This document discusses healthy public policy and related concepts. It defines public policy as purposive courses of action by governments to achieve outcomes. Healthy public policy aims to create supportive environments that enable healthy living and make health choices easier. It also discusses the importance of cross-sector partnerships and stakeholder engagement to address complex health issues. Analyzing stakeholders' knowledge, positions, interests, resources, power and leadership is key to developing effective policies.

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Health Partnerships, Politics and Power
HEALTHY PUBLIC POLICY
Louise Francis

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Overview
 Types of policy
 Public policy
 Health in All Policies
 Stakeholders and partnerships

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Types of policy
 Organisational Policy
 Administrative decision-making resulting in protocols or
guidelines for routine matters, quality assurance or
accreditation. Developed by organisations and include:
• Staffing policies such as equal opportunity, diversity,
anti-discrimination, bullying and harassment
• Guidelines for practice such as health promotion or counselling
services within community health services
• Protocols such as those in hospitals for universal precautions or
safe waste disposal

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Types of policy
 Policy for advocacy
 Position statements or declarations developed as lobbying
tools by interest groups or non-government organisations
(i.e. AHPA, AFAO, ANF, AMA, PHAA, CAHA, WACOSS).
 May have limited political power (organisation itself cannot
implement it) but may have authoritative power (influential
and evidence-based [or not]).

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Types of policy
 Public Policy
 Address public issues identified by governments as
priorities for action and detail the course for action.
 Sometimes also called strategies (i.e. National Health
Strategy), action plans (i.e. National Action Plan for
Alcohol) or frameworks.

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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What is public policy?
(Bridgman & Davis, 2004)
 A bill states policy but may not pass parliament
 A white paper states government policy intentions but these may not
be realised
 A ministerial statement might be policy, or it might just be one view on
the way to the government forming a position
 Election platforms describe a political party’s intentions, but do they
state the policy of the resulting government?
 Is it ‘policy’ when departmental activities proceed without explicit
statement of intent, continuing from government to government, never
exciting public interest or political scrutiny?

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Public policy is…
 “…deciding at any time and place what objectives and
substantive measures should be chosen in order to deal
with a particular problem, issue or innovation.
(Dimock et al. in Colebatch, 1993)
 “A statement of government intent, and its implementation
through the use of policy instruments.”
(Althaus et al. 2007)

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Public Policy
 A purposive course of action pursued by those in
government to achieve an outcome
 The decisions that direct public resources in one direction
but not another
 Is the outcome of the competition between ideas, interests
and ideologies that impels the political system

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Types of Policies: Lowi’s 1964 typology
(Palmer and Short 2010)
 Regulatory policies: relate to the imposition of restrictions on the
behaviour of individuals or groups.
 Self-regulatory policies: permits organisations to operate according
to their own standards; precludes government regulations
 Distributive policies: relate to the provision of services or benefits to
particular segments of the population
 Redistributive policies: are characteristic of the welfare state; are
deliberate efforts on the part of governments to change the distribution
of income, wealth, property, or rights between groups of the
population.

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Healthy Public Policy…
 “Healthy public policy is characterized by an explicit concern for
health and equity in all areas of policy and by an accountability for
health impact. The main aim of health public policy is to create a
supportive environment to enable people to lead healthy lives. Such a
policy makes health choices possible or easier for citizens. It makes
social and physical environments health-enhancing. In the pursuit of
healthy public policy, government sectors concerned with agriculture,
trade, education, industry, and communications need to take into
account health as an essential factor when formulating policy. These
sectors should be accountable for the health consequences of
their policy decisions. They should pay as much attention to health
as to economic considerations.” (WHO, 1988)


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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Flashback: What is a ‘wicked problem’?
 ‘Wicked Problems’ – an issue highly resistant to resolution
(Rittel & Webber, 1973)
 Complex public policy issues
 Beyond the scope of a single organisation
 Disagreement about the causes and solutions
 Often involves large scale behaviour change

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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The tangles of policy complexity
Productivity
Commission
2010,
Strengthening
Evidence
Based
Policy
in
the
Australian
Federation,
Volume
1:
Proceedings,
Roundtable
Proceedings,
Productivity
Commission,
Canberra.

