Program and public policy

The usage of the concepts designating the different types of initiatives we have termed “integrated governance” is remarkably variable in the academic and grey literatures that concern them. To provide some situational clarity and to establish more consistency in usage, this glossary strives to define the terms pertaining to this family of concepts.

To this end, the National Collaborating Centre for Healthy Public Policy (NCCHPP) has identified or drawn inspiration from definitions proposed by researchers in public administration, political science, and in the social sciences and humanities more generally. Definitions were also taken from or inspired by documents produced by public administration agencies (e.g., ministries or departments, strategic units, the World Health Organization) that are mobilizing these terms by giving them an explicit or (more often) implicit definition. In these cases, we have provided some brief comments to specify which usage we endorse.

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The following summary report details policies and programs in Canada that have had some measure of success in reducing health inequalities.

The National Collaborating Centre for Healthy Public Policy asked researchers at a research centre on health inequalities, Centre Léa-Roback, to report on programs and policies in Canada whose results have been evaluated using current medical evidence-based standards, including an evaluation of the quality of published evidence used in clinical guidelines.

Public health actors interested in promoting healthy public policies are concerned that these policies be based on a rigorous application of sound methodologies. Policies and broad government programs, in other words, are ideally based on what has been proven to work. Working with actual populations in social contexts, however, is not the same as working in a laboratory where the researcher has far more control over the experiment. Working with health inequalities and the socia…

Some Canadian regional health authorities have fully committed to partnerships with not-for-profit (NFP) organizations for the purpose of promoting healthy public policy. Some are seeking to go further in this direction and others have not yet embarked on this course. This document is part of a series of texts documenting existing partnership practices and analyzing their contributions in terms of public health. The aim is to allow authorities to weigh the benefits of such partnerships for the health of the populations under their responsibility and to determine the conditions for implementing such action.

Specifically, this document describes how the establishment of partnerships between the Vancouver regional health authority and an NFP organization delivering “low-threshold services” made it possible to reach people living with mental illness or substance abuse problems, while at the same time acting on the social and public policy context that, in part, determined their…

The concept of built environment refers to the human-constructed aspects of the living environments of populations. Together these constructed elements form an important part of human habitats, in that they affect the manner in which the places we inhabit are organized and populated. This document presents a reference framework to contextualize the concept of “built environment” while linking it to the actions of public health authorities in Canada.

The living conditions of populations, which include the built environment, have long been considered by North American and European health authorities to be important health determinants. Foucault (1976) showed that modern European public health administrations developed in parallel with increasing urban populations in the 18th century, notably because of concerns these increases raised about the impact of habitat on population health.

The following is a descriptive analysis of the policy frames used to interpret the central concerns of two organizations in their work to improve economic, social, and physical well being in some of the lowest-income neighbourhoods in Saskatoon, Saskatchewan. The central goal is to examine how different frames impact on the definition not only of the problems to be addressed, but on the solutions which are to be favoured. Awareness of these frames and how they colour approaches may be useful to those seeking to inform partnerships between public health actors and institutions and non-governmental groups. Choosing to concentrate on those areas where the frames are compatible may lead to more successful collaborations.

Although on the surface, and often in practice, the integration of different frames into common goals can be trying, it may well be a key to intervening in complex social contexts such as those beset by poverty and its attendant difficulties. Yet partnerships an…

This document provides a survey of the explicit goals, ethical principles, and ethics-related recommendations put forward by a selection of salient national, sub-national and international pandemic preparedness plans and policies. It is designed to provide a concise preliminary comparison of prominent ethical frameworks in order to stimulate examination of the relevance and utility of such tools for deliberation and justification in the context of an actual public health emergency. It does not claim to be exhaustive, and reflects the information and resources available at the time the review was carried out. The survey may be useful to health sector and other authorities as they reflect on their experiences, as well as to other professionals engaged in evaluating whether, how, and which existing ethical frameworks contribute to actual deliberation and decision making during routine and emergency public health practice in different contexts. It may also serve as a primer for further…

This collection of 11 case studies extracted from existing documents or research proposals is part of a larger project on ethics during a pandemic currently being undertaken by the National Collaborating Centre for Healthy Public Policy (NCCHPP), and is intended to contribute to one of our larger core objectives, which is to provoke reflection on the use of ethical analysis in public health practice and for the development of healthy public policy.

The general aim of this series of cases is to illustrate a wide range of pandemic and infectious disease control scenarios in which professional roles and responsibilities generate ethically complex situations. Covering issues related to the powers and duties of public health officials and health care providers, and designed to place ethical issues related to preparing and responding to outbreaks in practical contexts, the cases aim to assist in the development and application of moral reasoning through concrete examples. Suc…

Obesity's increasing prevalence is of concern because of its impacts on the population health and its associated costs. To promote healthy public policies, this scientific advisory documents the influence of economy-based agri-food policies that can affect the population's diet and weight. To this end, the following economic measures are reviewed: agricultural subsidies, trade policies, agricultural research and development programs, agricultural promotion programs, agricultural initiatives to supply institutions such as agricultural surplus and Farm-to-School programs and, lastly, price interventions.

In light of the information compiled, this scientific advisory identifies three promising avenues for interventions to guide agri-food policies:

• Increase the number of farmer's market offering fruits and vegetables, especially in disadvantaged areas
• Develop processing policies that correspond to public health objectives
• Develop school program…

In 2009, a workshop on health inequalities associated with transportation policies was jointly organized by the Population Health team of Edmonton's regional health authority, the former Capital Health, and the National Collaborating Centre for Healthy Public Policy (NCCHPP). The workshop was held on May 28, 2009 in Edmonton, Alberta and brought together representatives from the NCCHPP, Edmonton-based Alberta Health Services (AHS) staff with interest in transportation issues, traffic engineers and other public and private sector transportation professionals, urban planners, academics and members of non-profit organizations in Alberta, primarily from Edmonton and Calgary. The workshop was conducted to bring together practitioners with interests in the areas of transportation, health, and health inequalities to learn about transportation as a determinant of population health and to consider effective policy responses.

These notes are not intended as a formal report or pro…

The Coalitions Linking Action and Science for Prevention (CLASP) project is an initiative of the Canadian Partnership Against Cancer (CPAC). Through this project, seven coalitions have been funded to integrate and build upon their practices to prevent cancer and other chronic diseases with similar determinants. The National Collaborating Centre for Healthy Public Policy (NCCHPP) is a partner in one of these funded coalitions, Healthy Canada by Design. The principal goal of this coalition is to inspire change in the ways in which the built environment is currently developed, by influencing the policies that inform it. Gathering numerous partners from six health authorities, all members of the Urban Public Health Network (UPHN), the focus of this coalition is specifically the built environment of Canada’s large urban centres.

Funding for the Healthy Canada by Design coalition has made numerous knowledge exchange opportunities possible. One of these was the day-long colloquium…