IDSB04H3 Lecture Notes - Lecture 6: Smallpox, Malaria, Whitehall Study

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IDSB04 Lecture 6 Chp. 7 October 12/2010
Doing Policy Analysis
oAnalysis of past, existing, or proposed policies
oAnalysis of policy environment: background and context of a particular
policy issue
oAnalysis to recommend policy course
Not Mutually exclusive, of course
Policy change is political, dynamic, and complex
The Recommendation Policy Memo: Keeping it Simple
Five Steps
Identifying and describing the problem/issue
Identifying the objectives for solving the problem/issue
Identifying and describing feasible options for solving the problem/issue
Analyzing the feasible options
Recommending one the options analyzed.
Identifying, describing, and analyzing the problem/issue
Clearly identify problem to be addressed – be specific
Describe and analyze the problem: who, what, where, when, why (be careful with
Principal actor (stakeholder) analysis
Individuals and groups with an active/passive interest in an issue or policy
State actors, non-state actors, private sectors
Movement/people’s movements
Cross-sectoral networks
Power, position, interest, and commitment
1. Identify policy actors
2. Assess their political resources
3. Understand their position and interest
Identifying objectives for solving the problem
oRefer back to the identified and described problem
oWhat are the goals/objectives that, if reached, will ‘solve’ the problem?be
Options for Solving the Problem
Refer back to the problem and objectives
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IDSB04 Lecture 6 Chp. 7 October 12/2010
Continue to link: identify at least TWO feasible options that may achieve
objectivesbe specific
Feasible: ‘realistic’, no ‘straw’ options
Describe the options: what are they??
Analyzing the options
Key Step
‘Impartial analysis- no bias, impartial and objective.
Pros and Cons of each option
Criteria may include: how principle actors will be affected, political feasibility,
cost, ethical considerations, timeline, environmental consideration, etc.
No recommendation at this point!!
Policy Recommendation
Recommend only one of the options analyzed
No option combinations
No new options
Clearly justify the recommendation: why it is better than other analyzed options.
Emphasize pros but how this recommendation resolves the Cons.
Social Determinants of Health
Key questions
What makes Costa Ricans and Keralites so healthy and why does US wealth not
enable greater longevity?
Some definitions (See Box7-1 p.310-311_
Social Determinants of health: social characteristics within which living takes
Societal determiants of health:
Social inequalities ( or inequities) in health:
Equity in health:
Health Disparities: differences in health status without necessarily implying
presence of injustice
Some Basics
Ill health usually experienced individually but
Ill health can be understood in societal terms
Example: construction work on p.310.
Figure 4-2, p.138
Individual Characteristics and Experience (Individual Level)
Personal features and actions, including genetic conditions
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IDSB04 Lecture 6 Chp. 7 October 12/2010
oBut even genetic conditions are socially mediated
Life-course trajectory: approach helps explain how disadvantages (or advantage)
produced through societal determinants of health accumulates over time in an
Health ‘behaviours’: people’s behaviours that affect health but
oThese also mediated socially – look at differences in mortality between
working and upper class smokers.
Ok, shouldn’t people lead healthy lives?
Yes, but this level only ‘tip of the iceberg’
Assumes that:
oPeople are perfect decision makers
oPeople have day to day control over most if not all conditions of life
‘Blames the victim,’ but also..
Lets government, private business, and other actors off the hook.
Influence of living conditions
Water and sanitation
Nutrition and Food security
Housing and Human settlements
Neighborhood conditions
Public health and health care services
Culture and religion
Social Policies and government regulation
Income and poverty
Work conditions/.employment status
Violence and health
Social inclusion/exclusion, support, and capitcal
Social Inequalities in Health – Key Questions
How are social inequalities in health produced?
What is the relationship between societal determinants of health and social
inequalities in health?
Definition used
Social inequalities in health (or health inequalities): systematic and persistence
differences in health between and among different social classes, genders,
racialized groups, occupational groups, and so on, as linked to underlying power
and structural differences
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