What influences the transfer of research into health policy and practice? Observations from England and Australia☆

Summary 

Objectives: To explore the role of evidence in the public health policy-making process, and show how the way in which public health problems are defined and measured influences policy outcomes.

Methods: The policy responses of the Blair Labour Government in the UK and the Howard Coalition Government in Australia to persistent health inequalities over the last decade are examined as a case study.

Results: Soon after being elected, the Blair Government commissioned an independent inquiry into health inequalities, signalling the priority it gave to addressing this longstanding challenge. It chose to take a ‘whole-of-government’ approach, combining actions that addressed both personal risk factors and the social determinants of health. This approach reflects the long-established tradition in England of routinely measuring disparities in health outcomes and correlating them with socio-economic status and underlying social determinants of health. Over the same period, the Howard Government also outlined its ‘whole-of-government’ approach to addressing the most extreme and persistent health inequalities between indigenous and non-indigenous Australians. In contrast, its approach focused primarily on modifying risk factors and improving service provision. This approach reflects the different historical circumstances in Australia and a different tradition in the collection of health data, focused more on health service access and personal risk factors.

Conclusions: This case study offers some insight into the ways in which the production and presentation of evidence can influence and shape governmental responses to public health problems. The usefulness of available evidence is dependent upon the type of data that is produced routinely by government, as well as more deliberate decisions concerning public health research funding. Researchers can maximize the influence of research evidence on the policy process by engaging in the policy-making process, presenting research in ways that fit with the political context of the day, and, where necessary, using research evidence in public health advocacy in order to influence political priorities more directly.

Keywords: Evidence-based policy, Health inequalities, Social determinants of health