摘要：Objectives. The author investigated the willingness of the general public to pay for domestic violence prevention programs. Methods. An experimental design was used in a telephone survey of 522 California adults. One of 11 funding methods and one of 4 dollar amounts were randomly assigned to each respondent. Results. Most respondents (79.4%) reported support for domestic violence prevention programming. They were most willing to pay $5 or less via “user fees” (e.g., increased fines for batterers) and humanitarian “donations” (e.g., sales of special postage stamps). Conclusions. Health departments that want to increase their domestic violence prevention programming need to identify widely accepted methods by which funds can be raised. The methods used here can be applied to numerous public health activities and issues. Core public health functions are funded through allocations from taxes gathered at the local, state, and federal levels. Although these allocations usually are not reliant upon public opinion, such opinion can play a role. Results of a 1996 poll indicated that most people have little or no idea of what “public health” means. 1 Nonetheless, that poll and a follow-up poll conducted in 1999 2 revealed that public health activities, including health promotion and disease prevention, immunizations, and environmental risk reduction, are perceived as very important by almost all. In addition, a plurality of the public believes that disease prevention and health promotion should be a higher priority than treatment of disease. 2 Public health expenditures represent a very small portion of total health care expenditures 3 ; only 1% to 2% of the health care budget is allocated to prevention. 4 Federal public health agencies draw upon the considerable financial resources of the national income tax for their funding, and, at the same time, they have relatively few mandated responsibilities. 5 State governments depend on less robust state income taxes for funding about one half of their public health efforts. 5 In addition, as the principal entity responsible for protecting the public’s health, 6 states are mandated to provide many more services than is the US federal government. Although broad definitions exist regarding essential public health services, 6 funding for efforts that are not traditionally considered core public health activities generally is obtained from special assessments or taxes. For example, tobacco taxes have been used to underwrite popular smoking cessation campaigns. Marriage licenses are another example of such an assessment; in some states a portion of the fee for each marriage license issued is used to support battered women’s shelters. The study described here provides an example of a straightforward technique by which to obtain information from members of the general public on their opinions regarding the acceptability of various regressive taxes. The present method is a variation on the often intricate approach of economists who have addressed, along with global warming and other topices, the public’s willingness to pay. 7, 8 The information gained through this method is relevant to legislators and to health department personnel and community-based advocates who advise policymakers about expanding public health efforts. The content area under investigation in the present study was programming designed to prevent domestic violence, a major source of intentional injury morbidity and mortality among women, 9, 10 as well as a source of multiple negative health sequelae. 11
