International Journal of Health Policy and Management

International Journal of Health Policy and Management

Understanding the Role of Public Administration in Implementing Action on the Social Determinants of Health and Health Inequities

Document Type : Editorial

Authors
Gemma Carey
Sharon Friel
Regulatory Institutions Network, Australian National University, Canberra, ACT, Australia
10.15171/ijhpm.2015.185
Abstract
Many of the societal level factors that affect health – the ‘social determinants of health (SDH)’ – exist outside the health sector, across diverse portfolios of government, and other major institutions including non-governmental organisations (NGOs) and the private sector. This has created growing interest in how to create and implement public policies which will drive better and fairer health outcomes. While designing policies that can improve the SDH is critical, so too is ensuring they are appropriately administered and implemented. In this paper, we draw attention to an important area for future public health consideration – how policies are managed and implemented through complex administrative layers of  ‘the state.’ Implementation gaps have long been a concern of public administration scholarship. To precipitate further work in this area, in this paper, we provide an overview of the scholarly field of public administration and highlight its role in helping to understand better the challenges and opportunities for implementing policies and programs to improve health equity.

Highlights

Commentaries Published on this Paper

  • A Sophisticated Architecture Is Indeed Necessary for the Implementation of Health in All Policies but not Enough; Comment on “Understanding the Role of Public Administration in Implementing Action on the Social Determinants of Health and Health Inequities”

          Abstract | PDF

  • Implementing Health in All Policies – Time and Ideas Matter Too!; Comment on “Understanding the Role of Public Administration in Implementing Action on the Social Determinants of Health and Health Inequities”

          Abstract | PDF

  • From Headline to Hard Grind: The Importance of Understanding Public Administration in Achieving Health Outcomes; Comment on “Understanding the Role of Public Administration in Implementing Action on the Social Determinants of Health and Health Inequities”

          Abstract | PDF

  • We Need Action on Social Determinants of Health – but Do We Want It, too?; Comment on “Understanding the Role of Public Administration in Implementing Action on the Social Determinants of Health and Health Inequities”

          Abstract | PDF

 

Author’s Response to the Commentaries

  • Re-Conceptualising Public Health Interventions in Government: A Response to Recent Commentaries

