Flashcards in Public Health Deck (23):
Policy and health beyond our professional lives:
policies at the local/state/and federal level have effects on a large number of aspects of our daily lives.
ex. lead in water regulation
**local/state policies determine our health significantly!
How can policy impact health?
policy making --> POLICY --->implementation
--> change in behavior or change in environment --> overall population health
-ex no smoking in areas or public places can lead to a change in someones behavior and overall better health
What is big P policy?
-enacted by governmental body
b. exec order
c. court decisions
What is little P policy?
=institutional level for organizations or groups of organizations
What is the operational category of policy?
-it is what happens when the policies are ENACTED
what are the TWO levels of government?
-these 2 entities share the power between authority
-state determines what powers local authorities have **POWER is determined by the state**
what are the powers of the federal government?
legislative branch [enumerated powers]
-tax and spend***
-interstate and foreign commerce (how the ACA was passed) ***=public heath related
-monetary and posta systems
-everything the feds do they have to link it directly to powers stated within the constitution
what are the powers of the state governments?
all other powers!
-public health and safety
-there obviously then is large variations in policy for different states
-the feds can incentivize the states to do what they want by providing taxes and spending
What are the 3 branches of government?
-used to make sure no one branch has too much power
what is the 4th branch of government?
-congress makes laws with broad language and gives it to the agencies to set standards and determine what the law means
-do this because of the experts at each agency
the flow of power between the different levels of the government:
1. federal=set list of powers in which it can act under; its laws supersede state and local laws
2. state=reserved powers that the feds don't have; **most public health policy occurs at the state level**
-large variation among states!: police powers, state-local division of powers
-defining who has authority is an evolutionary process
definition of policy/what is the problem with the definition?
=existing laws and recorded decisions on a particular issue
a.decisions are made by multiple layers
b. discrepancy with intention v actual enforcement of policy
c. doesn't include hidden agendas!
d. doesn't include broader issue of societal norms
e. policy includes actions and INACTION (these can still have an impact)
what SHOULD the definition of policy be?
=set of actions (laws, regulations, judicial orders, ExO) and inactions taken by the STATE representatives to achieve a societal goal
What does public health policy involve?
both public health law and public policy
-involves aspects of infrastructural/interventional/and incidental
-interventional and incidental can be influenced by SDOH
What does health care policy regulate?
-business and industry
-patient access to health care
-quality of care
-special medical issues
-pharm and medical tech
infrastructural PH policy
-looks at health systems as a whole
-mandatory medical exam testing
interventional PH policy
promoting and protecting the publics health via prevention
can be through
-injury prevention (seatbelt)
-maternal and child health
-public preparedness (food safety)
incidental PH policy
laws that don't intentionally intend to impact public health but do
ex. zoning law of schools and fast food places
what is the definition of public health policy?
=protect and promote the health and safety of the community without unduly infringing on individual freedoms and rights
-finding the right balance between how much the government should be involved and how much it should be left up to individuals
what is the process of policy making?
1. identify the problem and agenda setting (depends on how you frame the question and this can lead to completely different issues)
2. formulate policy
3. adopt policy
4. implement policy
5. evaluate the policy and its effects
what are legal tools that can be used to influence PH policy?
1. influence via tax and spend disincentives and incentives (on tobacco)
2. change information environment (exposure and change labeling)
3. change built environment (sidewalks, cigarettes behind counter)
4. change SES environment
5. direct regulation
6. indirect regulation through tort (lawsuit) system
7. deregulation (good samaritan law)
when is policy most effective?
it is most effective when done at multiple levels and using multiple tools to address the policy