Creating Political Will for Action on Health Equity: Practical Lessons for Public Health Policy Actors

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نوع سند: مقاله ژورنالی
زبان: English
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JR_HPM-11-7_009

تاریخ نمایه سازی: 17 مرداد 1403

Abstract:

BackgroundDespite growing evidence on the social determinants of health and health equity, political action has not been commensurate. Little is known about how political will operates to enact pro-equity policies or not. This paper examines how political will for pro-health equity policies is created through analysis of public policy in multiple sectors. MethodsEight case studies were undertaken of Australian policies where action was either taken or proposed on health equity or where the policy seemed contrary to such action. Telephone or face-to-face interviews were conducted with ۱۹۲ state and non-state participants. Analysis of the cases was done through thematic analysis and triangulated with document analysis. ResultsOur case studies covered: trade agreements, primary healthcare (PHC), work conditions, digital access, urban planning, social welfare and Indigenous health. The extent of political will for pro-equity policies depended on the strength of path dependency, electoral concerns, political philosophy, the strength of economic and biomedical framings, whether elite interests were threatened and the success or otherwise of civil society lobbying. ConclusionPublic health policy actors may create political will through: determining how path dependency that exacerbates health inequities can be broken, working with sympathetic political forces committed to fairness; framing policy options in a way that makes them more likely to be adopted, outlining factors to consider in challenging the interests of elites, and considering the extent to which civil society will work in favour of equitable policies. A shift in norms is required to stress equity and the right to health.

Keywords:

Political Will , Social Determinants of Health , Health Equity , Health Policy , Advocacy , Australia

Authors

Fran Baum

Southgate Institute for Health, Society & Equity, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia

Belinda Townsend

Menzies Centre for Health Governance, School of Regulation and Global Governance, College of Asia and the Pacific, Australian National University, Canberra, ACT, Australia

Matthew Fisher

Southgate Institute for Health, Society & Equity, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia

Kathryn Browne-Yung

Deceased March ۱۹, ۲۰۲۰

Toby Freeman

Southgate Institute for Health, Society & Equity, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia

Anna Ziersch

Southgate Institute for Health, Society & Equity, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia

Patrick Harris

Menzies Centre for Health Policy, School of Public Health, The University of Sydney, Sydney, NSW, Australia

Sharon Friel

Menzies Centre for Health Governance, School of Regulation and Global Governance, College of Asia and the Pacific, Australian National University, Canberra, ACT, Australia