Thursday, May 28, 2009

Research and Policymaking Merge in Public Health

How does a State know whether fluoridating its water supply will prove cost-effective in reducing tooth decay and its related health costs of their residents? Are mass media campaigns effective in discouraging smoking among young people?

These questions and others are posed in a Fall 2008 report by the Council of State Governments entitled "State Policy Guide: Using Research in Public Health Policymaking". 

The report indicates strong support for State governments to begin making public health decisions based on empirical evidence rather than the influence of lobbyists or in the interest of political expediency. The challenge of making evidence based decisions is directly addressed in the report, as is the need to distinguish public health policies directed at the population (i.e. community) level from medical care policies, which focus on treating or preventing disease in individual patients. 

Rating scales to evaluate the evidence for particular interventions are provided, as well as a step-by-step guide to drafting and reviewing proposed legislation on public health policy. 

I wonder how much attention to evidence-based policy making is currently happening at the local and State level. Have other sectors of government (apart from health) been making evidence-based policies or is this something new altogether?

It is imperative that we elect and promote individuals with a strong ability to identify and critique the public health literature so that informed public health policies can be implemented. At the least, we must expect our policymakers to surround themselves with people who are public health experts and can inform the content that goes in to the legislation. This guide is a good first step -- a call to action of sorts. 

Next Steps:
  • Are evidence-based public health policies being made in your State? 
  • What are the risks/rewards of being the first State to adopt a new public health policy? Can these decisions still be evidence-based?
  • Who will keep local and State governments accountable for their public health policies?

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