HEP 6400

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(5) Pressing health care challenges of our time
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Terms in this set (76)
(5) Pressing health care challenges of our time
rising health care expenditures
an aging population
workforce shortages
health disparities
inequities rooted in determinants of health
The seven foundational principles of population health are meant to
empower stakeholders and inform the development of practical tools, research, and education
What is population health policy?
Principle 1
Population health policy includes directives, plans, and courses of action that may be required by law or developed in compliance thereto, or proffered voluntarily, documented in written instruments or manifest in norms and behaviors sanctioned through customary practice without objection
What aspects of prevention should public health prioritize?
Principle 2
Population health policy prioritizes early detection of, treatment, and mitigation of, and rehabilitation following disease among at-risk and symptomatic individuals
How is population health policy developed?
Principle 3
The development of population health policy is the product of political, economic, epidemiological, ethical, behavioral, and legal considerations
Should population health policy be uniform?
Principle 4
The heterogeneity of population health policy needs among groups of individuals across different demographics and jurisdictions requires the develpment of population health policy that balances the standardization and customization
What standards should be used to measure the effectiveness of population health policy?
Principle 5
Determination of the effect of population health policy, insofar as it creates or does not impede the exercise of rights, duties, or privileges associated with outcomes, must also take into account the status, and effect, of social determinants of health
How should population health policy be evaluated?
Principle 6
The evaluation of population health policy includes normative and empirical inquiries that may be applied to all of its component considerations and their covariation
How does population health policy inform population health management?
Principle 7
The management of population health requires alignment between organization al strategic planning and strategic management of human resources with the population health needs identified through available health needs assessments and input from affected population members
What are the seven steps to CDC's policy process
1- Problem ID
2- Policy analysis
3- Strategy and policy development
4- Policy enactment
5- Policy implementation
6- Stakeholder engagement and education
7- Evaluation
Problem IDcollect, summarize, interpret information relevant to the problem or issue; define characteristics (frequency, severity, scope, economic impact), frame the problem to suggest a solutionPolicy analysisresearch and identify policy options; describe health impact, economic and budgetary impact, and feasibility; assess and prioritize policy optionsStrategy and policy developmentidentify how policy will operate and what is needed for enactment and implementation; define the strategy for engaging stakeholders; draft the policyPolicy enactmentenact law, regulation, procedure, administrative action, incentive, or voluntary practicePolicy implementation-translate policy into operational practice, define implementation standards, guidelines, recommendations, directives, and organizational policies -identify indicators and metrics -coordinate resources and build personnel capacity -ensure compliance through an assessment -support post-implementation sustainabilityStakeholder engagement and education-identify and connect with decision makers, partners, those affected by the policy, and the general public; -identify key stakeholders, assess relevant characteristics (knowledge, attitudes, beliefs, needs) -implement communication strategies -solicit and gather feedbackEvaluation-formally assess the appropriate steps of the policy cycle including impact and outcomes of the policy, -define evaluation needs, purpose, intended users, -conduct evaluation of evaluation questions, -disseminate evaluation results and facilitate use5 Procedural and substantive requirements a policy writing process should need to deal with ...-stakeholder representation -deliberation on all the organizations obligations -explicit rationale -avenue for critique -evaluationPublic Health Institute definition of "policy"rule or set of rules people must followCDC definition of "policy"a law, regulation, procedure, administrative action, incentive, or voluntary practice of governments and other institutions.Actions to improve public health (3)-nudge with incentives -inform and educate -regulation or taxDo systematic literature reviews support subsidies and taxes effect on nutrition patterns?Yes, taxes decrease consumption and subsidies increase consumptionWho organized and funded the Committee Against Unfair Taxes?The tobacco industryDo tobacco taxes disproportionately affect the poor?Yes- they improve their health the mostWhich are more popular? Subsidies or taxes?Subsidies, but not much real world data regarding impactHow does the balance of power compare between the food industry and public health officials?There is an enormous imbalance to the food industry's favor. Denmark instituted a saturated fat tax, industry spent billions to squash it within the yearUnintended consequences to food taxesToo many jobs would be lost if people ate healthy People may swap out the sugary cookie for the salty chips Less SSB purchases may mean more beer purchasesWhat are the