What is Policy Cycle?
Question:
Discuss about the Policy, Power and Politics in Health Care Provision.
Policy is a collective term that encompasses the procedure of actions that is formulated by a particular individual or organization. In other words, policies can be defined as factors that comprise of a plethora of issues, visions, goals, ideas and thoughts, which in turn facilitate development of particular plans that are put into action (Fleming & Parker, 2012). Moreover policies also assist recognition of the ideas and theories that are imperative for designing the structure or framework of the proposed actions.
Policy cycle is often considered essential and assists in formulation of new policies owing to the fact that it comprises of the major frameworks that are made up of limited concepts. This in turn facilitates accomplishment of the intended goals by the particular organization. Hence, the policy cycle can be defined as a series of processes that follow certain pre-determined steps. According to research evidences, different steps are followed by the Australian Policy Cycle Model, while contriving new policies (Althaus et. al., 2013). The series of steps that are present in the policy cycle model are most commonly associated with several issues or problems, followed by policy analysis and utilization of appropriate tools or instruments, in combination with consultation with experts with the aim of refining the instrument, accompanied by decision making and a final evaluation and implementation of the recognised policy.
In other words, it can be stated that activities and ideas, which play a role in reducing the existing inequalities are collected in a policy cycle, followed by appropriate resource sharing. Policy cycle is imperative owing to the fact that not only does it illustrate the importance of a structured, chronological, and constant process, but also helps in demonstrating a particular way, that guides the procedure of recognising and performing essential things, in an effective way. The old policies are thereby replaced by newly formulated policies, in the complex network of a policy cycle (Hugwood & Peters, 1983; Fisher, Miller & Sidney, 2006).
Thus, it can be concluded that formulation of new policies can be best conducted by implementing a policy cycle. Although use of policy cycle fails to ensure complete success of the process that relates to policy making, it plays a significant role in reducing chances of failure. Identification of problem, searching for appropriate evidences, verification of proposal, advice giving, and outcome evaluation are the essential steps performed while implementing certain policies, with the aim of providing assistance to a certain organization for accomplishing its intended goals.
The subject that encompasses conduction of an exhaustive study of the art and science of increasing lifespan of individual, preventing onset of chronic health diseases, and promoting the overall health and wellbeing is referred to as public health. It is principally facilitated by conducting an organisation of effort and taking into account the informed decisions of individual, communities, society, public, and different private organisations. The concept of public health often encompasses two approaches such as Old Public Health (OPH), and New Public Health (NPH). Old Public Health illustrates the necessity of enhancing physical infrastructure that will help in increasing life span, and also focuses on ensuring appropriate coverage of the major issues, faced by the public such as, hygiene maintenance, vaccination, and access to safe drinking water (Baum, 2008). On the other hand, New Public Health can be defined as an integrative approach that works with the aim of promoting and safeguarding health status of all individuals living in a community.
Understanding Public Health Approaches
It relies on the application of a methodological, political, conceptual and scientific approach that works to determine the existing interrelationship of health of individuals living in a community and the nation. In addition, concepts of moral and ethical aspects are also encompassed by NPH, thereby improving the overall health related environment (Tulchinsky & Varavikova, 2010).
The concept of Old Public Health had been introduced in the form of a major tool that acted as a guiding principle for formulation of New Public Health concepts. While OPH illustrates the importance of research technique that is based on epidemiology, NPH often elaborates on different approaches and methodologies that are undertaken by health studies (Baum, 2008). However the similarity between both these approaches can be attributed to the fact that their primary objective is prevention of major diseases. An individual is always considered healthy according to OPH if he/she fails to show signs of illness. On the other hand, NPH often emphasizes on prevention of diseases and promoting the overall health and wellness of individuals (Tulchinsky & Varavikova, 2010).
In addition, the primary objective of OPH also relies from the mechanism to control contamination of food and water and prevent transmission of diseases, thereby reducing rates of infection among individuals. It also emphasizes on recognition of the physical, social and mental health needs of the vulnerable population (Baum, 2008). NPH focuses on mental health issues such as prevailing chronic disorders or psychological condition and also helps in identifying risk factors that govern chronic disorders and psychological condition, and also helps in identifying risk factors that worsen the scenario (McMurray & Clendon, 2011).
Thus, it can be stated that in spite of differences in the basic principles of OPH and NPH, both of these approaches work towards promoting optimal welfare of the society and community. While OPH elaborates on improving the health status of the entire society, NPH focuses on implementation of evidence based approach in public health.
