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Analyzing Health Policies: Understanding Approaches, Power Dynamics, and Development, Exams of Nursing

An in-depth exploration of health policy, focusing on 'hard' and 'soft' policies, power dynamics, and policy development. 'hard' policies refer to laws, regulations, and taxes, while 'soft' policies involve guidelines, advice, and support. The document also covers policy analysis, readiness for policy development, and various research methods. Actors and their motivations, power dynamics, and critical social theory are discussed, as well as the importance of evaluating and monitoring policies.

Typology: Exams

2023/2024

Available from 03/01/2024

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NURS 2000
"hard policy" - ans-Types of policy laws, regulations, taxes
-Often a fine or possibility of conviction
-Consequence that you don't want
-E.g., speeding you get tickets, taxes you can go to jail
"soft policy" - ans-Types of policy guidelines, advice, support To lead in a direction
-E.g., more labels on all foods and at restaurants
-More just pushing you in the correct direction
Actors: consider power - ansPolicy analysis: Policy triangle
Who has power? Who doesn't have power? Who was consulted? Consider wealth,
economics, personality, knowledge, authority All power is connected with organizations,
structures, context where actors work within Motivations in the use of power can differ:
self interest (profit), social movements (environmental), public health COVID)
Assess Readiness for Policy Development - ansDetermine whether to proceed. This
decision should be based on whether your community is ready for a specific policy and
your organization is ready to lead or support the process.
Association - ansa specified health outcome more likely in people with a particular
"exposure"? Is there a link? Association is a statistical relationship between two
variables
Biostatics - ansNeed to quantify disease frequency and its relationships to antecedents
(denominators, testing hypotheses)
Build Support for the Policy - ansChoose channels and vehicles through which to try to
persuade decisionmakers to proceed with policy development. Develop the messages
that are put forth using these methods. This step can win or lose battles.
Case control studies - ansThe individuals in the group with the disease are matched
with individuals who are similar in some characteristics (age, time, or geographic
residence) but who have not manifested the disease
Case series studies - anscounts of selected variables within a specific population.
Through this data collection researcher would determine morbidity and mortality rates
and looks to other factors
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NURS 2000

"hard policy" - ans-Types of policy laws, regulations, taxes -Often a fine or possibility of conviction -Consequence that you don't want -E.g., speeding you get tickets, taxes you can go to jail "soft policy" - ans-Types of policy guidelines, advice, support To lead in a direction -E.g., more labels on all foods and at restaurants -More just pushing you in the correct direction Actors: consider power - ansPolicy analysis: Policy triangle Who has power? Who doesn't have power? Who was consulted? Consider wealth, economics, personality, knowledge, authority All power is connected with organizations, structures, context where actors work within Motivations in the use of power can differ: self interest (profit), social movements (environmental), public health COVID) Assess Readiness for Policy Development - ansDetermine whether to proceed. This decision should be based on whether your community is ready for a specific policy and your organization is ready to lead or support the process. Association - ansa specified health outcome more likely in people with a particular "exposure"? Is there a link? Association is a statistical relationship between two variables Biostatics - ansNeed to quantify disease frequency and its relationships to antecedents (denominators, testing hypotheses) Build Support for the Policy - ansChoose channels and vehicles through which to try to persuade decision‐makers to proceed with policy development. Develop the messages that are put forth using these methods. This step can win or lose battles. Case control studies - ansThe individuals in the group with the disease are matched with individuals who are similar in some characteristics (age, time, or geographic residence) but who have not manifested the disease Case series studies - anscounts of selected variables within a specific population. Through this data collection researcher would determine morbidity and mortality rates and looks to other factors