three domains of the CDC's Policy Analytical Framework?Problem identification, Policy analysis, and Strategy and policy developmentProblem identification-clearly ID problem, -synthesize data, -be specific regarding contributing (or risk) factors, frame appropriately instead of increasing physical activity say provide safe places for physical activityParts of problem identification (4)Burden Frequency Severity ScopeBurdennumber of people it affectsfrequencyhow often it occursseverityhow serious is the problemscoperange of outcomes affectedPolicy analysis 2Aresearch policy options and potential strategies; collect evidence to address opposing viewsWhat are potential policy analysis strategies-literature review -survey of best practices -environmental scan to identify other jurisdictions' implementationsIs the policy lever ______, ________, _______, or other?legislative, administrative, regulatoryWhat ______ of government or institution will implement?levelHow does the policy __________? (eg. is it mandatory? will ________be necessary? how is it __________, who is responsible for administering the policy?)work, enforcement, fundedWhat are the _______ of the policy?objectivesWhat is the _______ ________ surrounding he policy (eg. court rulings, constitutionality)?legal landscapeWhat is the _________ _________ of the policy )eg has the policy been debated previously)?historical contextWhat are the experiences of other ______?jurisdictionsWhat is the _______-_______ of the policy?value-addedWhat are the expected _____, _______, and ________ ______ outcomes?short, intermediary, long termWhat might be the ______ _______ and _________ consequences to the policy?unintended, positive, negativeWhat are 3 criteria to describe the policy in the policy analysis Domain 2public health impact feasibility economic and budgetary impactpublic health impactpotential for the policy to impact risk factors, quality of life, disparities, morbidity, and mortalityfeasibilitylikelihood the policy can be successfully adopted and implementedeconomic and budgetary impactcomparison to the cost to enact, implement, or enforce the policy with the value of the benefitspublic health impact question to ask How does the policy address the ____ or _____(eg. increase ____ or decrease _____)problem, issue, access, exposurepublic health impact question What are the _____, ______, and ______ of benefit and ______ (including impact on risk factor, __________ of __________, ___________ and _________)magnitude, reach, distribution, burden, quality, life, morbidity, mortalityWhat population will _____? How much? When?benefitWhat population will be ______ ______? How much? When?negatively impactedWill the policy impact ______ ______/_______ _____? How?health disparities, health equityAre there gaps in the ________/_________ _________?data, evidence baseFeasibility questions can be _____________ or _____________political, operationalPolitical feasibility questions-Current political forces, history, environment, debate? -Stakeholders? Supporters? Opponents? -Potential social, educational, and cultural persepctives? -Potential impacts on policy of other sectors and high priority issues (sustainability economic impact)?What are some policy change challenging social educational and cultural perspectives?lack of knowledge, fear of change, force of habitWhat are some operational feasibility questions?What are the resource, capacity and technical needs developing enacting, and implementing the policy? How much time is needed? How scalable, flexible and transferrable is the policy?What are the ____, _____, and _____ _____ developing, enacting and implementing the policy?resource, capacity, technical needsHow much time is needed to ___, ____, and ____ the policy?develop, enact, implementHow ____, ______, and _________ is the policy?scalable, flexible, transferableBudget question - What are the ______ and _______ associated with the policycosts, benefitsEconomic question - How do costs compare to benefits (_______-_____, ______ _______, ______ on ________, cost-___________, cost-_______ analysiscost savings, costs averted, return on investments, cost effectiveness, cost benefit analysisWhere are there _______ in ______/________-_________?gaps, data, evidence-baseDomain 2BAssess policy optionsDomain 2CPrioritize policy options based on criteria and scoring, the weight of each determined by the priorityAssess each option ______ against _________, note where there are _________ _________ and include no change as an option. Ground rankings in ______ and _____________.independently criteria data concerns data, evidenceSome possible ways to quantify the rankings in Domain 2Blow, med, high less favorable, favorable, more favorable empirical data (cost effectiveness, lives saved)Domain 3Develop a strategy for furthering the adoption of the policy solution to get it enacted and implementedClarifying operational issuesID how the policy will operate ID implementation steps ID considerations and possible assistance neededSharing informationshare results of the analysis with key stakeholder groupswho are key stakeholder groupstribal leaders state, local, territorial governments federal agencies community-based organizations decision-makersConducting additional background work-research agenda for insufficient data -possibility of a more incremental policy option to increase the feasibilityProducts to share policy information-background white paper that summarizes data related to increase health impact feasibility and economic and budget impact -bibliography and data compendium -presentation of policy, priorities, and recommendations -policy brief that summarizes options and recommendations