International Journal of Health Policy and Management

International Journal of Health Policy and Management

Shaping Policy Change in Population Health: Policy Entrepreneurs, Ideas, and Institutions

Document Type : Perspective

Authors
Daniel Béland 1, 2
Tarun R. Katapally 2, 1
1 Johnson Shoyama Graduate School of Public Policy, University of Saskatchewan, Saskatoon, SK, Canada
2 Johnson Shoyama Graduate School of Public Policy, University of Regina, Regina, SK, Canada
10.15171/ijhpm.2017.143
Abstract
Political realities and institutional structures are often ignored when gathering evidence to influence population health policies. If these policies are to be successful, social science literature on policy change should be integrated into the population health approach. In this contribution, drawing on the work of John W. Kingdon and related scholarship, we set out to examine how key components of the policy change literature could contribute towards the effective development of population health policies. Shaping policy change would require a realignment of the existing school of thought, where the contribution of population health seems to end at knowledge translation. Through our critical analysis of selected literature, we extend recommendations to advance a burgeoning discussion in adopting new approaches to successfully implement evidence-informed population health policies.
Keywords
Population Health
Policy Change
Policy Entrepreneurs
Ideas
Institutions
Evidence
Subjects
  1. What is the Population Health Approach? Public Health Agency of Canada website. http://www.phac-aspc.gc.ca/ph-sp/approach-approche/index-eng.php. Accessed July 20, 2017.
  2. Evans R, Stoddart G. Producing health, consuming health care. Soc Sci Med. 1990;31(12):1347-1363.
  3. Kindig D, Stoddart G. What is population health? Am J Public Health. 2003;93(3):380-383.
  4. Drummond M, Stoddart G. Assessment of health producing measures across different sectors. Health Policy. 1995;33:219-231.
  5. Lavis JN, Ross SE, Hurley JE, et al. Examining the role of health services research in public policy making. Milbank Q. 2002;80:125-154.
  6. Lomas J. Using “linkage and exchange” to move research into policy at a Canadian foundation. Health Aff. 2000;19(3):236-240.
  7. De Leeuw E. Engagement of sectors other than health in integrated health governance, policy, and action. Annu Rev of Publ Health. 2017;38:329-349.
  8. Freiler A, Muntaner C, Shankardass K, et al. Glossary for the implementation of Health in All Policies (HiAP). J Epidemiol Commun H. 2013;67(12):1068-1072. doi:10.1136/jech-2013-202731
  9. 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.
  10. De Leeuw E, Clavier C. Healthy public in all policies. Health Promot Int. 2011;26(Suppl 2):ii237-ii244.
  11. Gagnon F, Bergeron P, Clavier C, Farfard P, Martin E, Blouin C. Why and how political science can contribute to public health? Proposals for collaborative research avenues. Int J Health Policy Manag. 2017;6(9):495-499. doi:10.15171/ijhpm.2017.38
  12. Kickbusch I. The political determinants of health. BMJ Clin Res. 2015;350:h81. doi:10.1136/bmj.h81 
  13. Béland D. Policy change and health care research. J Health Polit Policy Law. 2010;35(4):615-641.
  14. Parsons C. How to Map Arguments in Political Science. Oxford: Oxford University Press; 2007.
  15. Genieys W, Smyrl M, eds. Elites, Ideas, and the Evolution of Public Policy. Basingstoke: Palgrave; 2008.
  16. Mintrom M, Norman P. Policy entrepreneurship and policy change. Policy Stud J. 2009;37(4):649-667.
  17. Kingdon JW. Agendas, Alternatives, and Public Policies. 2nd ed. New York: Harper Collins; 1995.
  18. Fligstein N, McAdam D. A Theory of Fields. New York: Oxford University Press; 2012.
  19. Jacobs L, Skocpol, T. Health Care Reform and American Politics: What Everyone Needs to Know. 3rd ed. New York: Oxford University Press; 2015.
  20. Fafard P. Beyond the usual suspects: using political science to enhance public health policy making. J Epidemiol Community Health. 2015;69(11):1129-1132.
  21. 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. New York: Oxford; 2013:189-217.
