Temporal Trends in U.S. Policy and Environmental Supports for Nutrition and Physical Activity: Analysis of CDC Surveillance Data (2002–2021)

Background : Environmental and policy supports are central to promoting healthy behaviors. This study analyzes temporal trends in U.S. state-level indicators related to nutrition, physical activity, and other behavioral policies. Methods : Aggregated CDC surveillance data from 2002–2021 were analyzed. Only observations with valid numerical values were included. Linear regression models were fitted for each thematic policy class (e.g., breastfeeding, fruit/vegetable access). Results : Among 2,400 records analyzed, the most significant temporal increase was observed in breastfeeding support policies, with an average yearly increase of +3.64 points (p < 0.001, R² = 0.36). Policies promoting fruit and vegetable access also improved modestly (+1.77/year, p < 0.001), while sugar drink restriction policies showed a decreasing trend (–1.65/year, p < 0.001). No significant temporal changes were observed for physical activity indicators. Conclusions : While certain health policy domains like breastfeeding and nutrition have shown marked improvement over the last two decades, areas such as physical activity policies remain stagnant. These findings emphasize the need for targeted efforts in less-developed domains to promote equitable and comprehensive public health strategies.