Social determinants of health is an umbrella term that can be rightly defined as factors that have been found to exert a direct influence on the health condition of an individual or group of individuals. These factors are often governed by the circumstances or environment in which a person resides, such as, ecological, social, economical, and cultural background. It is often associated with demographic features like age, gender, birth, educational attainment, lifestyle features and genetics (Baum, 2008). In other words, it can be stated that social determinants of health are responsible for directly influencing the health status of an individual in a positive or negative manner (Wilkinson & Marmot, 2003). Most commonly identified risk factors are living conditions, inequalities in access to healthcare services, social exclusion, and prevalence of chronic disease on a global scale. Individuals are most often affected by dissimilarities in their exposure to these risk factors that makes them vulnerable, and more likely to face consequences of these determinants (“WHO The determinants of health”, 2016). These determinants of health cannot be addressed by individuals alone. Moreover lack of insufficient resources, poverty and unemployment has also been found to play an essential role in this context.
Exploring Social Determinants of Health
Drastic changes in the sociological factors lead to the development of several psychological problems that often includes mental distress and huge prevalence of physical health abnormality, in addition to disability. Individuals belonging to underdeveloped countries or low socioeconomic strata of the society are more likely to suffer from poverty, which in turn increases rates of mortality and associated morbidity, thereby contributing to poor health outcome.
Therefore, there is a need to emphasize more on excess of healthcare services, formulation of awareness program and implementation of principles of equality among all individuals, with the aim of improving health condition in developing countries. These approaches will work towards eliminating or reducing the existing socio-economical issues that act as determinants of health of an individual or community.
Ever increasing trends in the prevalence of obesity among people due to wrong diet patterns is a major issue that contributes to mortality among people. Increasing rates of obesity can often be attributed to a sophisticated and sedentary lifestyle. This in turn results in an increase in consumption of wrong food that is associated with elevated rates of morbidity and mortality (Swinburn et al., 2011). Thus, obesity cannot be considered as health problem faced by a handful of individuals. It is a chronic health issue that is prevalent on a global scale, in the society (Moore & Cunningham, 2012). Hence, there is a need to put a control on the rates of obesity.
The primary objective should be related to implementation of appropriate healthcare legislation and strategies that will promote the practice of living a healthy lifestyle, in order to achieve maximum health benefits. Creating provisions for providing appropriate healthcare education will serve as an essential strategy. This can be accomplished by developing awareness programs, with the use of mass media and delivering these campaigns in the society. It will help in providing information to all individuals regarding the healthcare risk and complications that might arise from obesity in the long run. Providing health education to children at schools is also an essential step (Callahan, 2012). Appropriate dietary intake that should be followed by all people can be promoted in the society by implementation of legal framework (Cecchini et al., 2010). Efforts must be taken to restrict the use of unhealthy food products in commercials. In addition, to impose includes taxes on fat rich or junk food (Malik, Willett & Hu, 2012). Focusing on economic framework will also act as an important step that will encompass bringing reductions in prices of healthy food and nutritional supplements. Increasing rates of a healthy food will also serve as an important strategy. Moreover, implementing policy of taxation at restaurants, and other eating places will also help in effectively reducing rates of obesity (Powell & Chaloupka, 2009). The social framework and encompass public areas such a sports center, recreation clubs, and community parks, where members of the community will be involved in reducing rates of obesity.
Hence, it can be suggested that there are several challenges that will be encountered while controlling rates of obesity, in all countries, owing to rapid rates of urbanization and advancement. However, formulation and implementation of appropriate strategies by the public as well as the government can help in gaining a control over obesity.
The primary objective of the university should be focused on promoting a concept related to smoke free environment at all regions (Blanco-Marquizo et al., 2010). This would help in enhancing the health status of the concerned individual, by eliminating or reducing major risks that are associated with passive smoking. Furthermore, it would also leads to a reduction in smoking rates by active smokers (Fichtenberg, 2002). According to the present scenario, smoking rates are found to be higher in adolescence and teenagers. Therefore, there is a need to formulate effective strategies and policies targeted at such individuals (Glassman, Reindl & Whewell, 2011). People belonging to this target population are found to spend most of their time at educational institutions such as, schools and universities. Hence, implementation of a smoke-free environment through campaigns and awareness programs are essential. Formulation of effective new policies is governed by a range of factors that will help in achieving a smoke-free environment.
