Navigating complex trade‐offs in public health interventions

Abstract

Public health, just as any policy‐related field, faces the evergreen problem of turning knowledge into action. Among other problems, there is a clash between the inherent complexity of public health problems and the inevitable push, by decision‐makers and the public, to simplify them. The Covid‐19 pandemic has shown the insufficiencies of our current epistemological, methodological and normative apparatus to handle such crises in a timely manner. Despite this, several authors have been arguing for the importance of engaging global crises such as Covid‐19 in ways that do not oversimplify key dimensions of the issues involved. In this paper, we contribute to this emerging scholarship. Building on existing work in the field of environmental problem‐solving, we propose an integrative approach to navigating complex trade‐offs in public health interventions. Briefly put, we propose that decision making should be informed by an analysis of any given problem from four distinct, but interrelated, lenses: (i) values and valuation, (ii) process and governance, (iii) power and inequalities and (iv) scientific evidence, methods and concepts. This normative framework, we argue, can help with spelling out the complexity of public health problems and with spelling out the rationale behind public health decision making to non‐specialists and the general public. We illustrate our approach using the controversy over wearing face masks in the Covid‐19 pandemic.

The public health benefits of implementing environmental policies: A comprehensive review of recent studies

“…The project's findings provide key policy messages on how to support local initiatives that influence behaviors towards more sustainable and healthy choices, offering insights into building back better in the post-pandemic era (Stegeman et al, 2020). Russo and Hirsch (2023) contribute to the discussion by proposing an integrative approach to navigating complex trade-offs in public health interventions. They argue that decision-making should be informed by an analysis of problems through four lenses: values and valuation, process and governance, power and inequalities, and scientific evidence, methods, and concepts.…”

“…This framework helps articulate the complexity of public health problems and rationalize public health decision-making to non-specialists and the general public. Using the controversy over wearing face masks during the COVID-19 pandemic as an example, they illustrate how this approach can clarify the multifaceted nature of public health challenges (Russo & Hirsch, 2023). In summary, the key concepts in environmental policy and public health revolve around the intricate relationships between environmental determinants and health outcomes.…”

How is who: evidence as clues for action in participatory sustainability science and public health research

“…As normative, they may be used as guidelines helping to determine the strategy that should be followed to carry out a good investigation. They help to spell out the complex trade-offs used in the implementation and evaluation of research through different lenses (i.e., valuation, governance, power, scientific evidence, methods) (Russo & Hirsch, 2023 ). In this section, we present the general characteristics of the six procedural criteria, inspired by Haack’s account (Haack, 2001 ).…”