Objectives
Our aim was to synthesize published scholarship that applies policy diffusion—a theory of the policy process that considers the interdependence of government-level public health policy choices. We paid particular attention to the role of scientific evidence in the diffusion process, and to identifying challenges and gaps towards strengthening the intersection of public health, public policy, and political science.
Methods
We systematically searched 17 electronic academic databases. We included English-language, peer-reviewed articles published between 2000 and 2021. For each article, we extracted the following information: public health policy domain, geographic setting, diffusion directions and mechanisms, the role of scientific evidence in the diffusion process, and author research discipline.
Synthesis
We identified 39 peer-reviewed, primary research articles. Anti-smoking and tobacco control policies in the United States (n = 9/39) were the most common policy domain and geographic context examined; comparatively fewer studies examined policy diffusion in the Canadian context (n = 4/39). In terms of how policies diffuse, we found evidence of five diffusion mechanisms (learning, emulation, competition, coercion, and social contagion), which could moreover be conditional on internal government characteristics. The role of scientific evidence in the diffusion process was unclear, as only five articles discussed this. Policy diffusion theory was primarily used by public policy and political science scholars (n = 19/39), with comparatively fewer interdisciplinary authorship teams (n = 6/39).
Conclusion
Policy diffusion theory provides important insights into the intergovernmental factors that influence public health policy decisions, thus helping to expand our conceptualization of evidence-informed public health. Despite this, policy diffusion research in the Canadian public health context is limited.
Objective: Much of the extensive quantitative research linking socio-economic position (SEP) and health utilizes three common indicators: income, occupation and education. Existing survey data may enable researchers to include indicators of additional forms of capital in their analyses, permitting more nuanced consideration of the relationship between SEP and health. Our objective was to identify the breadth of survey questions related to economic, cultural, and social capital available through Statistics Canada surveys, and the extent to which those surveys also include health measures.Methods: We compiled a list of all population-based Statistics Canada surveys, and developed a broad list of potential indicators of forms of capital. We systematically searched the surveys for those indicators and health measures, analyzing their co-occurrence.Results: Traditional SEP indicators were present in 73% of surveys containing health measures, while additional indicators of social and cultural capital were available in 57%.Conclusion: Existing national survey data represent an under-exploited opportunity for research examining the relationship between various forms of capital and health in Canada. Future empirical explorations of these data could enrich our theoretical understanding of health inequities.
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