Areas Of Public Policy Research Articles

Maltreatment of Seniors in the Second Decade of the 21st century

The author points out the issue of abuse—violence against seniors related to the changes in post-modern society which creates place for this negative phenomenon to spread, by the atmosphere of fear, indifference or not adopting the principles of ethics and social policy. Despite the fact that in the second decade of the 21st century we have expected behavior based on morality and respect for the dignity of each individual, we see the opposite. Senior abuse could be defined as a systemic phenomenon of many dimensions, which belong in area of public and civic policies. This negative phenomenon is often associated with issues of dependency of seniors on help from their surrounding or dependency on social service. In this context we solve an issue of abuse in residential facilities.

Meeting the challenges of data infrastructure for collaborative research

Increasingly, major national or international research challenges are being addressed by multidisciplinary teams. To take one example, in addressing climate adaptation it is necessary to understand the global models predicting future climate but also the structure of the ecosystems likely to be affected, the frequency and severity of extreme weather events, the ability of our built environments to withstand such events, the impact on the economy and the social fabric. In each of these areas, data are being generated at prodigious rates from sensor arrays, from computational models, from satellites and other forms of observation. The challenge of so-called Big Data has been outlined in a variety of publications – The Economist[1], the McKinsey Global Institute [2], Nature [3], to name just three. The data are not simply more voluminous, they also appear in more complex forms (eg time series of images) and they arrive at breathtaking speed. To address the associated research challenges it is necessary to be able to share the data in a seamless fashion. This is a significant challenge in its own right and open access policies and procedures are essential for this. Open data access is the cornerstone of collaborative research but achieving it is not a simple matter. Three essential ingredients are infrastructure, an appropriately collaborative research culture, and researchers and data experts with the necessary skills. These factors are far from being independent. The existence of robust and flexible infrastructure along with the associated capacity to use it effectively is potentially a powerful agent for culture change. And it is extremely unlikely that the development of a collaborative, data-sharing culture could occur in isolation from the other two factors. The benefits of getting this right are profound. Our ability to tackle public policy areas such as effective delivery of health services, water systems, energy usage and biosecurity absolutely depends on it. Furthermore many of the same issues underpin our ability to undertake research in highly competitive scientific areas such as astronomy, genomics and bioinformatics. In this paper I shall focus on the issues involved in Australia’s significant investment in data infrastructure and its potential global significance as well as the role statisticians might play in bringing their special skills to bear on collaborative data-focused research.

NHS arm's length bodies and regulatory networks in England: quantitative analysis

Health regulation is an area of English public policy that involves a plethora of different bodies operating independently of one another with the purported aim of monitoring standards, ensuring minimum standards are met and providing assurance for the public and government. The purpose of this research is to ascertain as well as possible whether regulation generally is having a positive effect on service provision as well as what the relationship between the data collected by these bodies is. The rationale for testing whether the effect of regulation is positive is obvious; it costs money, time and effort, so does it work? The rationale for testing the relationships is that providers who score well on quality measures should also be experiencing fewer deaths compared with what would be expected. They should also be the providers who are performing well in terms of finances and governance. If there is no relationship between these data sets, then surely something is going wrong; that is, does the various regulatory monitoring and scrutiny actually measure what it sets out to measure?

The global financial crisis: Essay on the possibility of substantive change in the discipline of finance

Abstract In this essay, we reflect on difficulties that may constrain the achievement of substantive change in areas of public policy. Our focus is the discipline of finance – as a field of practices and a field of research – in the aftermath of the Global Financial Crisis. Our exploratory analysis indicates difficulties in concretizing substantive change in both fields, although difficulties do not imply absolute inertia and structural inalterability. In particular, we found indications that, apart from a few exceptions, the core of finance research has largely failed to invest in the promotion of paradigmatic diversity, and continues to resist the idea. Yet, the stakes involved are significant, since finance's lack of diversity in research paradigms arguably translates into a body of knowledge that presents important limitations when trying to make sense of important phenomena, not least of which are infrequent but highly significant events unfolding in the political economy. Although we are aware of the underlying obstacles, we maintain that there is a need for finance academics to increase their commitment to research diversity and engage more thoroughly in the examination of finance in action. While the development of behavioral finance constitutes an interesting intellectual ramification, which allows the field to experiment in relaxing the assumption of investor rationality, a stronger engagement in diversifying knowledge, paradigmatically and methodologically, is needed for richer and grounded understandings of finance in action to concretize.

