Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, SA, Australia.
College of Business, Government and Law, Flinders University, Adelaide, SA, Australia.
Health Promot Int. 2019 Aug 1;34(4):833-846. doi: 10.1093/heapro/day014.
There is strong, and growing, evidence documenting health inequities across the world. However, most governments do not prioritize policies to encourage action on the social determinants of health and health equity. Furthermore, despite evidence concerning the benefits of joined-up, intersectoral policy to promote health and health equity, it is rare for such policy approaches to be applied systematically. To examine the usefulness of political and social science theory in understanding the reasons for this disjuncture between evidence and practice, researchers and public servants gathered in Adelaide for an Academy of the Social Sciences in Australia (ASSA) Workshop. This paper draws together the learnings that emerged from the Workshop, including key messages about the usefulness of various theories as well as insights drawn from policy practice. Discussions during the Workshop highlighted that applying multiple theories is particularly helpful in directing attention to, and understanding, the influence of all stages of the policy process; from the construction and framing of policy problems, to the implementation of policy and evaluation of outcomes, including those outcomes that may be unintended. In addition, the Workshop emphasized the value of collaborations among public health researchers, political and social scientists and public servants to open up critical discussion about the intersections between theory, research evidence and practice. Such critique is vital to render visible the processes through which particular sources of knowledge may be privileged over others and to examine how political and bureaucratic environments shape policy proposals and implementation action.
世界范围内有大量证据表明存在健康不平等现象,而且这一现象还在不断加剧。然而,大多数政府并没有优先制定鼓励采取行动来解决健康的社会决定因素和实现健康公平的政策。此外,尽管有证据表明采取综合性跨部门政策对促进健康和健康公平有益,但很少有国家系统地应用此类政策方法。为了研究政治和社会科学理论在理解证据与实践之间脱节的原因方面的作用,研究人员和公务员在阿德莱德聚集一堂,参加澳大利亚社会科学院(ASSA)的一次研讨会。本文汇集了研讨会得出的一些认识,包括关于各种理论的有用性的主要信息以及从政策实践中得出的一些见解。研讨会的讨论强调,应用多种理论特别有助于关注和理解政策过程各个阶段的影响,从政策问题的构建和框架设定到政策的实施和结果评估,包括可能是意料之外的结果。此外,研讨会强调了公共卫生研究人员、政治和社会科学家以及公务员之间合作的价值,以开放地讨论理论、研究证据和实践之间的交叉点。这种批判对于揭示特定知识来源可能优于其他来源的过程以及检查政治和官僚环境如何塑造政策建议和实施行动至关重要。