The growing role of emergency departments in hospital admissions.

391 public will automatically lead to policy action. In a classic 1972 article, public­policy scholar An­ thony Downs described an “issue­ attention cycle” in which societal problems leap into public promi­ nence, captivate public attention for some time, then gradually re­ cede from the public’s view, often before the problem has been re­ solved.5 This pattern occurs when initial public alarm over the dis­ covery of a problem and opti­ mism about its quick resolution are replaced by the realization that solving the problem will re­ quire some public sacrifice and will displace powerful societal in­ terests. This pattern has been repeated in relation to many public issues over the past several decades. Cli­ mate change is one recent exam­ ple, in which U.S. policy action has been trivial despite widespread media, public, and expert atten­ tion. Sustained policy attention to a societal problem can also lead to the politicization of that issue, prompting the public to consider it in polarized terms that may in­ hibit action or even prompt back­ lash. The IOM has laid out a clear and compelling vision for accel­ erating change on obesity preven­ tion, and its recommendations are too important to rely on the hope that public awareness of the obe­ sity crisis alone will catalyze change. Comprehensive, evidence­ based communication campaigns, along with grassroots community mobilization, cross­sector advo­ cacy, political champions, and a favorable political environment, are needed to accelerate the tran­ sition from vision to action.