Awareness campaigns and health education are considered as the major strategies that can be implemented for creating smoke free environment at the university. Awareness programs should emphasize on utilisation of workshops and campaigns that will be effective in bringing about a change in perception, and attitude of the target population towards their smoking habits (Glassman, Reindl & Whewell, 2011). Participation of students is another major factor that should be considered in this context. Discussion in peer groups and active student participation will help in eliminating rates of smoking, by fostering student involvement in smoke-free programs (Fichtenberg, 2002). Another factor that will effectively work towards reducing smoking rates is implementation of appropriate legal framework that will ensure prevention of consumption of tobacco, in any form in the canteen or other areas of the university. Imposing bands and taxes on selling of tobacco products should also be applied, if the students are found using them. The final factors should also encompass several recreational activities of the students and counselling programs, which in turn will act as essential social factors.
References:
Althaus, C., Bridgman, Peter, & Davis, Glyn. (2013). The Australian policy handbook (5th ed., pp.59-92). Crows Nest, A: Allen & Unwin.
Baum, F.(2008). The new public health evolves. In The new public health (3rd ed.,pp. 31-68). South Melbourne, Australia. Oxford University Press.
Blanco-Marquizo, A., Goja, B., Peruga, A., Jones, M., Yuan, J., & Samet, J. et al. (2010). Reduction of secondhand tobacco smoke in public places following national smoke-free legislation in Uruguay. Tobacco Control, 19(3), 231-234. https://dx.doi.org/10.1136/tc.2009.034769
Callahan, D. (2012). Obesity: Chasing an Elusive Epidemic. Hastings Center Report, 43(1), 34-40. https://dx.doi.org/10.1002/hast.114
Cecchini, M., Sassi, F., Lauer, J., Lee, Y., Guajardo-Barron, V., & Chisholm, D. (2010). Tackling of unhealthy diets, physical inactivity, and obesity: health effects and cost-effectiveness. The Lancet, 376(9754), 1775-1784. https://dx.doi.org/10.1016/s0140-6736(10)61514-0
Fichtenberg, C. (2002). Effect of smoke-free workplaces on smoking behaviour: systematic review. BMJ, 325(7357), 188-188. https://dx.doi.org/10.1136/bmj.325.7357.188
Fischer, F., Miller, G., & Sidney, M. (2007). Handbook of public policy analysis (pp. 29-43). Boca Raton: CRC/Taylor & Francis.
Fleming, M., & Parker, E. (2012). Introduction to public health (pp. 210-218). Sydney: Churchill Livingstone
Glassman, T., Reindl, D., & Whewell, A. (2011). Strategies for Implementing a Tobacco-Free Campus Policy. Journal Of American College Health, 59(8), 764-768. https://dx.doi.org/10.1080/07448481.2010.529479
Malik, V., Willett, W., & Hu, F. (2012). Global obesity: trends, risk factors and policy implications. Nat Rev Endocrinol, 9(1), 13-27. https://dx.doi.org/10.1038/nrendo.2012.199
McMurray, A., & Clendon, Jill. (2011). Community health and wellness : Primary health care in practice (4th ed.). Chatswood, N.S.W.: Elsevier Australia.
Moore, C., & Cunningham, S. (2012). Social Position, Psychological Stress, and Obesity: A Systematic Review. Journal Of The Academy Of Nutrition And Dietetics, 112(4), 518-526. https://dx.doi.org/10.1016/j.jand.2011.12.001
Powell, L., & Chaloupka, F. (2009). Food Prices and Obesity: Evidence and Policy Implications for Taxes and Subsidies. Milbank Quarterly, 87(1), 229-257. https://dx.doi.org/10.1111/j.1468-0009.2009.00554.x
Swinburn, B., Sacks, G., Hall, K., McPherson, K., Finegood, D., Moodie, M., & Gortmaker, S. (2011). The global obesity pandemic: shaped by global drivers and local environments. The Lancet, 378(9793), 804-814. https://dx.doi.org/10.1016/s0140-6736(11)60813-1
The Lancet,. (2011). Urgently needed: a framework convention for obesity control. The Lancet, 378(9793), 741. https://dx.doi.org/10.1016/s0140-6736(11)61356-1
Tulchinsky, Theodore H,M.D., M.P.H., & Varavikova, Elena A, MD,M.P.H., PhD. (2010). What is the “new public health”? Public Health Reviews, 32(1), 25-53. Retrieved from https://search-proquest-com.ezproxy.uws.edu.au/docview/848717090?accountid=36155
Wilkinson, R., Marmot, M. G, & Ebrary, Inc. (2003). Social determinants of health the solid facts. Copenhagen: World Health Organization, Regional Office for Europe.
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