The greenest government ever? The Coalition Government and low-carbon policy

In 2010 David Cameron pledged that he would lead the ‘greenest government ever’. In practice environmental policy has been pulled in different directions by competing factions and the hollowing out of environmental governance through deregulation and deficit reduction. This is particularly evident in low-carbon policy which has been strengthened as well as weakened under the Coalition Government. The following contribution unpicks the twists and turns of low-carbon policy since 2010 and reflects on the future direction of travel in this key area of public policy.

It’s Academic

To investigate whether and how faculty members in a department of medicine are engaged in public policy activities. Between February and April 2011, the authors conducted a cross-sectional, Web-based survey of all active Department of Medicine faculty members at the University of California, San Francisco. Survey questions covered demographics, academic role, academic rank, and participation in three specific public policy activities during the past five years: (1) policy-related research, (2) expert advice to government officials, and (3) public policy advocacy in collaboration with organizations outside government. Two hundred twenty of 553 faculty (40%) responded to the survey. One hundred twenty-four faculty members (56% of respondents and 22% of total active faculty) reported that they were engaged in at least one of the three types of policy-related activities: 51 (23%) conducted policy-related research, 67 (30%) provided expert advice to government officials, and 93 (42%) collaborated with organizations to advocate for public policy. Higher faculty rank was significantly associated with faculty members reporting that they were involved in one or more of the three policy activities (P = .04). Academic departments should identify public policy expertise among their faculty and leverage this expertise by facilitating opportunities to develop a shared faculty awareness of their public policy activities, by supporting the establishment of mentoring relationships for less experienced faculty in the area of public policy, and by incorporating standards of excellence for work in public policy into the promotions process.

Introduction to the Special Issue: Community Living and Participation

Background. In July 2012 the Research and Training Center on Community Living at the University of Minnesota hosted a State-of-theScience Conference on Community Living Outcomes and Quality of Life (SOSC). The purpose of this conference was to bring together researchers and other stakeholders to provide a summary of what is known, identify points of debate and gaps, and establish recommendations for future research related to community living outcomes and quality of life in for people with intellectual and developmental disabilities (IDD). The conference had a number of focus areas, including: social inclusion; self-determination; family experiences, support and siblings; employment; health and wellness; methodological issues in research; quality of life indicators; outcome predictors; and using outcome data to inform policy. The State of the Science Conference was a vehicle through which these key topics related to community living and participation could be discussed and future research goals identified. This special issue of Intellectual and Developmental Disabilities (IDD) includes papers written by the presenters and participants of the SOSC on key topics associated with community living outcomes. The purpose of this introduction is to place the special issue papers in a broader research, policy and service-delivery context. The phrase ‘‘state-of-thescience’’ connotes rigorous, technical analysis of scientific knowledge using techniques such as systematic reviews and meta-analysis. These are valid approaches, but they require a level of research evidence and a consistency in outcomes measures that are rarely available in IDD research. As Moseley, Kleinert, Sheppard-Jones, and Hall (2013, this issue) note, public policy draws on the best available evidence, and often cannot wait for gold-standard randomized control design studies to be completed. Moreover, in many public policy areas, including IDD services, it is neither possible, nor ethical, to randomly assign people with IDD to treatment and non-treatment groups. Nature of the special issue papers. Instead of systematic reviews, this special issue presents a series of expert commentaries and narrative reviews that focus on important policy-related and conceptual issues that were examined at the State-of-theScience Conference. As Lakin (2012) noted, ‘‘In policy research it is often necessary to accept the preponderance of good evidence through comprehensive reviews of all the available credible evidence’’. Ideally, such reviews select the best available evidence and analyze and interpret it in a manner underpinned by a detailed understanding of the circumstances in which the evidence was obtained, and of the IDD policy and service-delivery context in which the conclusions are to be applied. We hope readers will find that the commentaries, reviews and analyses presented in this special issue display these characteristics. US focus drawing on US data. One feature of a number of the special-issue papers is a strong focus on outcomes, services, policy and research involving people with IDD in the US. A related characteristic is that many of these papers draw on data from one or more US national surveys, such as the Administration on Intellectual and Developmental Disabilities (AIDD) Projects of National Significance. These projects include the National Core Indicators project (Human Services Research Institute and the National Association of State Directors of Developmental Disability Services), Residential Information Systems Project (University of Minnesota), State of the States in Developmental Disabilities Project (University of Colorado, Boulder) and Access to Integrated Employment: National Data Collection on Day and Employment Services for Citizens with Developmental Disabilities (University of Massachusetts, Boston). However, the spotlight on the US is not all encompassing. For example, Amado, Stancliffe, McCarron and McCallion (2013, this issue) draw on national findings from Ireland arising from the Intellectual Disability Supplement to The Irish Longitudinal INTELLECTUAL AND DEVELOPMENTAL DISABILITIES

