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Social determinants of health and health equity policy research: Exploring the use, misuse, and nonuse of policy analysis theory

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  • Embrett, Mark G.
  • Randall, G.E.

Abstract

Despite a dramatic growth in SDH/HE (social determinants of health/health equity) public policy research and demonstrated government interest in promoting equity in health policies, health inequities are actually growing among some populations and there is little evidence that “healthy public policies” are being adopted and implemented. Moreover, these issues are typically failing to even reach governments' policy agendas, which is a critical step towards serious debate and the identification of policy options. This systematic review pursues three main objectives. First, is to identify barriers to SDH/HE issues reaching the government policy agenda. Second, to evaluate the characteristics of peer-reviewed research articles that utilize common policy analysis theories. And third, to determine the extent to which the SDH/HE literature utilizes common policy analysis theories. Our systematic review, conducted in June 2012, identified 6200 SDH/HE related articles in the peer-reviewed literature; however, only seven articles explicitly used a commonly recognized policy analysis theory to inform their analysis. Our analysis revealed that the SDH/HE policy literature appears to be focused on advocacy rather than analysis and that the use of policy analysis theory is extremely limited. Our results also suggest that when such theories are incorporated into an analysis they are often not comprehensively employed. We propose explanations for this non-use and misuse of policy analysis theory, and conclude that researchers may have greater influence in helping to get SDH/HE issues onto government policy agendas if they gain a greater understanding of the policy process and the value of incorporating policy analysis theories into their research. Using a policy analysis lens to help identify why healthy public policies are typically not being adopted is an important step towards moving beyond advocacy to understanding and addressing some of the political barriers to reforms.

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  • Embrett, Mark G. & Randall, G.E., 2014. "Social determinants of health and health equity policy research: Exploring the use, misuse, and nonuse of policy analysis theory," Social Science & Medicine, Elsevier, vol. 108(C), pages 147-155.
    • Handle: RePEc:eee:socmed:v:108:y:2014:i:c:p:147-155
    DOI: 10.1016/j.socscimed.2014.03.004
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    5. Townsend, Belinda & Strazdins, Lyndall & Harris, Patrick & Baum, Fran & Friel, Sharon, 2020. "Bringing in critical frameworks to investigate agenda-setting for the social determinants of health: Lessons from a multiple framework analysis," Social Science & Medicine, Elsevier, vol. 250(C).
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    7. Anthony McCosker & Anne Matan & Dora Marinova, 2018. "Policies, Politics, and Paradigms: Healthy Planning in Australian Local Government," Sustainability, MDPI, vol. 10(4), pages 1-25, March.
    8. Galetsi, Panagiota & Katsaliaki, Korina & Kumar, Sameer, 2022. "The medical and societal impact of big data analytics and artificial intelligence applications in combating pandemics: A review focused on Covid-19," Social Science & Medicine, Elsevier, vol. 301(C).
    9. Viengsamay Sengchaleun & Hina Hakim & Sengchanh Kounnavong & Daniel Reinharz, 2022. "Analysis of the Relevance of the Advocacy Coalition Framework to Analyze Public Policies in Non-Pluralist Countries," Social Sciences, MDPI, vol. 11(12), pages 1-11, November.
    10. Helen Van Eyk & Elizabeth Harris & Fran Baum & Toni Delany-Crowe & Angela Lawless & Colin MacDougall, 2017. "Health in All Policies in South Australia—Did It Promote and Enact an Equity Perspective?," IJERPH, MDPI, vol. 14(11), pages 1-25, October.
    11. McGreevy, Michael & Harris, Patrick & Delaney-Crowe, Toni & Fisher, Matt & Sainsbury, Peter & Riley, Emily & Baum, Fran, 2020. "How well do Australian government urban planning policies respond to the social determinants of health and health equity?," Land Use Policy, Elsevier, vol. 99(C).
    12. Harris, Patrick & Kent, Jennifer & Sainsbury, Peter & Thow, Anne Marie, 2016. "Framing health for land-use planning legislation: A qualitative descriptive content analysis," Social Science & Medicine, Elsevier, vol. 148(C), pages 42-51.
    13. Clifford, Brendan & Wilson, Andrew & Harris, Patrick, 2019. "Homelessness, health and the policy process: A literature review," Health Policy, Elsevier, vol. 123(11), pages 1125-1132.
    14. Kelsey Lucyk & Lindsay McLaren, 2017. "Taking stock of the social determinants of health: A scoping review," PLOS ONE, Public Library of Science, vol. 12(5), pages 1-24, May.
    15. Jones, Catherine M. & Clavier, Carole & Potvin, Louise, 2017. "Adapting public policy theory for public health research: A framework to understand the development of national policies on global health," Social Science & Medicine, Elsevier, vol. 177(C), pages 69-77.
    16. Carol Bacchi, 2016. "Problematizations in Health Policy," SAGE Open, , vol. 6(2), pages 21582440166, June.

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