Healthy Public Policy
- LAST REVIEWED: 13 December 2022
- LAST MODIFIED: 25 March 2020
- DOI: 10.1093/obo/9780199756797-0196
- LAST REVIEWED: 13 December 2022
- LAST MODIFIED: 25 March 2020
- DOI: 10.1093/obo/9780199756797-0196
Introduction
Healthy public policy (HPP) became an important idea in the 1980s. The concept can be traced primarily to Nancy Milio, who produced a now hard-to-find book, Promoting Health through Public Policy (Philadelphia: Davis, 1981), and was subsequently cemented in the WHO’s Ottawa Charter for Health Promotion as a strategy to use in promoting, protecting, and maintaining the health of populations. HPP is not, however, a modern phenomenon. Historically HPP was embedded in the 16th-century Poor Laws and passed through to 19th- and early-20th-century public health activity and legislation. Across this history is the recognition that improving public health requires addressing the social and economic (and environmental) conditions created by public policy. It follows, as explained by many, that public health practice is inherently political. This bibliography introduces the large literature that falls under the broad pantheon of HPP. Definitions, as this bibliography will show, do matter. Central is the often underrealized truth that “healthy public policy” fundamentally concerns how public policy influences the health of populations. This, in turn, necessitates that HPP practice is interdisciplinary. For knowledge, this means much of the theory and evidence underpinning HPP is to be found in other disciplines that have public policy at their core, political science being the most obvious (public administration another). It is through HPP that societies in general and public health researchers and practitioners in particular seek to create social and economic and environmental conditions for whole populations. Attention thus moves “upstream” to policies and institutions rather than “downstream” to behaviors or health services. Not all healthy public policy is generated with the intention to influence population health directly. Nor are all public policies that impact on the health of populations generated by the health sector, although many are. A core goal of HPP is reducing inequities in health. These inequities are what the 2008 WHO Commission on the Social Determinants of Health named as a “toxic mix of poor social policies, unfair economic arrangements and bad politics.” Just as policy actors are responsible for policies that have created inequalities, so too are they responsible for developing and implementing policies in that overcome the unfair and unjust distribution of the resources necessary for good health and well-being. Public policies are formed through “contests for power” between the various actors involved in policy-making in part because they are value-laden. The choices actors make are influenced by powerful structures and ideas that are not always explicit. HPP, therefore, can never be “atheoretical” just as it cannot be divorced from a normative position (what is believed “should” happen) concerned with changing political conditions for the betterment of the health of the population in general and disadvantaged in particular. In recent years there has been some confusion (see Oxford Bibliographies article Health in All Policies) whether HiAP replaces HPP as a concept and method. This article errs on the side of history by suggesting HiAP, with intersectoral action, is one recent strategy to achieve HPP.
Introductory Works
There is a range of seminal texts introducing HPP. The “ecological” approach that is central to these early texts is notably out of date and has been replaced by a complex systems and network governance approach, but, as Milio argued, in order to achieve optimum population health and health equity all public policies must take into account the health interests of the public. HPP requires collaboration across sectors, levels of government and non-Government Organisations, community and private sectors. Simon Szreter and others provide an extensive historical analysis of public policymaking—a valuable backdrop to understanding HPP—beginning with the realization that HPP may be generated by any sector, and that progressive change requires democracy, sustained advocacy, and action by all forms of governance to bring the benefits of policy change to the whole population. Once change has been achieved, there must be vigilance to protect and maintain it. Healthy public policies can be, but are not always, generated by or with the health sector; many are instead generated by sectors other than health—with no a priori reference to health or health equity. A significant challenge for HPP work for population health, however, lies in identifying ways in which the workforce can advocate for, support, and work to secure the adoption of policy ideas intended to increase economic and social equity as contributions to the health of the population. It is a question as to whether this is a legitimate role for the population health workforce—or whether, instead, the work to secure the adoption of such policies lies in our roles as citizens, community members, and voters. Working through these introductory texts it will become clear that the journal Health Promotion International has played a central part in progressing HPP (and more recently HiAP). This is largely due to the mission of the journal to advance the ideas presented in the Ottawa Charter. Crucial across these articles is the identification that the HPP “oeuvre” has failed to take on theoretical insights from political science, the discipline most concerned with the same objective that HPP is concerned with—that is, “healthy” public policy. This is a theme taken up in two important glossaries in Journal of Epidemiology and Community Health (JECH) which provide the essential definitions to build a deeper understanding of HPP by being interdisciplinary in focus and turning to the political science literature.