Coalition portfolios and interest group influence over the policy process

An interest group coalition exists whenever two or more interest groups collaborate in advocating their public policy agendas. Working together in coalition is one of the most common tactics that interest groups use to advance their interests in the policy process. The extant literature on coalitions emphasizes interest group decisions to participate or not in one coalition, or their strategy toward coalitions in general, but gives insufficient attention to interest group participation in multiple coalitions. To rectify this deficit, this article examines the implications of groups’ participation in multiple coalitions for their ability to influence the policy process. In order to account for interest group involvement in multiple coalitions, we introduce the concept of the coalition portfolio, which is the set of all coalitions within a given area of public policy in which an interest group participates at a particular point in time. The portfolio concept recognizes that interest groups may have a wide variety of coalition strategies depending on the mix of coalitions that they join. Variations in the structure of these portfolios matter both to interest groups and to policymakers. Moreover, coalition portfolios evolve over time as coalitions form and dissolve, and as political conditions adjust over the course of the policy process. We develop and test hypotheses that the change in the composition of coalition portfolios increases the influence of interest groups over public policy when: (i) the number of coalitions in a group’s portfolio gets larger; (ii) the average size of the coalitions in a group’s portfolio gets larger or smaller; and (iii) a group’s portfolio improves its position within the overall network of coalitions. Network position is measured based on the betweenness of interest groups in coalition networks, which gives higher scores to groups that lie on the shortest paths between other groups. We test these hypotheses while accounting for other explanations for interest group influence, including: (i) the group’s position in communication networks; (ii) the group’s number of registered lobbyists working on Medicare; (iii) whether or not the group has a Political Action Committee; (iv) the extent to which a group’s lobbying contacts lean toward one political party; (v) whether or not the group endorsed the legislation in question; (vi) the organization’s age in years; and (vii) whether the group is a citizens advocacy organization, a business advocacy organization or some other organizational type. We evaluate these hypotheses using a study of 115 interest groups involved in the enactment and implementation of the Medicare Modernization Act of 2003. This legislation established an outpatient prescription drug benefit in Medicare – a government health insurance program for the elderly and disabled in the United States – and made other significant changes to the program. We conducted personal interviews with representatives of 102 of these groups. We analyzed data resulting from these interviews using negative binomial and ordinary least squares regression models. The results support Hypothesis (iii); groups gain influence over the policy process when their coalition portfolios increase the extent to which they are situated between other groups in the coalition network. However, interest groups are limited in the extent to which they can create portfolios that have desirable levels of betweenness because network position is also a function of membership decisions made by all other groups in the network. These results provide insight into how the composition of coalition portfolios affects the ability of interest groups to exert influence over the policy process. This analysis is most directly applicable to policy debates over complex pieces of legislation.

Re-Balancing the Roles of Public and Private Health Sectors in Wales

In 1989 the UK implemented a form of political devolution to Wales, Scotland and Northern Ireland such that certain public policy areas, including health, became the responsibility of devolved Parliament or Assemblies and not the London based Parliament and Government. In the case of Wales, the Welsh Government is faced with a series of daunting challenges in relation to the future provision of health care but, unlike the situation in England, has rejected any significant increase in the involvement of the private sector in health care provision. The magnitude of the challenges faced in coping with the impacts of financial austerity on the Welsh health budget suggest there may be a role for the private sector to play in relation to the provision of health care in Wales. This paper explores those potential roles concerning: the supply of services to the NHS in Wales, the supply of health services to the Welsh population and the financing of Welsh health services.

