Public Health Understandings of Policy and Power: Lessons from INSITE

Fafard, Patrick

doi:10.1007/s11524-012-9698-2

Cited by 19 publications

(15 citation statements)

References 30 publications

(31 reference statements)

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“…Building on Foucault, Esposito (2011, 9) has described bio-politics as the state's efforts to "immunize" itself against threats like HIV by constructing divisive notions of community and the other: "immunity constitutes or reconstitutes community precisely by negating it." The Canadian government's funding cuts to HIV programs that oppose its policies (Paperny, 2012), and fighting expensive legal battles to close others it deems morally problematic (Fafard, 2012), while actively scaling-up the HIV CBR program (CIHR, 2012b) are examples of this "immunizing." Communities are researched not to improve their conditions, but to protect the collective from them.…”

Section: Discussionmentioning

confidence: 99%

Governing through community-based research: Lessons from the Canadian HIV research sector

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et al. 2014

Social Science & Medicine

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The "general public" and specific "communities" are increasingly being integrated into scientific decision-making. This shift emphasizes "scientific citizenship" and collaboration between interdisciplinary scientists, lay people, and multi-sector stakeholders (universities, healthcare, and government). The objective of this paper is to problematize these developments through a theoretically informed reading of empirical data that describes the consequences of bringing together actors in the Canadian HIV community-based research (CBR) movement. Drawing on Foucauldian "governmentality" the complex inner workings of the impetus to conduct collaborative research are explored. The analysis offered surfaces the ways in which a formalized approach to CBR, as promoted through state funding mechanisms, determines the structure and limits of engagement while simultaneously reinforcing the need for finer grained knowledge about marginalized communities. Here, discourses about risk merge with notions of "scientific citizenship" to implicate both researchers and communities in a process of governance.

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Section: Discussionmentioning

confidence: 99%

Governing through community-based research: Lessons from the Canadian HIV research sector

Guţă

Strike

Flicker

et al. 2014

Social Science & Medicine

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“…In doing so, however, she makes the perceptive and provocative point that on a number of occasions tobacco control measures were introduced before the research evidence was available. Note that a similar pattern can be found in other areas of public health notably harm reduction and illegal drugs 25 26. Having made the case for the primacy of ideas (rather than evidence), the three subsequent chapters develop a second core argument of the book namely that the relationship between research and policy is, following Rein, one of ‘interplay’ or, as Smith puts it a “continual exchange and translation of ideas” (ref.…”

Section: Challenging the Evidence-based Premisementioning

confidence: 86%

Beyond the usual suspects: using political science to enhance public health policy making

Fafard

2015

J Epidemiol Community Health

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That public health policy and practice should be evidence based is a seemingly uncontroversial claim. Yet governments and citizens routinely reject the best available evidence and prefer policies that reflect other considerations and concerns. The most common explanations of this paradox emphasise scientific disagreement, the power of ‘politics’, or the belief that scientists and policymakers live in two separate communities that do not communicate. However, another explanation may lie in the limits of the very notion of evidence-based policy making. In fact, the social science discipline of political science offers a rich body of theory and empirical evidence to explain the apparent gap between evidence and policy. This essay introduces this literature with a particular emphasis on a recent book by Katherine Smith,Beyond evidence-based policy in public health: the interplay of ideas. As the title suggests, Smith argues that what matters for public health policy is less scientific evidence and much more a more complex set of ideas. Based on detailed case studies of UK tobacco and health inequality policy, Smith offers a richly textured alternative account of what matters for policy making. This excellent book is part of a small but growing body of political science research on public health policy that draws on contemporary theories of policy change and governance more generally. This essay provides a window on this research, describes some examples, but emphasises that public health scholars and practitioners too often retain a narrow if not naive view of the policy-making process.

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“…For example, determining whether injection drug use should be approached by using a criminal justice lens or a public health lens has dogged policy related to Vancouver's Insite supervised injection site for several years. 31 In cases such as these, there may be limited or no political willingness for decisionmakers who use a criminal justice lens to coordinate with harm reduction researchers in problem solving. This simple reality can make the KT goal of close cooperation between researchers and decision makers an awkward proposition.…”

Section: Kt For Policy: Taking Power and Politics Seriouslymentioning

confidence: 99%

Taking Power, Politics, and Policy Problems Seriously

Murphy

Fafard

2012

J Urban Health

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Knowledge Translation (KT) is a growing movement in clinical and health services research, aimed to help make research more relevant and to move research into practice and policy. This paper examines the conventional model of policy change presented in KT and assesses its applicability for increasing the impact of urban health research on urban health policy. In general, KT conceptualizes research utilization in terms of the technical implementation of scientific findings, on the part of individual decision-makers who can be "targeted" for a KT intervention, in a context that is absent of political interests. However, complex urban health problems and interventions infrequently resemble this single decision, single decision-maker model posited by KT. In order to clarify the conditions under which urban health research is more likely or not to have an influence on public policy development, we propose to supplement the conventional model with three concepts drawn from the social science: policy stages, policy networks, and a discourse analysis approach for theorizing power in policy-making.

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Public Health Understandings of Policy and Power: Lessons from INSITE

Cited by 19 publications

References 30 publications

Governing through community-based research: Lessons from the Canadian HIV research sector

Governing through community-based research: Lessons from the Canadian HIV research sector

Beyond the usual suspects: using political science to enhance public health policy making

Taking Power, Politics, and Policy Problems Seriously

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