Copyright © 2018 American Institutes for Research. All rights reserved.

INFLUENCING SUPPORTIVE PUBLIC POLICY FOR

PREVENTION Thomas Workman, Ph.D.

Principal Researcher, Health Services and Systems

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• Understand the Policy and Public Health Link

• Learn the Roadmap of Policy Adoption

• Activating the Steps to Change

• Planning and Strategizing Together

Today’s Objectives

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The measurement of good policy is the well-being of the community. I saw the human faces of failed policies, and they weren't smiling.

Raul Ruiz

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What is Policy?

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• A plan or course of action, as of a government, political party, or business, intended to influence and determine decisions, actions, and other matters

• A codified community standard

• An agreement on issues, goals, or a course of action by the people with power to carry it out and enforce it

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.

World Health Organization

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Policy as Prevention

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“It is essential to promote an environment based on principles of wellness and healthy

lifestyle choices. It is necessary to invest in programs and implement policies that foster

healthy and safe lives and communities. Priority attention is required to ensure health

equity for everyone through public and private sector initiatives and partnerships and to

help racial and ethnic minorities and other underserved populations reach their full health

potential. To this end, it is critical to address social determinants of health, including

economic, social, and geographic conditions that influence the health of populations and

contribute to chronic diseases and injury.”

Statement by the Association of State and Territorial Health Officials (ASTHO)

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Thinking Broadly About Policy

Laws &

Ordinances

Corporate

Policies

Community

Covenants

• Voluntary compliance: undertaken by an individual

organization without any coercion

• Self-regulation: for example, an unorganized group that

regulates the behavior of its own members through a

voluntary code of practice

• Economic instruments: for example, supply funding

sanctions or incentives for health care providers, and/or

demand-side measures that give more power to consumers

• Meta-regulation: involving an external regulatory body to

ensure that health care providers implement safety and

quality practices and program;

• Command and control mechanisms: enforced by

government authorities and adjudicated by courts

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1. Infectious Disease Preventiona. Mandatory Vaccinationb. Quality and Safety Reporting

2. Tobacco Controla. Cigarette Taxb. Second Hand Smoke Law

3. Traffic Controla. Driving Under the Influenceb. Mandatory Insurance and Minimum Age Requirementsc. Open Container

4. Child Welfarea. Food Fortificationb. Marketing restrictionsc. Food product restrictions

5.

Top Public Health Policies in the United States

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Chronic Disease Climate Change Communicable Disease

Community Water Fluoridation Ebola Environmental Health

Global Health Gun Violence Health Equity

Health in All Policies Health Rankings Health Reform

Healthy Community Design Healthy Housing High School Graduation

Injury & Violence Prevention Lead ContaminationMaternal and Child Health

Mental Health Preparedness Prescription Drug Overdose

Public Health Accreditation Public Health Standards Racism and Health

Reproductive & Sexual Health School-Based Health Care Social Determinants of Health

Substance Misuse Suicide Tobacco

Transportation Vaccines Zika

A List of Issues in Health Policy – American Public Health Association

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Two Approaches to Change• Problem Solving • Appreciative Inquiry

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WE HAVE A PROBLEM(IT’S REALLY BAD)

WE HAVE TO DO SOMETHING

THIS WILL FIX IT

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Making the Link to Environmental Factors of Health

Behaviors

Norms

Spaces., Places, and Resources

Systems

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The Path to Policy Change

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Defined Problem or

Issue

Measured Impact

Perspectives& Interests Considered

Policy Solutions Identified

Champions & Agents of

Action Identified

Policy Drafted

Policy Refined by Opposition

Policy Adopted

OutcomesMeasured

PUBLIC SUPPORT

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• What systems are in place that enables the status quo?

• What hardships are created by the status quo? To whom?

• Who is currently benefitting from those systems?

• What is lost if those systems change? What is gained? For whom?

• What solutions provide the largest benefits to the greatest number of people?

• What political structures have been formed to support the status quo?

• How does the hardship pose a risk for these political structures ?

Perspectives & Interests

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• A crowd whose discontent has risen no higher than the level of slogans is only a crowd. But a crowd that understands the reasons for its discontent and knows the remedies is a vital community, and it will have to be reckoned with. I would rather go before the government with two people who have a competent understanding of an issue, and who therefore deserve a hearing, than with two thousand who are vaguely dissatisfied.

– Wendell Berry: The Art of the Commonplace

Building Support

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A M E R I C A N I N S T I T U T E S F O R R E S E A R C H | A I R .O R G

1. Beliefs are shaped by DATA and NARRATIVE; both should be tools in your arsenal.

2. MIX your media; messages must come from MULTIPLE SOURCES.

3. Focus on SALIENT AUDIENCE INTERESTS, even if they are different from your own.

4. Remember the LAW OF THE FEW; use your KEY INFLUENCERS.

5. SHOW more than you TELL.

Keys to Shaping Public Debates

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Tools of EvidenceGraphic Information Systems

“Mapping” crime, police call for service, or medical rescue data by address.

Shows “hot spots” of activity by location

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• The issue: Fake ID use impacted underage drinking, stolen ID, and check cashing fraud

• The cause: Nebraska’s analog driver’s license system made fake IDs easy to make

• The solution: Digital driver’s licenses with advanced security features

• The challenge: Adopting a system would cost millions to the state and to consumers

• The goal: Get Unicameral to pass a law requiring the new driver’s license system and to invest the funds to make the change.

Example 1: NE Driver’s License Legislation

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Feature Stories

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6/18/19

A VERY different form of support for digital driver’s licenses: VANITY

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6/18/19

Nebraska's hologram licenses help solve the fake ID problem The current three-colored hologram Nebraska driver's license has been the very pain it set out to be to any under-21s plotting deception in the name of bar revelry.March 25, 2007 7:00 pm • BRIAN CHRISTOPHERSON / Lincoln Journal Star

The current three-colored hologram Nebraska driver’s license has been the very pain it set

out to be to any under-21s plotting deception in the name of bar revelry.

From one of the easiest state IDs to duplicate to one of the hardest, most attempts at

copying the new license have been laughable.

“They’re so horrible you look at it just a second and it’s like, ‘This isn’t any good,’” Ward

said.

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