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Health in All Policies
 “Health in All Policies is an approach to public policies
across sectors that systematically takes into account the
health implications of decisions, seeks synergies, and
avoids harmful health impacts in order to improve
population health and health equity.”
 “It improves accountability of policymakers for health
impacts at all levels of policy-making. It includes an
emphasis on the consequences of public policies on health
systems, determinants of health and well-being.”
The Helsinki Statement on Health in All Policies, 2013

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Health in All Policies
https://www.youtube.com/watch?v=x-KBg6qVAsI

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Health in All Policies and the SDGs
https://www.youtube.com/watch?v=a5edACNwIQw

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Activity 11.1: Healthy Public Policy
1. Why is working across sectors so important for public health?
2. Pick one of the following sectors and provide some reflections
and specific examples of how public health is impacted by
decisions made within this sector:
• Agriculture
• Criminal justice
• Housing
• Transport

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Partnerships…
 A shared commitment, where all partners have a right and
an obligation to participate and will be affected equally by
the benefits and disadvantages arising from the
partnership.

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Partnerships by any other name…
 Alliance
 Network
 Coalition
 Cooperative
 Collective
 Joint venture
 Association

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
CRICOS Provider Code 00301J
Partnership types (Vichealth, 2011)
 Networking: Exchange of information for mutual
benefit.
 Coordinating: Exchange of information for mutual
benefit and altering activities for common purpose.
 Cooperating: Exchange of information for mutual
benefit, altering activities and sharing resources
for mutual benefit and a common purpose.
 Collaboration: Exchange of information for mutual
benefit, altering activities and sharing resources
for mutual benefit and a common purpose whilst
enhancing the capacity of the other partner.

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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What are stakeholders?
 Individuals or groups that have an interest or a ‘stake’ in
the issue of concern or policy approach.

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Stakeholders can be:
 consumers (i.e. general public or specific segment of population)
 political (i.e. legislators, politicians, local government)
 public sector (i.e. government departments)
 commercial (i.e. individual businesses or corporate interest groups)
 labour (i.e. unions, professional associations)
 non-profit (i.e. non-government organisations,)
 civil society (i.e. grassroots community groups or advocates)
 international (i.e. international organisations that administer treaties
or agreements)

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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What do we want to know about them?
 Knowledge
 Position
 Interest
 Alliances
 Resources
 Power
 Leadership

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Knowledge
 The level of accurate knowledge the stakeholder has
regarding the issue under analysis, and how each
stakeholder defines the issue in question.
 This is important for identifying stakeholders who oppose
or support the reforms due to misunderstandings or lack of
information.

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Position
 Whether the stakeholder supports, opposes, or is neutral
about the issue, which is key to establishing whether or not
he or she will block policy implementation.

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
CRICOS Provider Code 00301J
Interest
 The stakeholder’s interest in the issue, or the advantages
and disadvantages that implementation of the reforms may
bring to the stakeholder or his or her organisation.
 Determining the stakeholder’s vested interests helps to
better understand his or her position and address his or
her concerns.

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Alliances
 Organisations that collaborate with this stakeholder to
support or oppose the reforms.
 Alliances can make a weak stakeholder stronger, or
provide a way to influence several stakeholders by dealing
with one key stakeholder.

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Resources
 The quantity of resources (human, financial, technological,
political, and other) available to the stakeholder and his or
her ability to mobilise them.
 This is an important characteristic that will determine the
level of force with which the stakeholder might support or
oppose the reforms.

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Power
 The ability of the stakeholder to affect the implementation
of the reforms.

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Leadership
 The willingness to initiate, convoke, or lead an action for or
against the reforms.
 Establishing whether or not the stakeholder has leadership
will help to target those stakeholders who will be more
likely to take active steps to support or oppose the reforms
(and convince others to do so).

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
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Discussion: stakeholder analysis
1. Select a topic: Obesity, Alcohol or Tobacco
2. Select ONE policy to implement to help address this
health issue (outside of the healthcare system)
2. Identify 10 stakeholders relevant to the topic/policy
 Select stakeholder/s and complete the analysis against
 Knowledge
 Position
 Interest
 Alliances
 Resources
 Power
 Leadership

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Activity 11.2: Public Health Coalitions
Some examples of public health coalitions in Australia include:
 Climate and Health Alliance http://www.caha.org.au/
 National Alliance for Action on Alcohol http://actiononalcohol.org.au/
 Obesity Policy Coalition http://www.opc.org.au/
 Choose one and provide an overview including:
1. Who are the participating organisations?
2. What is the core purpose of the coalition?
3. What strategies does the coalition use to influence change (with particular reference
to the chapters by Laverack)?

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
CRICOS Provider Code 00301J
Key concepts
 Public policy
 Health in All Policies
 Partnerships

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Module 11: Healthy Public Policy
Health Partnerships, Politics and Power
Curtin University is a trademark of Curtin University of Technology
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Next week
 Advocating for a healthy future
 Social movements, advocacy and activism
 Final reflections

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Module 11: Healthy Public Policy
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Questions & comments

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