Frameworks for Action in Policy and Politics

Frameworks for Action in Policy and Politics

• Policy frameworks are general structures that provide institutions a guiding architecture for policy action across one or multiple policy areas.

Social Determinants of Health (SDH)

• SDH are the non-medical factors that influence health outcomes, including conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping daily life.
• These factors include economic policies, development agendas, social norms, social policies, and political systems.
• Addressing SDH is important for improving health and reducing health disparities.

Upstream and Downstream Factors

• Upstream factors are the root causes of health problems, such as social structures, policies, and cultural norms.
• Downstream factors are tied to individual behaviors and healthcare access.
• Targeting upstream factors is crucial to effectively address health disparities.

The Quintuple Aim

• With 70% of healthcare outcomes linked to SDH, healthcare transformation efforts are bound to be futile without a targeted approach to address health equity.
• The quintuple aim includes improving population health, enhancing the patient experience, reducing healthcare costs, improving healthcare workforce, and advancing health equity.

Policy and the Policy Process

• Policy is a relatively stable, purposive course of action or inaction followed by an actor or set of actors in dealing with a problem or matter of concern.
• Public policy is policy crafted by governments to influence health or healthcare.
• Types of public policies include allocative policies, which provide benefits to a distinct group, and regulatory policies, which influence individual or group behavior.

Forces that Shape Health and Social Policy

• Values form the foundation of proposed and implemented policies, influencing political and policymaking actions.
• Politics is the use of relationships and power to gain ascendancy among competing stakeholders to influence policy and the allocation of scarce resources.
• Science and research provide evidence to support policy recommendations and inform policy decisions.

The Framework for Action

• Nursing is bound by a commitment to the public, with a moral obligation to actively engage in shaping policy, given their frontline experience with its implementation and impact on patient care.
• Nurses need to work in multiple spheres of influence, including government, workplaces, interest groups, and communities, to shape health and social policy.

Spheres of Influence

• Government: significantly shapes nursing and its practice, and nurses can impact government policymaking through various means.
• Workforce and workplace: policies guide many activities in healthcare workplaces, and nurses can affect policy through internal organizational policies.
• Interest groups: nurses can participate in interest groups to advocate for policies that benefit the nursing profession and patients.
• Communities: nurses can engage with communities to promote optimal health and influence policy decisions.### External Policies and Associations
• External policies, such as state laws regulating nursing licensure, influence the healthcare workplace.
• Professional nursing associations play a crucial role in shaping practice by advocating for policies that support their members and address patient needs.
• Associations serve as valuable platforms for novice nurses to gain insight into policy development and political engagement.

Community and Policy Influence

• Communities can be geographic, online, or faith-based networks, and nurses can influence them by identifying problems, strategizing, and advocating for change.
• Nurses can expand their influence by collaborating with other interest groups, which have become significant players in policy debates.

Political Skill and Competence

• Political skill involves understanding others and using knowledge to influence actions, comprising social astuteness, interpersonal influence, networking ability, and apparent sincerity.
• Political competence refers to the ability to navigate the political landscape, influence decision-making, and shape policies, requiring elements such as deep knowledge, political antennae, and power.
• Political skill and competence are essential for nurses to influence healthcare policy and promote optimal health.

Strategies for Developing Political Skills

• Strategies for developing political skills include power-sharing, active listening, problem-solving, empathy, prioritizing others, and incorporating political education into nursing curricula.
• Empowerment, engagement in professional organizations, experience, mentoring, and peer support can also enhance political skills.

Parochialism and Obstacles to Political Education

• Parochialism is a narrow approach that focuses on self-interest, limiting options and appearing self-serving.
• Integrating real-life experiences into policy discussions can be highly impactful, linking human stories with scientific evidence.
• Obstacles to political education include security concerns, emphasizing the need for trust between youth and political engagement.

Conclusion

• Social determinants of health (SDH) affect health outcomes, and measuring SDH provides evidence for political action.
• Forces shaping health and social policy include value, politics, science, advocacy, interest groups, policy analysis, media, and leadership.
• Nurses play a crucial role in shaping health and social policy across four interconnected spheres: government, workplaces, interest groups, and communities.