  22. Macnaughton E, Nelson G, Goering P. Bringing politics and evidence together: policy entrepreneurship and the conception of the At Home/Chez Soi Housing First Initiative for addressing homelessness and mental illness in Canada. Soc Sci Med. 2013;82:100-107.
  23. Gagnon ML, Labonté R. Understanding how and why health is integrated into foreign policy—a case study of health is global. A UK Government Strategy 2008-2013. Global Health. 2013;9:24.
  24. Nay O. How do policy ideas spread among international administrations? Policy entrepreneurs and bureaucratic influence in the UN response to AIDS. J Public Policy. 2012;32:53-76.
  25. Breton E, de Leeuw E. Multiple streams theory in Sweden: An error III. Health Promot Int. 2010;25:134-135.
  26. Studlar DT. Tobacco control policy instruments in a shrinking world: How much policy learning? Intl J Public Adm. 2006;29:367-396.
  27. Howlett M, Ramesh M, Perl A. Studying Public Policy: Policy Cycles and Policy Subsystems. 3rd ed. Toronto: Oxford University Press; 2009.
  28. Lipsky M. Street-level Bureaucracy: Dilemmas of the Individual in Public Services. New York: Russel Sage Foundation; 2010 (1980).
  29. Béland D, Ridde V. Ideas and policy implementation: Understanding the resistance against free health care in Africa. Global Health Gov. 2016;X(3):10-23.
  30. Padamsee T. Culture in connection: Re-contextualizing ideational processes in the analysis of policy development. Soc Polit. 2009;16(4):413-445. doi:10.1093/sp/jxp018
  31. Mehta J. The varied roles of ideas in politics: From “whether” to “how.” In: Béland D, Cox RH, eds. Ideas and Politics in Social Science Research. New York: Oxford University Press; 2011:23-46.
  32. Rochefort DA, Cobb RW, eds. The Politics of Problem Definition: Shaping the Policy Agenda. Lawrence: University Press of Kansas; 1994.
  33. Mills CW. The Sociological Imagination. New York: Oxford University Press; 1959.
  34. Béland D. Gender, ideational analysis, and social policy. Soc Polit. 2009;16(4):558-581.
  35. Gusfield JR. The Culture of Public Problems: Drinking-Driving and the Symbolic Order. Chicago: University of Chicago Press; 1984.
  36. Lynch J. Reframing inequality? The health inequalities turn as a dangerous frame shift. J Public Health (Oxf). 2017. doi:10.1093/pubmed/fdw140
  37. Campbell JL. Institutional Change and Globalization. Princeton: Princeton University Press; 2004.
  38. Voß JP, Simons A. Instrument constituencies and the supply side of policy innovation: the social life of emissions trading. Environ Polit. 2014;23(5):735-754. doi:10.1080/09644016.2014.923625
  39. Béland D, Cox RH. Ideas as coalition magnets: Coalition building, policy entrepreneurs, and power relations. J Euro Public Policy. 2016;23(3):428-445. doi:10.1080/13501763.2015.1115533
  40. Cox RH. The social construction of an imperative: Why welfare reform happened in Denmark and the Netherlands but not in Germany. World Polit. 2001;53:463-498.
  41. Skocpol T. Protecting Soldiers and Mothers: The Political Origins of Social Policy in United States. Cambridge, MA: Harvard University Press; 1992.
  42. Béland D. Kingdon reconsidered: Ideas, interests and institutions in comparative policy analysis. J Comp Policy Anal. 2016;18(3):228-242.  doi:10.1080/13876988.2015.1029770
  43. Weir M. Politics and Jobs: The Boundaries of Employment Policy in the United States. Princeton University Press; 1992.
  44. Immergut EM. Health Politics: Interests and Institutions in Western Europe. New York: Cambridge University Press; 1992.
  45. Pierson P. Dismantling the Welfare State? Reagan, Thatcher, and the Politics of Retrenchment. New York: Cambridge University Press; 1994.
  46. Jacobs AM, Weaver RK. When policies undo themselves: Self-undermining feedback as a source of policy change. Governance. 2015;28(4):441-457. doi:10.1111/gove.12101
  47. Obinger H, Leibfried S, Castles FG, eds. Federalism and the Welfare State: New World and European Experiences. Cambridge: Cambridge University Press; 2005.
  48. Orenstein MA. Privatizing Pensions: The Transnational Campaign for Social Security Reform. Princeton: Princeton University Press; 2008.
  49. Daniels N. Equity and population health: toward a broader bioethics agenda. Hastings Cent Rep. 2006;36(4):22-35.
