[EQ] The Politics of Healthy Policies

The Politics of Healthy Policies:
Redesigning health impact assessment to integrate health in public policy

 

Marleen Petra Maria Bekker
Institute of Health Policy and Management at Eramus MC, Rotterdam, the Netherlands

Erasmus University Rotterdam, September 2007

 

Available online PDF [239p.] at:

http://publishing.eur.nl/ir/repub/asset/10491/070912_Bekker%2C%20Marleen%20Petra%20Maria.pdf

 

 

“….Public health issues, such as obesity, lung disease from air pollution or mental health complaints from living in an unsafe neighbourhood, are complex, intractable policy problems. The causes are dispersed at the individual and the collective level among different societal sectors.

 

One strategy to integrate health in other sectors policies for developing effective and cooperative policy solutions is to provide evidence in a Health Impact Assessment (HIA) from proposed policies and project plans. In 15 years of practising HIA, policymakers and academics nevertheless express concern about its effectiveness. In The Politics of Healthy Policies a conceptual and empirical analysis is presented of the role of HIA in policy development.

 

From a governance perspective the author identifies different purposes of HIA for indicating societal problems and democratic deficits. These suggest that a technical design of HIA to assess causes and effects insufficiently addresses the political and normative issues of collaborative policymaking without institutional requirements or incentives. Four case studies are analysed of Dutch HIA practices at the national and local policy level, including a game simulation of health advocacy without HIA.

 

The outcomes suggest that a re- orientation on HIA is necessary in order to mobilise other sectors to prevent or mitigate public health problems. The author proposes an interaction-oriented, reflective design and a new definition of HIA. The book is especially relevant to HIA practitioners and health policymakers at different governmental levels. Many of the implications are highly relevant to other forms of impact assessment as well…..”

 

 

Table of Contents

1. The effectiveness of Health Impact Assessment

1.1 Health policy

1.2 Research questions

1.2.1 Health Impact Assessment as a coordination tool

1.2.2 Epistemological points of departure

1.3 Method

1.3.1 Interpretive method

1.3.2 Case selection on HIA research and interaction design

1.3.2 Maximum case variation

1.3.3 Informal coordination in game simulations

1.4 Outline of the book

2. Conceptualising the relationship between HIA and policy

3. Reframing policy and knowledge boundaries

4. Dordwijk: a City & Environment HIA of urban renewal

5. Healthy Housing: HIA of national housing policy

6. HIA of the national ‘Covenant on Obesity’ Action plan

7. Simulating informal policy coordination by health advocacy

8. Conclusions and discussion

8.1 The effectiveness of HIA

8.2 HIA as a boundary object to reframe public policies

8.3 Empirical findings

8.3.1 Intractable public health problems

8.3.2 Limited commitment to integrate health in public policy

8.3.3 Current HIA practices generate conflicting frames of health in policy

8.3.4 HIA design not compatible with strategic reframing by policymakers

8.3.5 Overall conclusion

8.4 Discussion

8.4.1 Methodological reflections on this research

8.4.2 Practical implications for HIA: creating policy dynamics

8.4.3 Delivering ‘serviceable truth’

8.4.4 Towards a new definition of Health Impact Assessment

8.4.5 Managing the politics of healthy policies

 

Website: http://repub.eur.nl/publications/index/696073637/

 

 

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