Accountability as a policy technology: accounting for education performance in Europe

This article discusses the investigation of accountability in different national contexts in the rapidly developing and increasingly important policy field of education in Europe. It draws on recent and current research to argue for a focus on what changing practices of accountability in education tell us about changes in governing education (and by extension, other public policy areas) within and across shifting policy spaces. The article further argues that accountability in education is increasingly defined as technical accountability through international and national comparative measures of performance, so that political accountability has been displaced, and performativity contributes to growing problems of diminished trust across and within education systems.Points for practitionersThis article seeks to place the development of comparative measures of performance – in education and in other public sector provision – in a critical frame that draws attention to the reduction in political accountability that accompanies the explosion of performance measurement. The article underlines the extent to which competitive measurement of performance both drives out other, more complex forms of assessment of performance and creates relations of mistrust between education professionals and governments. Professionals working in the education sector are encouraged to scrutinize the operation of technologies like PISA and to be informed about their political effects and assumptions

Do planners matter? Examining factors driving incorporation of land use approaches into hazard mitigation plans

Local hazard mitigation plans help communities organise a comprehensive set of policies and actions to reduce long-term risks from natural hazards. Land use policies hold the greatest long-term risk reduction potential, but are under-utilised. Using multivariate regression models, we assessed the influence of involvement of local planners on hazard mitigation planning committees on the inclusion of land use policies into three principles of plan quality, controlling for state and local factors. Results indicate a need for greater involvement of local planners and stronger emphasis by federal and state officials on integrating land use planning approaches into mitigation plans. Findings may be relevant to other areas of public policy with important land use dimensions for which non-planning agencies and professions have lead responsibility or historical dominance, such as transportation and climate change.

The American Presidency and the Power of the Purchaser

Federal procurement is a powerful weapon by which American presidents attempt to expand their power and shape public policy in areas in which Congress has not acted or will not act. In the same way that presidents exercise political control over the bureaucracy and agency regulatory rulemaking, they exert direct control and influence over procurement rulemaking and thereby attempt to shape the behavior of private sector companies. For more than half a century, presidents have exercised this political control over federal procurement and influence on public policy without violating the separation of powers, affirming the unilateral presidential power of the purchaser-in-chief to set terms and conditions beyond a traditional proprietary contractual relationship. Historically, procurement- and acquisition-related executive orders have been based upon the president's broad powers under article II of the Constitution or the powers delegated to the president under the little-known 1949 Federal Property and Administrative Services Act (FPASA). In the latter, Congress delegated statutory authority to the American president to act as the principal and uniform purchaser in contracting with any private sector entity that does business with the federal government. The FPASA authorizes the president to adopt policies and directives that provide for an and efficient procurement system. Presidents thereby gain a range of strategic advantages over Congress, largely as a result of the legislature's collective-action problems, the relative ease with which the president can block attempts to reverse procurement and acquisition orders, and a range of federal judicial decisions affirming congressional delegation of this statutory authority. Through this power of the purchaser over time, presidents attempt to influence public policy and private sector behavior in contested areas such as antidiscrimination and equal employment opportunity; unemployment and inflation; labor-management relations; environmental protection; gun control; international child labor standards; immigration enforcement; economic opportunities for minority- and women-owned businesses, service-disabled veterans, and accountability and transparency in political contributions from federal contractors. To make policy in many of these areas, presidents need not always secure the consent of Congress. Instead, presidents simply amend federal purchasing rules and dare others to oppose the change. In this, the market and political power of the purchaser can be more important--for presidential power, for the administrative presidency, for policy making--than political scientists have recognized. The Administrative Presidency and Political Control of the Bureaucracy The administrative presidency remains the nexus of policy making in the modern era. Any discussion of the administrative presidency focuses on the emergence of national administrative agencies and the formulation of public policy through them. Presidents have sought to exert political control and influence over the administrative state through a variety of means such as expanding the White House staff and centralizing political control over federal regulatory policy. Modern presidents have exerted political control and influence over all federal rulemaking at the start of their administrations by imposing moratoriums on new regulations and postponing the effective dates of existing rules (Copeland 2008). The theme of political control--how politicians control bureaucrats and how bureaucrats control subordinates--permeates the administrative presidency literature. While disagreement remains about who controls the bureaucracy, a scholarly consensus holds that agencies translate the broad mandates of political actors into concrete policy. Scholars focus on how presidents get political control of the institutions that create and implement policy as a means of exercising residual decision rights. …

Does Social Capital Promote Pro-Environmental Behaviors? Implications for Collaborative Governance

Nations around the globe are increasingly facing tough challenges when dealing with environmental problems. The limited success of government interventions to protect the environment is a testament to the growing concern about government's inability, or insufficient capacity, to address environmental issues. As a response, scholars note that promoting environmentally responsible behavior (ERB) on the part of the citizenry is critical for the growth and development of efficient environmental governance. However, despite the introduction of a variety of measures by governments to encourage greener practices, influencing citizens' behavior remains a major challenge. Using social capital theory, this article examines the effects of various social relation components on the promotion of pro-environmental behavior in five key public policy areas—recycling, food purchasing behavior, gasoline, energy conservation, and water use. Implications for practice and future research are discussed.

