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Lecture 6

Week 6 readings

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University of Toronto Scarborough
Health Studies
Toba Bryant

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.
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