Public health: How much evidence is needed to support our policies?

Éthique et santé publique

“…Cette proximité soulève bien sûr la question du degré avec lequel l'éthique de la santé publique est et sera capable de rester indépendante, dans sa démarche, de couleurs politiques particulières. Cette difficulté est bien illustrée par nos difficultés à considérer sereinement les données scientifiques relatives à la santé publique de manière indépendante de ce type de positionnement politique (32). Ce deuxième niveau de lecture est donc philosophique mais aussi souvent politique, un de ses enjeux étant justement de savoir dans quelle mesure ces dimensions peuvent, et peut-être doivent, y rester distinctes.…”

Childhood Obesity Prevention: Does Policy Meet Research? Evidence-Based Reflections upon the Spanish Case

“…Here we tap into four of them. First, the controversial understanding of obesity itself; [5][6][7] second, the pressure posed by the utterly competitive food industry; [6][7][8][9] third, the very own human nature in biological, psychological, cultural, and social terms; [7][8][9][10][11] and fourth, the current scientific evidence hierarchy and the difficulty to translate it into actual policy [5][6][7][8][9][10][11][12][13][14] which will be the main focus of this paper. In the first Lancet's Obesity Series published in 2011, the globalization of food systems that led to overconsumption, an expectable outcome of market economies, was posed as the main factor responsible for the increasing burden of obesity.…”

“…Notwithstanding that, tackling obesity demands broader, more specific actions than the ones used in these cases, as food is indispensable to life and, anthropologically, its connotations for human beings go beyond nutrition and acquire a psychological, social and cultural meaning (among others) that cannot be overlooked. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] All the previous considered, one might think that enough evidence to tackle obesity is not yet available. However, a quick search on PubMed with the words "obesity prevention" indicates just the opposite.…”

“…From the late nineties, the emergence of evidence-based medicine overflowed the clinical field and policymakers were also required to found their work on sound data. [4][5][6][7][8][9][10][11][12][13][14] The need for evidence-based policy is difficult to argue. However, the actual development of evidence-based policies is certainly challenged by a poor fit between atomized academic research, rigid evaluation standards, and the complex needs of policymakers.…”

Evidence, values, and ‘right versus right’ dilemmas in public health practice

“…The distinction between 'facts and values are difficult to keep in mind in public health debates'. 1 In clinical medicine, patient values have been defined as 'the unique preferences, concerns and expectations each patient brings to a clinical encounter'. 4 In public health, the values of WHO might be a useful guide.…”