causation - ansWhen a relationship or association have been confirmed beyond doubt, Causation (or causality) is said to be present; when you can state statistically, there is a definite cause and effect Clinical medicine - ansEmphasis on disease classification and diagnosis (numerators) Cohort studies - ansExamine the individual histories of a group of people manifesting a certain disease to find out what other factors they share and what differences can discerned. Remember Framingham study first it was a cohort study and then, case control study Content of policy - ansPolicy analysis: Policy triangle Can be upstream, looking at the causes of the causes, targeting populations Can be downstream, looking and lifestyles, targeting individuals and families primarily Policies can impact all people or select populations Policies have a purpose or goal Context in which policy is made - ansPolicy analysis: Policy triangle Ideologies Racism, heterosexism, sexism, ableism Colonialism Crisis Changing circumstances Political power Economics Everyday lived experiences Critical social theory - ansSeeks to uncover constraints, expose oppressions and liberate people, leading to emancipation and freedom Cross-sectional studies - anssnapshots of the present Describe the Problem - ansObtain a detailed understanding of the specific problem. This will be a foundation for developing clear goals, assessing options, and building support for the policy among decision‐makers. Develop Goals, Objectives, and Policy Options - ansDefine clear goals and objectives for the policy change and generate a list of policy options that you want decision‐ makers to consider. Putting forward more than one option shows stakeholders that you are flexible and willing to negotiate. Draft and/or Revise the Policy - ansDefine the specific logistical and legal details about a policy. The precise wording of a policy often dictates whether or not it is passed. Environmental Health: DPSEEA - ansTo provide a common language to talk about environmental issues Epidemiological triad - ansModel of disease causation: Host Agent Environment Epidemiology - ans"Defined "as the study of the occurrence and distribution of health- related such as states or events in specified populations, including the study of determinants influencing such states and the application of this knowledge to control the health problem"

Primary: prevent from occurring Secondary: early detection Tertiary: reduce severity and threat Life course approach - ansPolicy approaches to act on SDH: considers short and long term impacts and life trajectories Macrosocial policy - ans-Policy approaches to act on SDH: Large scale societal policy, with systematic interventions and change, such as universal drug coverage -E.g. universal health care Marginalization - ansA social process that results in groups having limited access to needed resources and being peripheralized on the basis of their identities, associations, experience and environments Othering - ansA social process whereby a dominant group or person defines and subordinates others, creating exclusive relationships and putting patients at risk and impacting collegial engagement, "the other" Pathophysiology - ansNeed to understand basic biological mechanisms in disease (natural history) Pathways of contaminants - ans-Source: leaded gasoline, paint, toys, dust, old pipes, contaminated soil -Medium (how travels): soil, manufactured goods, water -Point of contact: home, community -Receptor of contaminant: children -Route of exposure: ingestion Period prevalence - ansduring a particular interval of time (existing cases + new cases) Point prevalence - ansat a particular instant in time Policy - ans- A set of principles or rules that guide decision making and action

  • Guides decision making and action by someone who can act on things Political economy approach - ans-Policy approaches to act on SDH: influence economics or social welfare, shaping the distribution of resources -E.g. economic policies (taxing people to use it for other things) Private policy - ansOrganizations, businesses, think tanks Impacts some people, or indirect effects Privilege - ansUnearned advantages and benefits Process - ansPolicy analysis: Policy triangle

Policy cycle Depends on if public policy (governments) or private policy Level of government Size of organization Can take a long time Program - ansPrograms come from policy, and are the plans in action, including funding and interventions Happens because of policy Public health - ansEmphasis on disease prevention Public health ontario: - ans8 steps to policy development Public policy - ansGovernments at all levels Usually impacts everyone Relative risk = 1 - ansmeans no difference Relative Risk > 1 - ansshows existence of an association between exposure and disease RISK - ans-Risk: is the probability of exposure of a susceptible individual to the hazard -Hazard : consider the property that leads to adverse outcomes -Susceptibility: property of the receptor (host) affected by the hazard -Exposure: a property of the environment Social Justice - ans- Social justice assumes that all societies experience systematic oppression and inequities (i.e. racism, sexism, heterosexism, classism), which affect some people more than others

  • 10 social justice attributes: equity, humans rights, democracy and civil rights, capacity building, just institutions, enabling environments, poverty reductions, ethical practice, advocacy, and partnership Social sciences - ansNeed to understand the social context in which disease occurs and resents (social determinants of health phenomena) Specific focus on - ansPolicy approaches to act on SDH: working conditions, setting, communities and supporting individuals urban centrism - ansa tendency for psychologists and other professionals, as well as the general public, to pay more attention to the problems of cities and suburbs than to those of rural areas. Where does marginalization happen? - ansIndividual level: Assumptions about "drug seeking" in the ER Community level: NIMBY regarding safe injection sites Global level: vaccine inequity