7.6 Public health sciences and policy in high-income countries

Abstract

The very nature of public health research, as it has evolved since the early 1900s, has increasingly required active intervention in public policy processes in order for the research insights generated by public health to have practical application. However, as in many other areas of public policy, policies regarding public health are typically only marginally influenced by research. This gap between research and policy can be perplexing and frustrating to public health researchers. The academic enterprise of policy studies, which draws from the social science disciplines of politics, sociology, and economics, can shed a great deal of light regarding why the gap exists and what might be done about it.The chapter begins with an introduction into the broad topic of the role of public health research in policy (‘Introduction: Getting from research to policy’). The main theme advanced in this chapter is that research is best considered as one of a myriad of factors including values, interests, and institutions that influence policy. The bulk of this chapter (‘Power’ and ‘Processes’) provides an overview of the key insights and conceptual frameworks that have been generated by policy studies. This material boils down to answers to two basic questions—who has power over public policy and why? (‘Power’); and (ii) what is the nature of public policy processes? (‘Processes’). The picture that develops from this overview is that public health in high income countries has been very successful at defining policy problems, but meets very significant obstacles on the road to translating the definition of problems into concrete policy action.The final quarter of this chapter (‘Research to policy informed by policy studies’) returns the focus to the role of research in public policy, drawing on the material outlined in ‘Power’ and ‘Processes’ regarding power and process. Research is important for its capacity to contribute to policy arguments. However, while research may be an increasingly necessary component of policy arguments, it is rarely sufficient. The key to maximizing the impact of research in policy is to develop arguments that successfully integrate research-based knowledge with an understanding of values and practical political exigencies. Few public health researchers have the capacity to develop all of these components. Therefore it is imperative that relationships and alliances are built with other participants in policy processes such as government agencies and interest groups that are capable of supplementing public health research expertise.