Lecture 1 Sept 10th Flashcards
What is policy?
Why study policy?
- Central instrument for helping to organize and manage modern societies
- Often key in advocacy work
-Not just why and how to act, but also the allocation of resources - Policy can be thought of as ‘intent’, and, also as understanding and process
-Understanding the evidence that guides policy AND the beliefs that guide what we do/do not do - Essential programs that work to change society
What is Public Policy
A course of action or inaction chosen by public authorities
Addresses a given problem
addresses inter-related sets of problems
Anchored in a set of beliefs about the best way to achieve those goals
Health policy is a subset of public policy
> who has power and who does not have it to influence policy and outcomes? Who benefits/does not benefit?
Policy “Rhetoric” vs. Reality
- Policy as two choices: for or against? All or nothing? or more nuanced?
- Policy does not take place in a vacuum
- course of action created by actors in response to public problems
- accounting for different ways problems are approached and understood
- focusing events: episodes/experiences that catapult issues to the force
How did we end up with existing policies? What will they look like in the future?
- Political Environment
- Economic Environment
- Socio-cultural environment
- Administrative Environment
- Actors, Content, Context, Process
- Frameworks, tools, levers, “belief” systems
Ways of Thinking About Public Policy
One way is to sort policy analyses into two large buckets:
consensus and conflict / critical
Both assume policy choices are based on rational consideration of alternatives
Each has own place in explaining development/implementation
Consensus Policy Theory
- Policy - made using rational consideration of alternative courses of action
- choices are based on cost and benefits and evidence
- Focus on small improvements that can be made to improve existing services
- Emphasis on technical issues such as day-to-day organization, financing, delivery – not much about the forces (economical, political social) that shape overall organization
- Often neglects importance of ideology, values and power and misses the ‘big picture’
- AKA: “nuts and bolts” lens
Conflict / Critical Policy Theory
- Consider broader issues in the organization and development of policy
- Policy debates are influenced by social class politics and inequalities in influence and power including gender, race, class, disability, etc.
of policy - Acknowledges power differential
- WHO will be affected – for better or for worse – by policy decisions
- AKA: “socio-cultural-economic” lens
Another is to apply Social Theory to Policy Analysis
Different approaches to health
Medical approach
> individual based or micro
Behavioural/lifestyle approach
- individual based or micro
Socio-environmental approach
-both individual and environmentally based
Structural/critical approach
-socially based, structural, macro
Social theory that endorses the medical approach
Positivism
-objective, rational
Social theory that endorses the Behavioural/lifestyle approach
Structural Functionalism - objective, rational
Social theory that endorses the Socio-environmental approach
Interpretivism -subjective
Social theory that endorses the Structural/critical approach
Critical Theory and Political Economy -both objective and subjective
Positivism
- Only authentic knowledge is scientific
- Strict adherence to the scientific method
- Hypothesis testing and identifying relationships
- Predict and control
- Bottom up (a posteriori) approach
- e.g. biological and physical science, much of health sci
Structural Functionalism
- Apply positivist notions of knowledge and methodology
whose function together creates overall societal - Views society as an organism, a system of parts
- Shared norms and values; cooperation effectiveness
- e.g. herd immunity
