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Policy, Politics, and Collective Action
Public health policy has a profound impact on health status. Missing from the literature is a clear articulation of the definition of evidence-based policy and approaches to move the field forward. Policy-relevant evidence includes both quantitative (e.g., epidemiological) and qualitative information (e.g., narrative accounts).
We describe 3 key domains of evidence-based policy: (1) process, to understand approaches to enhance the likelihood of policy adoption; (2) content, to identify specific policy elements that are likely to be effective; and (3) outcomes, to document the potential impact of policy.
Actions to further evidence-based policy include preparing and communicating data more effectively, using existing analytic tools more effectively, conducting policy surveillance, and tracking outcomes with different types of evidence. (Am J Public Health. 2009;99:1576-1583. doi:10.2105/AJPH.2008.156224)
IT HAS LONG BEEN KNOWN that public health policy, in the form of laws, regulations, and guidelines, has a profound effect on health status. For example, in a review of the 10 great public health achievements of the 20th century,1 each of them was influenced by policy change such as seat belt laws or regulations governing permissible workplace exposures. As with any decision-making process in public health practice, formulation of health policies is complex and depends on a variety of scientific, economic, social, and political forces.2
There is a considerable gap between what research shows is effective and the policies that are enacted and enforced. The definition of policy is often broad, including laws, regulations, and judicial decrees as well as agency guidelines and budget priorities.2-4 In a systematic search of "model" public health laws (i.e., a public health law or private policy that is publicly recommended by at least 1 organization for adoption by government bodies or by specified private entities), Hartsfield et al.5 identified107model public health laws, covering 16 topics. The most common model laws were for tobacco control, injury prevention, and school health, whereas the least commonly covered topics included hearing, heart disease prevention, public health infrastructure, and rabies control. In only 6.5% of the model laws did the sponsors provide details showing that the law was based on scientific information (e.g., research-based guidelines).
Research is most likely to influence policy development through an extended process of communication and interaction.6 In part, the research-policy...