The second of the NCCHPP’s main content areas is the study of public policy processes. Promoting healthy public policy cannot be achieved through information alone. The public health community has expressed a need to understand public policy processes in a more substantive way. Although not part of the public health literature, the study of public policy has its own rich tradition. For the NCCHPP, the challenge is to link public policy knowledge with public health knowledge.
Health impact assessment as a tool to foster healthy public policy.
The NCCHPP is building an inventory of HIA tools, and preparing tools for potential use in the Canadian context. Although not commonly used in Canada outside of Quebec, health impact assessment (HIA) is used in several European countries. One of the NCCHPP's projects is to study HIA as a policy instrument and to make this knowledge accessible to the Canadian public health community. In our view, the value of HIA is not so much in any one specific approach or tool, but in its framework for bringing research information on health risks into focus around specific policy proposals. Go to our health impact assessment page to learn more, and to see examples of its use in different contexts.
An example of a process in place to foster healthy public policy: Quebec’s Section 54
Significant for our Centre is a recently adopted article in Quebec’s public health law. Section 54 (2002) mandates assessments of public policies in all ministries to identify their potential impact on health. The health ministry is responsible for receiving the assessments and other ministries are charged with reporting to the health ministry. This law, unique in Canada, provides an important platform for advancing healthy public policy.
Public Policy and Ethics
Like ethicist Daniel Weinstock writes : "Ethical scrutiny must also be devoted to a number of crucial political issues: for example, what are the “drivers” of medical and biotechnological research, and what should these drivers be? Or again, what role should the public have in shaping policy in the area of health care, and what form should public participation and consultation take?"
Whole-of-government and other multi-sectoral, multi-jurisdictional approaches
Most of our most vexing health problems are the combined effect of many factors, or health determinants. For example, the rate of diabetes is increased by inappropriate nutrition and inadequate exercise. These can be seen as individuals' lifestyle choices. However, we know that individuals' choices are affected by incomes, support levels, levels of education, types of jobs, and living situations. Decreasing the rate of diabetes requires attention to all of these factors, which requires public policy interventions in different sectors and levels of government as well as collaboration by nongovernmental organizations. Multi-sectoral and multi-jurisdictional policies and strategies are becoming more common, as a result. We are also seeing whole-of-government approaches, which are designed to involve all government sectors in collaborating to achieve a health goal. Quebec's efforts through Section 54 are one example. British Columbia’s efforts around ACTNOW, an intersectoral strategy for prevention of chronic disease, are another.
Tobacco: an example in public policy change
What led to the transformation of our society from its former tobacco-friendly culture to the current one of being ready to increasingly prevent smoking? Our “story”, about the tobacco struggle, uses the already prolific literature on this topic to highlight the role of information and its use by different actors throughout the decades, in the process of forming public policy. This is the first of several such illustrative stories about Canadian public policy developments we plan to build to increase knowledge and reflection about the public policy process.
Tools to understand healthy public policies
We have built several tools that we needed to better understand the Canadian policy landscape.