Illuminating policy for health: insights from a decade of researching urban and regional planning

Abstract

Abstract Background Public health focussed policy analysis focusses on policy making practice and the conditions under which policies are made. The field has great promise for interrogating and creating ‘healthy’ public policy. Engaging with the complex realities of policy with a critical lens using established knowledge from other disciplines, especially political science, is crucial. Objectives This presentation presents a comprehensive framework for public health focussed policy analysis, informed by deep engagement with political science especially new institutionalism. The presentation of the framework is supported by insights from its application to urban and infrastructure policy-making over the past decade. Methods A priori application of theory from political science was mixed with deductive and inductive data collection and critical policy analysis of case studies of urban planning practices and systems in Australia from 2011 to 2020, including 250 policy documents and 92 semi-structured interviews. Results The final framework from the research is presented as a ‘cube’ made up of Institutions (actors, structures, ideas), Action and Evaluation (processes, decisions and choices, and outcomes and events), Governance (constitutive, directive and operational), Power and Time. Essentially the research demonstrated the power of institutional silos and historical ways of working (path dependencies) that are challenging to shift and are underpinned by often unexplored normative values promoting market and economic growth and excluding risks to health and health equity such as climate change and social protections. Change however comes about by creating and ensuring health focussed representation and voices in the governance regimes that define, create and sustain policy-making. Conclusions This comprehensive decade long research demonstrates how to investigate and interrogate healthy public policy that accepts and illuminates complexity to critically unpack policymaking. Key messages • Research that interrogates policy-making as its main object is important in an era of increasing health inequities and the climate emergency. • This presentation demonstrates how to do such research with practical examples and insights from investigating urban and infrastructure policy systems.