Analysis of Public Health Policies in the United States and Canada - Case Study Example

Analysis of Public Health Policies in the United States and Canada Name: Course: Institution: Date: Analysis of Public Health Policies in the United States and Canada Executive summary Public health policies involve societal actions aimed at the improvement of health standards. The essence of this approach to health care is that it focuses on the function that shares some relationship with the assessments, assurance and policy setting. Agenda setting in public health policy development involves discussions on the development of different agendas and a discussion of the said agendas. It is a requirement for the stakeholders to get involved in the activities that will influence the government in ways that will pressurize it to get involved in the development and the implementation of the policy. This included the identification of groups that have a role to play in the in addressing the identified challenges Introduction Public health policy involves an elaborate planning, introduction of development initiatives, and the implementation of interventions that are designed in ways that will allow the maintenance and improvement of the health of a group of individuals. Through public health policies, the government with the support of different stakeholders has the ability to ensure some form of improvement in the health standards of its population. The main objective of this paper is to provide an analytical approach to public health policies in the United States and Canada. This will be through an understanding of case studies in relation to their models, concepts and perspectives. Evaluation of the concepts, models, and perspectives Agenda setting in public health policy Agenda setting is one of the fundamental aspects in the development of public health policies. This stage makes reference to the policy that is to be developed and the problem that this policy is intended to solve in regard to public interest (Blair et al 2015, p.56). The Health in All Policies is a public health policy approach that was initiated by the United States with the aim of improving on the health of every citizen within the United States. The approach of this public policy revolves around the desire to ensure an all-inclusive approach in the decision making process across different sectors within the United States (Rudolph et al 2013, p. 6). The agenda setting for this public health policy was largely influenced by the social, physical and the economic environment. This is based on the realization that for any public health policy to be functional it will be important to incorporate all the social determinants of health considering that they are essential drivers in the determination of health outcomes and health inequities (Tatto & Justin 2012, p.50). In Canada, Child Health Guidance Document provides a platform of agenda setting as required by the Health Protection and Promotion Act (HPPA). Through this Act, the federal government of Canada provides a technique through which problems that affect the community can be solved and the best policy approaches that can be used in the development of the said policies (Ministry of Health Promotion 2010, p. 5). This policy is founded on Ontario Public Health Standards (OPHS), which is founded on four agenda areas, which include the impact, capacity, partnerships and collaborations. While setting agenda on the basis of these principles it is possible for the decision making process to be made using existing standards such as population health assessments, research, knowledge exchange, program evaluation and surveillance (Ministry of Health Promotion 2010, p. 5). The development Child Health Guidance Document in Canada is an all inclusive approach considering that the decision making process in the agenda setting is characterized by consultations across different stakeholders that are to be affected by the policy. The government through the Ministry of Health Promotion (MHP) provides some form of guidance in the agenda setting process. This in a way ensures effective implementation of the standards of the program for which it is responsible (Ministry of Health Promotion 2010, p. 7). There are certain prerequisites that determine the possibility that a policy will be placed on the agenda. One of the prerequisites of determining the list of agenda setting is that the stakeholders must acknowledge that a specific situation is problematic to the community. In addition, these stakeholders must also have the capacity to identify the challenging aspects of the situation (Blair et al 2015, p.59). The Health in All Policies in the United States, the inclusion of this policy as a collaborative approach was based on the understanding that governments at the federal and the state level within the United States are facing challenges of declining revenue hence the need to involve other partners and share resources (Rudolph et al 2013, p. 13). In Canada, Child Health Guidance Document was founded on the understanding that the society has a moral responsibility of providing efficient health care to the children (Ministry of Health Promotion 2010, p. 4). This responsibility is based on the understanding that different agencies within the government and the private sector are always dedicated towards investing in children as a way of providing an assurance of generational continuity (Mason et al 2014, p. 88). Policy formulation Policy formulation stage is an essential concept in the development of public health policy. This is because it helps in the determination of the best approach to embrace out of the existing policy option. In addition, through the collaborative approach of various factors involved in the formulation employ the use of various advocacy strategies to gain priority in terms of the best interpretation that can be used in the problem and the solutions (Mason et al 2014, p. 102). It is during the process of policy formulation that different stakeholders develop power relationships, which are integral in the determination of the direction that the policy will take. In Canada the Child Health Guidance Document was based on the understanding that the involvement of different players that the national level, provincial and local levels is only realizable only when the national government is in charge of the formulation process (Ministry of Health Promotion 2010, p. 5). In the United States, the Health in All Policies the involvement of the Metropolitan Planning Organization (MPO) was considered as a crucial approach in the formulation of the policy. This is because of the ability of the organization to develop a systematic approach that will ensure equitable distribution of resources to the target areas (Rudolph et al 2013, p. 23). It was therefore necessary for all the stakeholders to develop some relationship with the organization as a way of ensuring that the areas given priority are