The past few years have seen the emergence of claims that the political determinants of health do not get due consideration and a growing demand for better insights into public policy analysis in the health research field. Several public health and health promotion researchers are calling for better training and a stronger research culture in health policy. The development of these studies tends to be more advanced in health promotion than in other areas of public health research, but researchers are still commonly caught in a naïve, idealistic and narrow view of public policy. This article argues that the political science discipline has developed a specific approach to public policy analysis that can help to open up unexplored levers of influence for public health research and practice and that can contribute to a better understanding of public policy as a determinant of health. It describes and critiques the public health model of policy analysis, analyzes political science's specific approach to public policy analysis, and discusses how the politics of research provides opportunities and barriers to the integration of political science's distinctive contributions to policy analysis in health promotion.
While Canada's international leadership in the area of health promotion has been widely acknowledged in the past, Quebec's approach could be better known. Canada's second largest province has indeed developed a comprehensive public health infrastructure and adopted a population health approach which features an integrated set of legislative, organizational and programmatic policy instruments. These instruments not only ensure the core functions of public health, but also foster public intervention on the social determinants of health. In addition, Quebec's policy is supported by a solid research infrastructure, networked expertise and a mobilized workforce among health professionals. In spite of the interest it represents for the larger public health community in Canada and elsewhere, this largely French-speaking province's approach remains little known because of language and cultural barriers between Quebec and Anglo-Saxon countries, and it has yet to be systematically discussed in the English-language literature. This article provides an overview of policies and administrative structures in Quebec to support public health and address socially determined inequalities in health. It analyzes the development of these policies over the past decade and offers insight to their core content.
L’adoption au Québec de la Loi sur la santé publique de 2001 est souvent considérée comme une victoire de la santé publique. L’article 54 de cette loi accorde au ministre de la Santé un droit de regard sur l’activité des autres secteurs. Toutefois, l’originalité de la politique québécoise (consolidée récemment) tient au fait qu’elle se caractérise par un ensemble intégré et à jour d’instruments administratifs, programmatiques et législatifs. Ce dispositif, qui assure les fonctions essentielles de la santé publique, reflète aussi une préoccupation pour les aspects sociaux de la santé; de ce fait, il institutionnalise une vision technoscientifique des problèmes sociaux qui se répercute dans les autres politiques de l’État providence québécois. L’auteur présente les orientations récentes et explore la portée et les limites de la politique de santé publique.
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