important. This racial/ethnic difference is largest in perceived role of schools and churches.

There are also differences in the perceived role of these 11 entities by the type of issue study participants name as the state's most important health concern. For the top health issues, the important entities identified by two-thirds or more include:

Cancer: hospitals (95%), doctors (91%), individuals (81%), families (74%), federal government (73%), and state government (68%).

Access to or ability to pay for care: state government (82%), hospitals (82%), doctors (80%), federal government (78%), families (77%), employers (74%), and individuals (73%).

AIDS/HIV: doctors (97%), hospitals (95%), families (90%), individuals (87%), schools (86%), state government (74%), federal government (72%), and local government (72%).

Conclusions

New Jerseyans' assessment of the state's most important health issues establishes a clear trend with cancer emerging as the top issue, followed closely by access/ability to pay for care and AIDS/HIV. Injury is considered the least important of the 12 issues specifically mentioned in the survey. The remaining eight issues -- alcohol/drug abuse, heart disease, worksite/environmental hazards, teen pregnancy, sexually transmitted disease, vaccine-preventable infectious disease, racial/ethnic differences in health, and infant deaths -- cluster together after the top three issues.

The top three issues are in a slightly different order than they were in 1991, when AIDS/HIV was the top issue, followed by access/ability to pay for care, and then cancer.

The health care profession (such as doctors and hospitals) along with individuals and their families are seen as playing the most important role in addressing the majority of these health issues. Government and schools are also considered to be important players in addressing these concerns. The news media, employers, and churches are generally seen as having less of a role. However, the relative importance of each of these entities varies depending on the health issue that is named as most important.

Background

The New Jersey Department of Health and Senior Services has been involved with the Healthy New Jersey initiative since 1991, when it published Healthy New Jersey 2000: A Public Health Agenda for the 1990s. For the first time, New Jersey not only defined a comprehensive set of goals for preventing disease and improving the health of the State's residents over the coming decade, but also identified very specific targets for improvements as well as indicators to measure progress toward these targets. In adopting this public health agenda, New Jersey followed the example set by the U.S. Department of Health and Human Services, which published Healthy People 2000 -- a set of 300 national health promotion and disease prevention objectives for the year 2000.

In January 1999, an Inter-Departmental Steering Committee chaired by the Department of Health and Senior Services was convened to prepare a similar health agenda for New Jersey for the next ten year period. To ensure public input early in the process, the department commissioned focus groups as well as this public opinion survey to assess New Jersey's leading health issues.