the most vulnerable and the policy formulation process is conducted in accordance with the existing laws and practices of the needs assessment that was in charge of defining the problems and the need for a policy (Thissen & Warren 2013, p. 33). Application of the theories, concepts, models, and perspectives Incrementalism This is a public policy approach, which is based on the understanding it is important to consider already existing policies and devise ways through which can be improved by developing alternative policies, or improving on the content of the available polices (Tatto & Justin 2012, p.125). According to this theoretical perspective, it is the responsibility of the legislators, the government and other policy makers within government agencies with a stake in ongoing programs or problem solving initiatives (Tatto & Justin 2012, p.125). Their involvement in policy initiatives is often aimed at the determination of the best approaches that can be used to ensure the continuation of past government activities with only some modifications to the existing policies. The Child Health Guidance Document is an example of a policy document in Canada that was developed in accordance with the tenets of Incremenatlism (Ministry of Health Promotion 2010, p. 8). This is because the policy was a modification of already existing policy programs in Canada such as the Oral Health Guidance Document of 2009 and the Healthy Babies Children Protocol of 2008. These programs were developed to ensure that the health sector in Canada was able to achieve broad health and societal outcomes targeting children. In addition, it was also an approach aimed at the improvement of all OPHS standards towards the health of children. In this document the age limits of the target children was increased for 0-15 years to 0-18 years. This was aimed at limiting the possibility of conflicts of interest among different players that operate within the area of children welfare (Ministry of Health Promotion 2010, p. 7). The unhealthy outcomes of the previous policies on matters related to the wellbeing of the children are considered as major reasons for the development of this policy. In addition, the use of a systematic approach aimed developing an understanding and planning for the activities that must be done to ensure that there is the expected change as expected by the policy actors and the concerned stakeholders (Porche 2012, p. 43). These changes are also necessitated by the understanding that the challenges that face the society are dynamic and must always be approached using improved policies. Like any other theoretical perspective of policymaking, formulation and implementation, incremenatlism must always focus on setting the objectives of the policy process (Thissen & Warren 2013, p. 79). This is to be followed by a process of identifying the indicators that will help the government and other stakeholders know whether the intended objectives are being achieved. In addition, it will also be important to identify the outputs that will identify what needs to be changes and how the change is to occur. The theory of incremenatlism also has some implications, which include the understanding that the policy makers must embrace the legitimacy of established programs despite the existence of some form of fear of the unintended consequences. Furthermore, the use of incremenatlism as an approach towards public health policy leads to the sinking of cost in other programs hence minimizing the possibility of embracing opportunities for radical change in the health sector (Thissen & Warren 2013, p. 80). Group theory Group theory is an assumption in public health policy that views the process of formulating and implementing policies as inspired by the needs of different groups in the society. Public policy according to this approach is therefore group equilibrium where all the parties concerned must benefit from the policy in relation to their mandate within a specific jurisdiction (Thissen & Warren 2013, p. 150). This approach views interest groups and their allies in governments as participants in public policy process. Public policy from this perspective is arrived at through group struggles where any amendments or deliberations are made with the objective of realizing the desires of different groups. In some situations, public policies especially those targeting the health sector are developed based on compromises. The rules that define the struggles by the interest groups are often defined by superior laws such as those of the constitution (Porche 2012, p. 123). In the United States, public health policies have been developed as a result of deliberations among different interest groups and the government with the aim of realizing some change in the society. The deliberations are often aimed at assembling the diverse interest of groups in ways that will ensure that all the stakeholders gain of or that the gains are directed towards that which is best for the country. The Health in All Policies is an example of a public health policy developed as a result of the deliberations of different interest groups within the health sectors and those of the government to ensure that every members of the American society receives proper health services. The United States spends more financial resources on matters related to health more than any other country in the world. This because of the desires by different stakeholders to ensure that there is equitable distribution of health resources (Rudolph et al 2013, p. 15). One of the major implication of the group approach in the development and implementation of public health policies is that it interest groups will only join to press on the issues that affect their mandate in the community (Porche 2012, p. 99). This means that there will always be some form of bias in the formulation of polies since these groups possess the ability to influence the direction that a policy will take (Barlow & Scott 2010, p. 20). Despite this possibility, there is also a high probability that all interest groups will be represented in the implementation process as the government has the ability to allocate responsibilities to different groups within the society that can engage in successful implementation of health programs aimed at benefiting the target areas within the community (Thissen & Warren 2013, p. 155). Evaluation of the similarities and differences in the public policies Similarities The Health in All Policies and the Child Health Guidance Document are American and Canadian public health polices respectively. These polices are aimed at solving particular problems within the health care sector in these countries. The ability of the government to realize the existence of a problem and the ability and the ability to develop solutions to the said problems forms the basis of these policies. In the United States for instance, the Health in all Policies is a multi-sectoral policy that aims at realizing