SPH 200 Unit 5 Health Policy: Policy Making & Agenda

SPH 200 Unit 5 Module 1 Health Policy  Health policy Policy – decisions taken by those with a responsibility for a specific area - health, environment, education, trade - policy can be made at many levels - government, business hospital, sch...

SPH 200 Unit 5 Module 1 Health Policy  Health policy Policy – decisions taken by those with a responsibility for a specific area - health, environment, education, trade - policy can be made at many levels - government, business hospital, school (both public and private sectors) Public policy – refers to government policy - what does the government choose to do or not do (Dye, T. 2001) - a lack of action on an issue constitutes policy Health policy – public and private policies about health that affect the institutions, organizations, services and funding arrangements of the public health and health care system.  Analyzing health policy Health policy is linked to politics - variations between countries - variations drivers of policy Economic lens – allocation of scarce resources for health Public health lens – influence determinants of health to improve population health Health care lens – health services for individuals The content (what) of policy defines what a particular health policy is meant to do to achieve established goals The context (who and how) of policy is also important to consider Conditions for policy change, implementation Political landcape  Why is health policy important? Health is affected by many factors that extend beyond the treatment provided by the healthcare system Many of the DOH are influenced primarily through policy Poverty, environment, education à important determinants of health that are impacted by policy Policies can be economic: Taxes on alcohol and tobacco products à influence behaviour Policies can be in place to protect from health hazards – food safety policy Policies can influence who can receive services and what kinds of services are made available Policies can influence who pays for those services  The health policy triangle Context Actors - Individuals - Groups - Organizations Content Process (Walt and Gibson, 1994)  Actors: those that make and/or influence policy Actors are at the centre of the framework. They can be: Individuals Groups Organizations Many outside the government can influence health policy Lobbyists – interest or pressure groups Corporations Non-governmental organizations Topic experts Actors and how they influence policy relates to power Power is often defined by the relationship between ‘agency’ and ‘structure’  Context: systemic factors that affect policy Context refers to political, economic, social, local, regional, national and international (systemic) factors that can impact health policy They can be categorized as: Situational factors – transient conditions or events that can influence policy Wars, natural disasters, outbreaks Structural factors – the unchanging elements of society Political system, demographic features Cultural factors – gender imbalances, ethnic division and inequality/inequity Exogenous factors - outside pressures International relationships, nationalism vs globalism, cooperation Time will influence context  The process of policy making Process is the way in which policies are developed, negotiated, communicated, implemented and evaluated Problem identification Policy Policy evaluation formation Policy implementation  Using the health policy triangle The health policy triangle can be used proactively to plan a policy (analysis for policy) or retroactively to analyze a policy (analysis of policy) The two can be used in combination Analysis of policy (policies) can be an effective way to develop new policy Understanding the four parts of the policy triangle are important steps to undertake before planning or developing policy SPH 200 Unit 5 Module 2 Health Policy  Setting health policy agenda Our health policy model suggests that ‘problem identification’ is the first step in the process of making or changing policy Problem Why do some issues emerge as being important? identification Changes in context Policy Policy Disease patterns evaluation formation Changes in actors Policy implementation  What is the policy agenda? Those issues that the government (or officials that influence policy) are paying close attention to What might be some health policy agenda issues currently? Covid-19 Mandating mask wearing in public spaces Physical distancing and limits on gathering size Limiting access to specific businesses Funding Supporting the financial costs associated with maintaining the health system Additional funding required for Covid-19 policy National Pharmaceutical Care plan  Why do some issues get onto the policy agenda? Some issues are obvious Covid-19 Others are related to routine changes in policy that come about based on government priorities or other pressures Important health issues can emerge all the time as new information arises Bisphenol A in plastics (infant bottles in particular) – banned in Canada in 2010 Other issues can be seen on the horizon Aging populations that may require additional support from the health system  The importance of power Ideas matter – recognizing something as an issue that the government responds to using policy requires defining what is ‘normal’ Ideologies, assumptions and public perception shape what a government defines as an issue The framing of an issue influences how it will be perceived and addressed Frequently different actors can clash on an issue due to a disagreement on how to frame it Those actors that can influence how an issue is framed can, thus, have an impact on the issues being addressed and how the issue is addressed This is an example of power  Who sets the agenda? Governments Primary health policy agenda setting is undertaken by governments Some governments can significantly impact health policy internationally The US EPA influences environmental policy all around the world Under US President George W Bush PEPFAR (President’s Emergency Plan for AIDs Relief) was initiated to combat the global HIV epidemic (2003) The main messaging was ABC (abstinence, be faithful and condom use) It influenced AIDs policy significantly in Central and Southern Africa and was widely criticized for the A and the B. Governments face more issues than can attend to They must prioritize  Who sets the agenda? Media The media can guide public attention towards issues While the media itself may not directly influence agenda setting by the government, they can influence public perception on an issue and the public influence government Social media is now used by many governments to help set agenda issues into the public consciousness Social media can also be used by governments to evaluate the public perception on an potential issue Social media has adjusted the ways in which the public and organizations can influence policy agenda Most mass media is part of large corporations – which can use media outlets to guide agenda  A hypothetical policy scenario Consider the implications to environmental public health for the following true circumstances… – a population’s average exposure to a chemical substance of concern has been established at