          Abstract | PDF

Keywords
Social Determinants of Health (SDH)
Health Equity
Public Policy
Implementation
Subjects
  1. Friel S, Marmot M. Social determinants of global health equity. Annu Rev Public Health. 2011;32:225-236.
  2. Marmot M, Friel S, Bell R, et al. Closing the gap in a generation: health equity through action on the social determinants of health. Lancet 2008;372:1661-1669.
  3. Commission on Social Determinants of Health (CSDH). Closing the Gap in a Generation. Geneva: WHO; 2008.
  4. Marmot M. Fair Society, Healthy Lives: The Marmot Review. Strategic Review of Health Inequalitites in England post-2010. London; 2010.
  5. Marmot M. Social Determinants of Health Inequalities. Lancet. 2005;365(9464):1099-1104.
  6. Baum F. Cracking the nut of health equity: top down and bottom up pressure for action on the social determinants of health. Promot Educ. 2007;14:90-95.
  7. Carey G, Crammond B, Keast R. Creating change in government to address the social determinants of health: how can efforts be improved? BMC Public Health. 2014;14:1087. doi:10.1186/1471-2458-14-1087
  8. Carey G, Crammond B. Action on the social determinants of health: Views from inside the policy process. Soc Sci  Med. 2015;128:134-141. doi:10.1016/j.socscimed.2015.01.024
  9. de Leeuw E. The Public Policy Approach: Governments, Institutions, Welfare States and Social Justice. In: McQueen D, ed. Global Handbook on Noncommunicable Diseases and Health Promotion. New York: Springer; 2013:237-248.
  10. de Leeuw E, Clavier C, Breton E. Health policy–why research it and how: health political science. Health Res Policy Syst. 2014;12:55.
  11. Hill M, Hupe P. Implementing Public Policy. 2nd ed. London: Sage; 2009.
  12. Lynn L. Public Management: A Concise History of the Field. In: Ferlie E, Lynn L, Pollit C, eds. The Oxford Handbook of Public Management. Oxford: Oxford University Press; 2007.
  13. Meier K, Hill G. Bureaucray in the Twenty-First Century. In: Ferlie E, Lynn L, Pollit C, eds. The Oxford Handbook of Public Management. Oxford: Oxford University Press; 2007:51-71.
  14. Barrett SM. Implementation studies: time for a revival? Public Adm. 2014;82:249-262.
  15. Matland RE. Synthesizing the implementation literature: The ambiguity-conflict model of policy implementation. J Public Adm Res Theory. 1995;5:145-174.
  16. Pollitt C. Joined-up Government: a Survey. Political Studies Review. 2003;1:34-49.
  17. 6 P. Holistic government. London: Demos; 1997.
  18. O’Flynn J. Crossing boundaries: The fundamental questions in public management, In: O’Flynn J, Wanna J, eds. Crossing Boundaries in Public Management and Policy: The International Experience. London: Routledge; 2013:11-44.
  19. O’Flynn J. The Cult of Collaboration in Public Policy. Australian Journal of Public Administration. 2009;68:112-116. doi:10.1111/j.1467-8500.2009.00616.x
  20. Baum F, Lawless A, Williams C. Health in All Policies from International Ideas to Local Implementation: Policies, Systems and Organizations. In: Clavier C, de Leeuw  E, eds. Health Promotion and the Policy Process. London: Oxford University Press; 2013:188-217.
  21. Declaration of Alma-Ata. Alma Ata; 1978.
  22. The Ottawa Charter for Health Promotion. Ottawa; 1986.
  23. Williams P. The Competent Boundary Spanner. Public Adm. 2002;80:103-124.
  24. Crosby B, Mclaughlin K, Chew C. Leading across frontiers. In: Osborne S, ed. The New Public Governance. New York: Routledge; 2010:200-222.
  25. Oliver AL, Ebers M. Networking network studies: an analysis of conceptual configurations in the study of inter-organizational relationships. Organization Studies. 1998;19:549-583.
  26. Friel S, Harris P, Simpson S, Bhushan A, Baer B. Health in All Policies Approaches: Pearls from the Western Pacific Region: Health in All Policies in the Pacific. Asia Pac Policy Stud. 2015;2:324-337. doi:10.1002/app5.89
  27. Kickbusch I. Policy Innovation for Health. New York: Springer; 2009.
  28. Carey G, Crammond B. What Works in Joined-Up Government? An Evidence Synthesis. Int J Public Adm. 2015. doi:10.1080/01900692.2014.982292
  29. Keast R. Joined-Up Governance in Australia: How the Past Can Inform the Future. Int J Public Adm. 2011;34:221-231. doi:10.1080/01900692.2010.549799
  30. O’Flynn J, Buick F, Blackman D, Halligan J. You Win Some, You Lose Some: Experiments with Joined-Up Government. Int J Public Adm. 2011;34:244-254. doi:10.1080/01900692.2010.540703
  31. Osborne SP. The New Public Governance? Public Management Review. 2006;8:377-387.
  32. Blackman D, Buick F, O’Donnell M, O’Flynn J, West D. Developing High Performance: Performance Management in the Australian Public Service. Strengthening the Performance Framework Project’: a joint research program of The Australian National University, The Australian Public Service Commission, The University of Canberra and The University of New South Wales; 2012.
  33. Fusarelli LD, Johnson B. Educational governance and the new public management. Public Administration and Management: An Interactive Journal. 2004;9(2):118-127.
  34. Reddel T. Beyond participation, hierarchies, management and markets: “New” governance and place policies. Australian Journal of Public Administration. 2002;61:50-63. doi:10.1111/1467-8500.00258
  35. Osborne S, ed. The New Public Governance. New York: Routledge; 2010.
  36. Kickert W, Koppenjan J. Public Management and Network Management: An Overiew. In: Kickert W, Klijn EH, Koppenjan J, eds. Managing Complex Networks: Strategies for the Public Sector. London: Sage; 1997:35-60.
  37. Dickinson H, Sullivan H. Imagining the 21st Century Public Service Workforce. Melbourne: School of Government, University of Melbourne; 2014.
  38. Atwood M, Pedler M, Pritchard S, Wilkinson D. Leading Change: A guide to whole of systems working. Bristol, UK: The Polity Press; 2003.
  39. Colebatch H. Beyond the Policy Cycle: The Policy Process in Australia. New South Wales: Allen and Unwin; 2006.
  40. Hawe P. Lessons from Complex Interventions to Improve Health. Annu Rev Public Health. 2015;36:307-323. doi:10.1146/annurev-publhealth-031912-114421
  41. Bernier NF, Clavier C. Public health policy research: making the case for a political science approach. Health Promot Int. 2011;26:109-116. doi:10.1093/heapro/daq079
  42. Clavier C, de Leeuw E, eds. Health Promotion and the Policy Process. London: Oxford University Press; 2013.
  43. Pollitt C. Context in Public Policy and Management: the Missing Link? Edward Elgar Pub; 2013

  • Received Date 14 September 2015
  • Revised Date 06 October 2015
  • Accepted Date 06 October 2015
  • First Published Date 01 December 2015
  • Published Date 01 December 2015