healthy living among all Americans with an additional objective of minimizing the possibility that American will develop chronic and terminal lifestyle illnesses such as obesity and cancerous infections (Rudolph et al 2013, p. 23). In Canada, the development of the Child Health Guidance Document was based on the understanding that the best way that the government can use in implement change in the public health sector is through improving the health standards of the children. This, in the view of the policy developers is the only way through which the government can ensure the existence of a healthy generation (Ministry of Health Promotion 2010, p. 6). The Heath in all Polices and The Child Health Guidance Document operate on the understanding that they are able to definer the type and complexity of the challenging situation, the magnitude of the expected change in relation to the target population. In addition, these polices have also been able to identify human and monetary resources that must be involved in the implementation process. The role of the government revolves around the understanding that there must be administrative structures that support the implementation process (Thissen & Warren 2013, p. 140). Differences One of the major differences between the two polies is their mandate and their target groups. The Health in all Policies targets the entire American population. This means that it is important for the government and all the other stakeholders to device a methodology through which it can ensure that all the healthcare sector within the country operate in accordance with the requirements of the policy (Weissert et al 2012, p. 56). The need for the public to engage in health eating and living habits will be integrated in different sectors that involve food and healthy living. The Child Health Guidance Document target children aged 0-18 years. This because of the understanding that children form an integral part of the society and the use of state machinery in ensuring tha they live healthily is essential in determining the future of the Canadian society (Ministry of Health Promotion 2010, p. 5). This is an indication that in terms of target populations, The Child Health Guidance Document is a more specific public health policy compared to the Health in all Polices. The use of incremenatlism as an approach to understanding the techniques of developing polies makes the Child Health Guidance Document possible to analyse using the analytical grid. This grid comprises of different policy developmental stages such as the agenda setting stage, the formulation, adoption and implementation stages. This process is made possible due to the existence of a previous program that makes it easier to develop new programs. In addition, through the incremental approach it is easier to eliminate barriers that may be essential inhibitors to the policy process in the United States. Public health policy in the Canadian society can therefore be perceived as a systematic approach based on an understanding of the achievements and failures of previous projects The Health in all Policies is a relatively new process whose understanding is based on the possibility that there is need for the involvement of different groups to facilitate its development. Being a novel public health policy, the Health in All Policies is expected to operate in accordance with the desires of the interest groups and the ability of the government to solve the identified problem (Rudolph et al 2013, p. 14). Inasmuch as the process of policy development includes agenda setting, formulation, adoption and implementations stages, it is always the responsibility of the government to ensure that the formulation and adoption processes are in line with the requirement of the law as the only guiding principle (Raphael et al 2010, p. 14). Recommendations One way through which governs in Canada and the United States can ensure that the process of developing public health polies is sound is by ensuring that the stakeholders understand how policies are developed. This will be based on the understanding that different policies require different approaches to fulfil their objective (Thissen & Warren 2013, p. 47). It is also important for the policy process to be founded on the incorporation of different stakeholders who have a role in influencing the determinants of health. This will make it possible for the government to determine the role of every determinant in influencing different stages in public health formulation and implementation processes (Raphael et al 2010, p.32). Conclusion Through public health policies, the government with the support of different stakeholders has the ability to ensure some form of improvement in the health standards of its population. Through the development of public health policies through government seeks alternative and better ways of addressing major health concerns with the available resources. The approaches used by Canada and the United States in the development and implementation of public policy also share some similarities and differences in their implementation. This is based on the understanding that there is always need to identify implementation parameters, which play a role in affecting the direct outcome of the policy. References Barlow, Hugh D., and Scott H. Decker. 2010. Criminology and public policy: putting theory to work. Philadelphia: Temple University Press. pp. 20 Blair, Kathryn A., and Michaelene P. Mirr Jansen. 2015. Advanced practice nursing: core concepts for professional role development. Cambridge University Press: Cambridge. pp. 55-59 Mason, Diana J., Judith K. Leavitt, and Mary W. Chaffee. 2014. Policy & politics in nursing and health care. Oxfrod University Press: Oxford. pp. 88, 89, 100-102 Ministry of Health Promotion, 2010. Child Health Guidance Document. Queen’s Printer for Ontario: Canada. pp. 4-8 Porche, Demetrius James. 2012. Health policy: application for nurses and other healthcare professionals. Sudbury, MA: Jones & Bartlett Learning. pp. 43, 99, 123 Raphael, Dennis, Marcia H. Rioux, and Toba Bryant. 2010. Staying alive: critical perspectives on health, illness, and health care. Toronto: CSPI, pp.14, 23, 33 Rudolph, Linda., Caplan, Julia, and Dillon, Lianne. 2013. Health in All Polices: A Guide for State and Local Governments. American Public health Association: New York. pp. 6, 13, 23, 14-15 Tatto, Maria Teresa, and Justin Bruner. 2012. Learning and doing policy analysis in education examining diverse approaches to increasing educational access. Rotterdam: SensePublishers. http://dx.doi.org/10.1007/978-94-6091-933-6. pp. 50- 54, 125 Thissen, Wil A. H, and Warren E Walker. 2013. Public Policy Analysis: New Developments. Oxford University Press: Oxford. pp. 33, 40, 79, 80. 140, 150, 155 Weissert, William G., Carol S. Weissert, and Carol S. Weissert. 2012. Governing health: the politics of health policy. Baltimore: Johns Hopkins University Press. pp. 56 Read More