Users without a subscription are not able to see the full content on this page. Please subscribe or login.
How to Subscribe
Oxford Bibliographies Online is available by subscription and perpetual access to institutions. For more information or to contact an Oxford Sales Representative click here.
Article
- Abortion
- Access to Health Care
- Action Research
- Active Aging
- Active Living
- Addiction
- Adolescent Health, Socioeconomic Inequalities in
- Adolescent Risk-Taking Behavior in the United States
- Advocacy, Public Health
- Agricultural Safety and Public Health
- Air Quality: Health Effects
- Air Quality: Indoor Health Effects
- Alcohol Availability and Violence
- Alternative Research Designs
- Ambient Air Quality Standards and Guidelines
- American Perspectives on Chronic Disease and Control
- Antimicrobial Resistance (AMR)
- Arts in Health
- Asbestos
- Asthma in Children
- Asthma, Work-Related
- Attachment as a Health Determinant
- Behavior
- Behavior Change Theory in Health Education and Promotion
- Behavioral Risk Factor Surveillance
- Bicycling and Cycling Safety
- Bioethics
- Birth and Death Registration
- Birth Cohort Studies
- Board of Health
- Breastfeeding
- Built Environment and Health, The
- Business and Corporate Practices
- Cancer Communication Strategies in North America
- Cancer Prevention
- Cancer Screening
- Capacity Building
- Capacity Building for NCDs in LMICs
- Capacity-Building for Applied Public Health in LMIC: A US ...
- Cardiovascular Health and Disease
- Child Labor
- Child Maltreatment
- Children, Air Pollution and
- Children, Injury Risk-Taking Behaviors in
- Children, Obesity in
- Citizen Advisory Boards
- Climate Change and Human Health
- Climate Change: Institutional Response
- Clinical Preventive Medicine
- Community Air Pollution
- Community Development
- Community Gardens
- Community Health Assessment
- Community Health Interventions
- Community Partnerships and Coalitions
- Community-Based Participatory Research
- Complexity and Systems Theory
- Critical Health Literacy
- Cultural Capital and Health
- Cultural Safety
- Culture and Public Health
- Definition of Health
- Dental Public Health
- Design and Health
- Dietary Guidelines
- Directions in Global Public Health Graduate Education
- Driving and Public Health
- Ecological Approaches
- Enabling Factors
- Environmental Health, Pediatric
- Environmental Laws
- Environmental Protection Agency
- Ethics of Public Health
- Evidence-Based Pediatric Dentistry
- Evidence-Based Public Health Practice
- Family Planning Services and Birth Control
- Food Safety
- Food Security and Food Banks
- Food Systems
- Frail Elderly
- Functional Literacy
- Genomics, Public Health
- Geographic Information Systems
- Geography and Health
- Global Health
- Global Health Diplomacy
- Global Health Promotion
- Global Health Security
- Guide to Community Preventive Services, The
- Health Administration
- Health Communication
- Health Disparities
- Health Education
- Health Impact Assessment
- Health in All Policies
- Health in All Policies in European Countries
- Health Literacy
- Health Literacy and Noncommunicable Diseases
- Health Measurement Scales
- Health Planning
- Health Promoting Hospitals
- Health Promotion
- Health Promotion Foundations
- Health Promotion Workforce Capacity
- Health Promotion Workforce Capacity
- Health Systems of Low and Middle-Income Countries, The
- Healthy People Initiative
- Healthy Public Policy
- Hepatitis C
- High Risk Prevention Strategies
- Homelessness
- Human Rights, Health and
- Human Sexuality and Sexual Health: A Western Perspective
- IANPHI and National Public Health Institutes
- Immigrant Populations
- Immunization and Pneumococcal Infection
- Immunization in Pregnancy
- Indigenous Peoples, Public Health and
- Indigenous Populations of North America, Australasia, and ...
