Reflections on Public Health Policies

Public health policies in the United States provide a means for governmental and special interest groups to assess how well their social service program dollars are benefitting society.  Health policy analysis, specifically, provides a map of sorts which allows the individuals studying a particular area to focus on how past and existing practices support interactions among institutions such as hospitals, schools and other public service sites, for example; how those policies and public health campaigning efforts worked to benefit the individuals for whom the policies were enacted; and how those policies could be improved, utilizing data provided by past practice, to achieve more effective, more reaching results. Essentially, analysis of public health policies allows researchers to report with greater accuracy the likely success of a particular program and the areas of public health which need greater attention.

The development of public health policies revolves around improving the health of communities through education, better and healthier lifestyle choices, and conducting research which ultimately serves to reduce or eliminate the consequences of disease or reduce the overall impacts of injuries. While the goal of public health is to improve the health of entire communities, such communities can be those who reside in particular neighborhoods or cities, those who, by virtue of their economic status, require access to better food and physical activities, or those who, through their occupations, require special protections or resolutions (soldiers, police, firemen, or individuals who work in dangerous occupations, for example). The development of public health policies serves to assist health professionals in preventing or reducing problems through educational programs, services administration, and research; it also serves to assist governmental agencies in determining the best allocation of limited funds to focus on issues which most need addressing for the betterment of society.

Intersectoral policy approaches to solving health problems is, effectively, a means by which researchers can “think outside the box.” Such approaches examine a health issue to its core rather than merely the top layer of potential causes.  For example, in our report on childhood obesity, the initial reaction of policy makers was to provide a healthy school environment on the belief that a healthy lunch and physical exercise during the day would reduce the number of children who reach that level of unhealthiness.  However, intersectoral research indicates that the problem goes deeper than the school day; that, in fact, it is more a crime and safety issue surrounding the home life of the child which has more impact on that child’s obesity—lack of access to healthy food options throughout the day and lack of access to safe areas in which to exercise and engage in physical activity resulting in a home-bound child unable to burn off excess calories. Intersectoral policy analysis allows researchers and public funding groups to determine the underlying cause of a particular health issue and utilize pooled talents and efforts to address the problem.

Effectively communicating health policy issues must taken into account the diverse audiences for whom the communications are intended.  Discussion opportunities through town meetings, for example, may serve to communicate a particular area within a specific community which needs addressing, and further communications from those community leaders to higher-level governmental funding authorities like the Obama Administration would require effective yet distinguished communication strategies. Continuing that chain, a policy enacted to improve the public health then needs to be communicated to those in charge of implementing the policy, as well as to those for whom the policy is intended to benefit.  Public service announcements, medical assessments through school nursing personnel or pediatric care providers, for example, are means by which better choices and solutions can be communicated between policy enactors and the society which stands to benefit.

Developing strategies to communicate and advocate for those policies requires understanding not only the issue but also the audience for whom the policy is intended. To effectively develop policy strategies, advocates must identify key audiences to support their positions. Once the health issue has been identified, the advocate must determine the most beneficial means to address that issue with the greatest impact. Targeting their audience, both the audience for whom the policy is intended to benefit, and the audience providing the ability to actually administer and fund the policy changes, becomes a key element to the success of the policy. Setting a specific goal for the policy—a benchmark system to assess its success during various stages—provides a means to advocate for continuing research and efforts to address the actual issue at hand, and, finally, identifying allies and opponents to the effort will also prepare the advocate for future issues which may require additional support.

Such competing interests often require the advocate to develop communication strategies to bolster support or combat opposing opinions. Supporting their position often requires effective advocacy utilizing dialectical inquiry or debate (devil’s advocacy).  Dialectical inquiries permit greater reach due to the ability to accommodate two competing positions (the benefit of social companionship at certain times and the need for solitude at others, for example). Debate provides a means by which the advocate can combat the opposition’s position; however, such device is can easily backfire and requires a communicator with in-depth knowledge of their subject and skilled at logic and argument. Consequently, the most effective and efficient strategy for debate is dialectical presentation as it tends to accommodate to a greater degree competing positions and solutions.