Democracy and the Policy Preferences of Wealthy Americans

It is important to know what wealthy Americans seek from politics and how (if at all) their policy preferences differ from those of other citizens. There can be little doubt that the wealthy exert more political influence than the less affluent do. If they tend to get their way in some areas of public policy, and if they have policy preferences that differ significantly from those of most Americans, the results could be troubling for democratic policy making. Recent evidence indicates that “affluent” Americans in the top fifth of the income distribution are socially more liberal but economically more conservative than others. But until now there has been little systematic evidence about the truly wealthy, such as the top 1 percent. We report the results of a pilot study of the political views and activities of the top 1 percent or so of US wealth-holders. We find that they are extremely active politically and that they are much more conservative than the American public as a whole with respect to important policies concerning taxation, economic regulation, and especially social welfare programs. Variation within this wealthy group suggests that the top one-tenth of 1 percent of wealth-holders (people with $40 million or more in net worth) may tend to hold still more conservative views that are even more distinct from those of the general public. We suggest that these distinctive policy preferences may help account for why certain public policies in the United States appear to deviate from what the majority of US citizens wants the government to do. If this is so, it raises serious issues for democratic theory.

Policy entrepreneurs and controversial science: governing human embryonic stem cell research

Policy entrepreneurs are political actors who seek policy changes that shift the status quo in given areas of public policy. This contribution examines the actions of policy entrepreneurs who have sought government funding and favourable regulation to advance human embryonic stem cell research. Those policy entrepreneurs have faced significant opposition owing to the morality issues at stake. Placing the actions of those policy entrepreneurs in a broader context makes two contributions. First, it explores how policy entrepreneurs pursue their goals in the face of intense morality politics. Second, it illustrates how the work of policy entrepreneurs can be both supported and inhibited by ideas, institutions and interest-group politics.

The Self-Provision of Public Healthcare Services: A Threat to Democracy

How and why could the self-provision of public healthcare services pose a threat to democratic values? We define the informal self-provision of healthcare, identify the factors that promote its appearance, and discuss its destructive implications for society. In addition to substantiating the existence of these strategies around the world, we also maintain that in the long run, such strategies may crush traditional political participation and weaken democratic values. How and why could the self-provision of public healthcare services pose a threat to democratic values? While the literature stresses various negative implications of strategies for the self-provision of healthcare services, the implications and influence of these strategies with regard to democratic values are less discussed. Defining self-provision strategies as informal methods and actions used by individuals and groups to satisfy their immediate interests and need for services, we point to informal payments for healthcare as emblematic of the self-provision of public healthcare goods and services. The literature reveals that there are both socio-economic benefits and disadvantages when citizens in any given society adopt such strategies. In many cases, these strategies negatively affect the quality of services received (Ensor 2004), increase inequality (Balabanova & McKee, 2002; Lewis, 2000) and hurt both lower and middle class (Cohen 2011). In addition to their negative effects, these strategies are often illegal, as they involve for-profit exchanges for illegal goods and services (Mendoza, 2010). Given that the informal self-provision of healthcare services is in many cases illegal, and problems with efficiency and equity arise from them, we would expect decision makers to fight the phenomenon. Yet, that does not always happen. Decision makers often ignore the phenomenon, especially given financial difficulties and crises. Hence, in the eyes of many decision makers around the world, the implications of these strategies are limited to the local healthcare system. In this article we argue that the main disadvantage of the phenomenon is not limited to the healthcare policy or system. Instead, we maintain that such strategies have a destructive effect on democratic values. In the long run, the self-provision of healthcare services not only threatens the values of efficiency and equity, but also challenges the values of participatory democracy. We suggest that over time, this strategy may slowly and silently pervade all of the players, sectors and areas of public policy and become an integral part of the patterns of a society's political behavior. This behavior bypasses formal institutions in favor of illegal or semi-legal means of acquiring desired public goods and services. Citizens who are dissatisfied with the quality and/or quality of public goods and services, and believe that the political structure is so paralyzed that they are powerless to effectively change the situation engage in such behavior. Thus, citizens internalize illegal and extra-legal behaviors or attitudes that in essence bypass the existing mechanisms of social participation and social norms.