- Indoor Air Quality Guidelines
- Inequities
- Infant Mortality
- Internet Applications in Promoting Health Behavior
- Intersectoral Action
- Intersectoral Strategies in Low - Middle Income Countries ...
- Justice, Social
- Knowledge Translation and Exchange
- Knowledge Utilization and Exchange
- Law of Public Health in the United States
- Media Advocacy
- Mental Health
- Mental Health Promotion
- Migrant Health
- Migrant Worker Health
- Motor Vehicle Injury Prevention
- Multi-Drug-Resistant Tuberculosis
- Nanotechnology
- National Association of Local Boards of Health
- National Public Health Institutions
- Needs Assessment
- Needs Assessments in International Disasters and Emergenci...
- Obesity Prevention
- Occupational Cancers
- Occupational Exposure to Benzene
- Occupational Exposure to Erionite
- Occupational Safety and Health
- Occupational Safety and Health Administration (OSHA)
- Oral Health Equity for Minority Populations in the United ...
- Ottawa Charter
- Parenting and Work
- Parenting Skills and Capacity
- Participatory Action Research
- Patient Decision Making
- Pesticide Exposure and Pesticide Health Effects
- Pesticides
- Physical Activity and Exercise
- Physical Activity Promotion
- Pneumoconiosis
- Polio Eradication in Pakistan
- Population Aging
- Population Determinants of Unhealthy Foods and Beverages
- Population Health Objectives and Targets
- Precautionary Principle
- Prenatal Health
- Preparedness
- Program Evaluation in American Health Education
- Program Planning and Evaluation
- Public Health, History of
- Public Health Surveillance
- Public-Private Partnerships in Public Health Research and ...
- Public-Private Partnerships to Prevent and Manage Obesity ...
- Quantitative Microbial Risk Assessment
- Racism as a Structural Determinant of Health
- Radiological and Nuclear Emergencies
- Randomized Controlled Trials
- Real World Evaluation Strategies
- Reducing Obesity-Related Health Disparities in Hispanic an...
- Research Integrity in Public Health
- Resilient Health Systems
- Rural Health in the United States
- Safety, Patient
- School Health Programs in the Pacific Region
- Sex Education in HIV/AIDS Prevention
- Silicosis
- Skin Cancer Prevention
- Smoking Cessation
- Social Determinants of Health
- Social Epidemiology
- Social Marketing
- Statistics in Public Health
- STI Networks, Patterns, and Control Strategies
- Stillbirths
- Suicide
- Sustainable Development Goals
- Systems in the United States, Public Health
- Systems Modeling and Big Data for Non-Communicable Disease...
- Systems Theory in Public Health
- Traditional, Complementary, Alternative, and Integrative M...
- Translation of Science to Practice and Policy
- Traumatic Stress and Post-Traumatic Stress Disorder
- Tuberculosis among Adults and the Determinants of Health
- UK Public Health Systems
- Unintentional Injury Prevention
- Urban Health
- Vaccination, Mandatory
- Vaccine Hesitancy
- Vermiculite
- Violence Prevention
- War
- Water Quality
- Water Quality and Water-Related Disease
- Weight Management in US Occupational Settings
- Welfare States, Public Health and Health Inequalities
- Workforce
- Worksite Health Promotion
- World Health Organization (WHO)