Health equity

Health equity implications of COVID-19

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Bringing in critical frameworks to investigate agenda-setting for the social determinants of health: Lessons from a multiple framework analysis

Author/s (editor/s):

Townsend, B.,
Strazdins, L.,
Harris, P. et al.

Publication year:

2021

Publication type:

Journal article

Find this publication at:
https://doi.org/10.1016/j.socscimed.2020.112886

Public health scholars have increasingly called for greater attention to the political and policy processes that enable or constrain successful prioritisation of health on government agendas. Much research investigating policy agenda-setting in public health has focused on the use of single frameworks, in particular Kingdon’s Multiple Streams Framework. More recently, scholars have argued that blending complementary policy frameworks can enable greater attention to a wider range of drivers that influence government agendas away from or towards progressive social and health policies. In this paper, we draw on multiple policy process frameworks in a study of agenda-setting for Australia’s first national paid parental leave scheme. Introduced in 2011 after decades of advocacy, this scheme provides federal government-funded parental leave for eighteen weeks’ pay at the minimum wage for primary caregivers, with evaluations showing improved health and equity outcomes. Drawing on empirical data collected from documentary sources and interviews with 25 key policy informants, we find that a combination of policy frameworks; in this case, Kingdon’s Multiple Streams; Advocacy Coalition Framework; Punctuated Equilibrium; Narrative Policy Framework; and Policy Feedback helped explain how this landmark social policy came about. However, none of these frameworks were adequate without situating them within a critical feminist lens which enabled an explicit focus on the gendered nature of power. We argue that, alongside making use of policy process frameworks, social determinants of health policy research needs to engage with critical frameworks which share an explicit agenda for improving people’s daily living conditions and the re-distribution of power, money, and resources in ways that promote health equity.

Cite the publication as

Belinda Townsend, Lyndall Strazdins, Patrick Harris, Fran Baum, Sharon Friel, Bringing in critical frameworks to investigate agenda-setting for the social determinants of health: Lessons from a multiple framework analysis, Social Science & Medicine,Volume 250, 2020, 112886, ISSN 0277-9536

Advancing a health equity agenda across multiple policy domains: a qualitative policy analysis of social, trade and welfare policy

Author/s (editor/s):

Townsend, Belinda
Friel, Sharon
Freeman T, et al

Publication year:

2020

Publication type:

Journal article

Find this publication at:
https://bmjopen.bmj.com/content/10/11/e040180

Objective While there is urgent need for policymaking that prioritises health equity, successful strategies for advancing such an agenda across multiple policy sectors are not well known. This study aims to address this gap by identifying successful strategies to advance a health equity agenda across multiple policy domains.

Design We conducted in-depth qualitative case studies in three important social determinants of health equity in Australia: employment and social policy (Paid Parental Leave); macroeconomics and trade policy (the Trans Pacific Partnership agreement); and welfare reform (the Northern Territory Emergency Response). The analysis triangulated multiple data sources included 71 semistructured interviews, document analysis and drew on political science theories related to interests, ideas and institutions.

Results Within and across case studies we observed three key strategies used by policy actors to advance a health equity agenda, with differing levels of success. The first was the use of multiple policy frames to appeal to a wide range of actors beyond health. The second was the formation of broad coalitions beyond the health sector, in particular networking with non-traditional policy allies. The third was the use of strategic forum shopping by policy actors to move the debate into more popular policy forums that were not health focused.

Conclusions This analysis provides nuanced strategies for agenda-setting for health equity and points to the need for multiple persuasive issue frames, coalitions with unusual bedfellows, and shopping around for supportive institutions outside the traditional health domain. Use of these nuanced strategies could generate greater ideational, actor and institutional support for prioritising health equity and thus could lead to improved health outcomes.

Cite the publication as

Townsend, B, Friel, S, Freeman, T et al. 2020, ‘Advancing a health equity agenda across multiple policy domains: a qualitative policy analysis of social, trade and welfare policy’, BMJ Open, no. 10:e040180. doi: 10.1136/bmjopen-2020-040180

Explaining covid-19 performance: what factors might predict national responses?

Author/s (editor/s):

Fran Baum et al.

Publication year:

2021

Publication type:

Journal article

Find this publication at:
https://doi.org/10.1136/bmj.n91

Cite the publication as

Baum Fran, Freeman Toby, Musolino Connie, Abramovitz Mimi, De Ceukelaire Wim, Flavel Joanne et al. Explaining covid-19 performance: what factors might predict national responses? BMJ 2021; 372 :n91

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