Land sales and the transformation of social relations and landscape in peri-urban Mali

Small-scale land acquisitions are transforming long-standing human–land relations in West Africa. In particular, high rates of urban population growth lead to the transfer of land from non-market customary tenure systems to market-based, formal land tenure regimes on the edges of cities. The literature suggests that the conversion process from inalienable land to private property is highly contested, locally specific, and historically contingent. However, little is known about how this process affects a community. In the Kati cercle on Bamako’s peri-urban eastern edge with exponential growth in land registration, this village case study examines: (1) how residents secure livelihoods, and (2) how the advent of a land market affects livelihood strategies. Interviews conducted in 2011 in the village of Soro complement data collected in 1996 and 1987. The longitudinal data show increases in population as well as indicators of relatively stable livelihood strategies. Since 2001 only men in the chieftancy lineage and families close to it have sold land, and that land was of least value to them using the subsistence logic of grain production. Those authorizing land sales at the local level are also the immediate beneficiaries. Land privatization reduces access to resources for those with secondary land rights recognized through social relations in a customary tenure system. This study concludes that public policy in areas undergoing land conversion – especially peri-urban areas – should consider the impact of social differentiation in communities and how new land values will change land use and access.

Assessing the Impact of the Fukushima Nuclear Disaster on Policy Dynamics and the Public Sphere

Social and political fallout following the March 2011 Fukushima-Daiichi nuclear disaster permanently altered the zeitgeist of global public attitude towards nuclear power and towards energy technology in general. This area of public policy, which in Japan is particularly opaque and stagnant, was forced into a period of energy sector review amid domestic and worldwide debate. This study explores novel methodologies for measuring these developments, covering the 1) framing effects of traditional media and the 2) user-sourced content of social media. This quantitative approach yielded the following hypothesis verifications; 1) in an AHP-style online survey, exposure to real and simulated nuclear-related disaster headlines reduced collective partiality towards nuclear power by 3% and 4% respectively, and 2) retrospective opinion mining of Twitter procured an relative increase in negative nuclear-related posts of 38% and 134% in Japanese and English respectively, from the pre to post-Fukushima world. Using nuclear power and Fukushima as a case study, this paper attempts to elucidate both the influence of media on the public sphere, and the influence of the public sphere on policy and policymakers. From the results it is possible to make the conjecture that a lack of scientific education with regard to energy issues increases the former influence, and similarly reduces the latter.

Robust Multidimensional Welfare Comparisons: One Vector of Weights, One Vote

Many aspects of social welfare are intrinsically multidimensional. Composite indices at-tempting to reduce this complexity to a unique measure abound in many areas of economics and public policy. Comparisons based on such measures depend, sometimes critically, on how the different dimensions of performance are weighted. Thus, a policy maker may wish to take into account imprecision over composite index weights in a systematic manner. In this paper, such weight imprecision is parameterized via the e-contamination framework of Bayesian statistics. Subsequently, combining results from polyhedral geometry, social choice, and theoretical computer science, an analytical procedure is presented that yields a provably robust ranking of the relevant alternatives in the presence of weight imprecision. The main idea is to consider a vector of weights as a voter and a continuum of weights as an electorate. The procedure is illustrated on recent versions of the Rule of Law and Human Development indices.

Ethical Agreement and Disagreement about Obesity Prevention Policy in the United States.

An active area of public health policy in the United States is policy meant to promote healthy eating, reduce overconsumption of food, and prevent overweight/obesity. Public discussion of such obesity prevention policies includes intense ethical disagreement. We suggest that some ethical disagreements about obesity prevention policies can be seen as rooted in a common concern with equality or with autonomy, but there are disagreements about which dimensions of equality or autonomy have priority, and about whether it is justifiable for policies to diminish equality or autonomy along one dimension in order to increase it along another dimension. We illustrate this point by discussing ethical disagreements about two obesity prevention policies.