Beyond ‘evidence-based policy’ in a ‘post-truth’ world: the role of ideas in public health policy

Abstract

This chapter discusses the role of ideas in policy making. The existence of conflicts between evidence-based and ideological approaches to politically contentious issues is widely recognised. However, for policy issues — such as public health — in which there seems to be rather more of a consensus about the overarching objectives, it seems less obvious how or why ‘politics’ might obstruct the use of evidence within policy making. Indeed, the majority of civil servants and politicians in a post-1997 UK context have signed up to taking an evidence-based approach to improving population health and reducing health inequalities. The existence of such a cross-sector consensus suggests that public heath might be one area in which evidence-based policy and practice are feasible. Yet, disappointingly, most assessments of public health policies continue to conclude that they are not evidence-based. A popular explanation for this disjuncture is that it results from communicative, institutional, and cultural gaps between researchers and policy makers.