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Lecture 6

Week 6 readings

7 Pages
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Department
Health Studies
Course Code
HLTA02H3
Professor
Toba Bryant

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Week 6 – Theories of Public Policy and Health
1.) Signal, L. (1998). The Politics of Health Promotion: Insights from Political Theory. Health Promotion
International 13 :3, 257-263.
Health promotion has developed over the past two decades and has been adopted by governments internationally.
oWHO defines health promotion as the process of enabling people to increase control over and to improve
their health
Signal examines the politics of health promotion using 3 political theories:
oPluralist interest group or Pluralism - (Micro-level)
Holds that public policy is developed according to the interests of a range of groups who compete
with each other in order to influence the policy process
Explains the influence of individuals and groups on the political process (state operates in a
democratic way meeting the needs of all its citizens)
The approach is concerned with identifying the interest groups in a policy arena, determining to
what extent these interest groups are organized, how well resourced they are and what strategies
they are adopting with regard to each other
Interest groups likely to be key in the development of health promotion, whether supporting or
restraining it are: public health professionals such as health promoters, health educators, public
health nurses and public health doctors.
Whether collectively or individually, we all influence health promotion policy and
practice through our group.
The government & business groups represents another key set of interests
In analyzing the power of interest groups in health promotion it is important to examine how well
organized they are, what resources such as money, political skill and experience they command
and what strategies they are using to influence the political process.
Key strategies are: direct and continuous contact with politicians and bureaucrats, the
presentation of submissions, representation on advisory groups, and use of the media to
influence public opinion.
oNew institutionalism (Meso-level)
Holds that policy-making is determined by the institutions in which it occurs
The approach examines the impact of policy structures on policy process and outcome.
It focuses on such aspects of institutions as the organizational structure, the formal rules of
operations, the processes used and the ideas built into them
As a meso level theory- the new institutionalism focuses on the institutions such as advisory
boards to government, government departments and the institution of Parliament
Organizational structure is a key institutional influence – legislated or mandated functions of
institutions are powerful determinants of their work
If an institution has a clear health promotion mandate – this provides considerable focus
for the institutions work
Institutional influence on public policy also include: rules, process and ideas of these
organizations
oNeo-Marxist (Macro-level)
Macro-level theory, which allows us to situate health promotion within its broad political and
economic context.
Builds on the work of Karl Marx – capitalist society characterized it as divided along class lines
between those members of society who own the means of production, the bourgeoisie and the
proletariat who are forced to sell their labour in order to survive.
www.notesolution.com
The dominant position of the bourgeoisie enables them to exploit the proletariat – results
in class struggle.
The state strives to ensure an effective capitalist economy at the same time as meeting the
needs of the people and thus ensuring reelection
Two traditions in neo-Marxist theory analysis:
The functional class perspective – concerned with specifying the form and functions of
the capitalist state and thereby showing the limits of political reformism
oExamines how the state is structures to reproduce capitalist accumulation and
capital rule
oThis perspective requires us to examine the economic and social policy direction
of government and situate health promotion within this framework
The political class perspective – examines the ability of organization to mobilize the
energies of large numbers of individuals in similar situations into collective actions
Three key political class groupings are: organized capital, organized labour and political
parties.
This perspective is concerned with examining the strength and influence of the 3 political
class groupings.
Theis perspective requires us to examine the support of the business community, trade
union movement and political parties for the economic and social policy direction of
government
Applying Political Theory to the Development of a National Drug Policy in New Zealand
Recently, a National Drug Policy has been developed for New Zealand. The goal of part one of this
intersectional policy is to minimize harm caused by tobacco and alcohol use to both individuals and the
community
Pluralist interest group theory
oThe policy will be more effective if the interests in the area are systematically defined, their potential for
influence analyzed and appropriate strategies determined.
i.e. Alcohol Advisory Council (ALAC) is a key player – government funded to promote
moderation in the use of alcohol and develop and promote strategies which reduce alcohol-
related problems
oThe active participation of ALAC will be vital to the success of the government-led National Drug
Policy
oThe success of the policy will depend in large part on identifying allies and working cooperatively with
them avoiding duplication of effort and ensuring there are no gaps in programme delivery
The new institutionalism
oThe National Drug Policy involves the establishment of two new institutions: a Ministerial Committee
and a Monitoring group.
oIn both cases, the mandated function of each institutional arrangement is to minimize harm caused by
drugs to both individuals and the community
oThe commitment to health promotion of those involved will be significant to the success of the policy
Neo-Marxist theory
oThe National Drug Policy was developed by a conservative government at a time economic rationalism
characterized by economic restraint and an increased focus on individual responsibility.
Since the initial development of the policy a new government has been formed – a coalition
between the conservative party
www.notesolution.com

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Description
Week 6 Theories of Public Policy and Health 1.) Signal, L. (1998). The Politics of Health Promotion: Insights from Political Theory. Health Promotion International 13:3, 257-263. Health promotion has developed over the past two decades and has been adopted by governments internationally. o WHO defines health promotion as the process of enabling people to increase control over and to improve their health Signal examines the politics of health promotion using 3 political theories: o Pluralist interest group or Pluralism - (Micro-level) Holds that public policy is developed according to the interests of a range of groups who compete with each other in order to influence the policy process Explains the influence of individuals and groups on the political process (state operates in a democratic way meeting the needs of all its citizens) The approach is concerned with identifying the interest groups in a policy arena, determining to what extent these interest groups are organized, how well resourced they are and what strategies they are adopting with regard to each other Interest groups likely to be key in the development of health promotion, whether supporting or restraining it are: public health professionals such as health promoters, health educators, public health nurses and public health doctors. Whether collectively or individually, we all influence health promotion policy and practice through our group. The government & business groups represents another key set of interests In analyzing the power of interest groups in health promotion it is important to examine how well organized they are, what resources such as money, political skill and experience they command and what strategies they are using to influence the political process. Key strategies are: direct and continuous contact with politicians and bureaucrats, the presentation of submissions, representation on advisory groups, and use of the media to influence public opinion. o New institutionalism (Meso-level) Holds that policy-making is determined by the institutions in which it occurs The approach examines the impact of policy structures on policy process and outcome. It focuses on such aspects of institutions as the organizational structure, the formal rules of operations, the processes used and the ideas built into them As a meso level theory- the new institutionalism focuses on the institutions such as advisory boards to government, government departments and the institution of Parliament Organizational structure is a key institutional influence legislated or mandated functions of institutions are powerful determinants of their work If an institution has a clear health promotion mandate this provides considerable focus for the institutions work Institutional influence on public policy also include: rules, process and ideas of these organizations o Neo-Marxist (Macro-level) Macro-level theory, which allows us to situate health promotion within its broad political and economic context. Builds on the work of Karl Marx capitalist society characterized it as divided along class lines between those members of society who own the means of production, the bourgeoisie and the proletariat who are forced to sell their labour in order to survive. www.notesolution.com
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