  50. Gostin LO, Powers M. What does social justice require for the public’s health? Public health ethics and policy imperatives. Health Affair. 2006;25(4):1053-1060.
  51. Braveman PA, Kumanyika S, Fielding J, et al. Health disparities and health equity: The issue is justice. Am J Public Health. 2011;101(Suppl 1):S149-S155. doi:10.2105/AJPH.2010.300062
  52. McGregor S. Neoliberalism and health care. Int J Consum Stud. 2001;25(2):82-89.
  53. A review on frameworks for determinants of health. Canadian Council on Social Determinants of Health website. http://ccsdh.ca/images/uploads/Frameworks_Report_English.pdf.Accessed August 1, 2017.
  54. Index of Conceptual Models of Population Health. University of Ottawa website. https://www.med.uottawa.ca/sim/data/Models/Default_models_e.htm. Accessed August 1, 2017.
  55. Tarlov AR. Public policy frameworks for improving population health. Ann NY Acad Sci. 1999;896:281-293.
  56. Patton GC, Cofffey C, Sawyer SM, et al. Global patterns of mortality in young people: a systematic analysis of population health data. Lancet. 2009;374(9693):881-892. doi:10.1016/S0140-6736(09)60741-8
  57. Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors, 2001: Systematic analysis of population health data. Lancet. 2006;367(9524):1747-1757.
  58. Vingilis ER, Wade TJ, Seeley JS.Predictors of adolescent self-rated health: Analysis of the National Population Health Survey. Can J Public Health. 2002;93(3):193-197.
  59. Pineo H, Glonti K, Rutter H, Zimmermann N, Wilkinson P, Davies M. Characteristics and use of urban health indicator tools by municipal built environment policy and decision-makers: a systematic review protocol. Syst Rev. 2017;6:2.
  60. Akom JB. Research Uptake Strategies in the Built Environment Faculties. Lambert Academic Publishing; 2017.
  61. Owusu-Manu D, Badu E, Agyekum K, Akom JB. Putting research into practice: exploring the inherent challenges of research uptake in the built environment faculties in Ghana. In: Laryea S, Leiringer R, eds. In: Procs 6th West Africa Built Environment Research (WABER) Conference; August 10-12, 2015; Accra, Ghana:993-1011.
  62. Guide to knowledge translation planning at CIHR: Integrated and end-of-grant approaches. Canadian Institutes of Health Research website. http://www.cihr-irsc.gc.ca/e/documents/kt_lm_ktplan-en.pdf. Accessed August 1, 2017.
  63. Lavis JN, Oxman AD, Moynihan R, Paulsen EJ. Evidence-informed health policy 1 - synthesis of findings from a multi-method study of organizations that support the use of research evidence. Implement Sci. 2008;3:53. doi:10.1186/1748-5908-3-56
  64. Oliver K, Lorenc T, Innvær S. New directions in evidence-based policy research: a critical analysis of the literature. Health Res Policy Sy. 2014;12:34.
  65. Parkhurst J. The Politics of Evidence: From Evidence-based Policy to the Good Governance of Evidence. New York: Routledge; 2017.
  66. Ahmad B, Chappel D, Pless-Mulloli T, White M. Enabling factors and barriers for the use of health impact assessment in decisions-making processes. Public Health. 2008;122(5):452-457.
  67. Bacigalupe A, Esnaola S, Calderon C, Zuazagoitia J, Aldasoro E. Health impact assessment of an urban regeneration project: opportunities and challenges in the context of a southern European city. J Epidemiol Community Health. 2010;64:950- 955. doi:10.1136/jech.2009.091256
  68. Dinour LM, Kwan A, Freudenberg N. Use of comparative case study methodology for US public health policy analysis: a review. J Public Health Manag Pract. 2017;23(1):81-89. doi:10.1097/ PHH.0000000000000406
  69. Legalization and Regulation of Cannabis in Canada. Website. https://www.canada.ca/en/services/policing/justice/legalization-regulation-marijuana.html. Accessed October 25, 2017.
  70. Siebert A. How each province and territory (except B.C.) is preparing for cannabis legalization. The Georgia Straight website. https://www.straight.com/cannabis/948061/how-each-province-and-territory-except-bc-preparing-cannabis-legalization. Accessed October 25, 2017.
International Journal of Health Policy and Management
Volume 7, Issue 5
2018
Pages 369-373

  • Received Date 26 August 2017
  • Revised Date 12 December 2017
  • Accepted Date 13 December 2017
  • First Published Date 01 May 2018
  • Published Date 01 May 2018