1 / 24

ENHANCING HEALTH POLICY THROUGH EPIDEMIOLOGY

ENHANCING HEALTH POLICY THROUGH EPIDEMIOLOGY. R.A. Spasoff, MD University of Ottawa. Policy. A set of principles guiding decision-making Public Policy : policy of governments Health Policy : health promotion, health protection, health services (plus…). Healthy Public Policy.

bernad
Download Presentation

ENHANCING HEALTH POLICY THROUGH EPIDEMIOLOGY

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. ENHANCING HEALTH POLICY THROUGH EPIDEMIOLOGY R.A. Spasoff, MD University of Ottawa

  2. Policy • A set of principles guiding decision-making • Public Policy: policy of governments • Health Policy: health promotion, health protection, health services (plus…)

  3. Healthy Public Policy • From health promotion movement • Use of policy in all sectors to promote health • Policy can also contribute to disease prevention and treatment at all levels

  4. Policy Instruments • Legislation and regulations • Taxation and financial incentives • Information and coordination • Provision of direct service

  5. The Basis of Policy • Values • Ideology • Politics • Evidence • Not usually the main influence on policy, but worth fighting for • The main contribution of epidemiology

  6. Premise of this presentation • Decisions must be made, regardless of the quality of the supporting evidence • Some evidence is better than no evidence • Epidemiology can provide much of the important evidence

  7. Policy Analysis • The process of predicting the impacts of possible policies and evaluating past policies • Epidemiology can make a major contribution to both steps

  8. Tugwell’s Iterative Loop • 1. Burden of illness • 2. Aetiology or causation • 3. Community effectiveness • 4. Efficiency • 5. Synthesis & Implementation • 6. Monitoring of Program • 7. Reassessment

  9. Policy Cycle • 1. Assessment of population health • 2. Assessment of potential interventions • 3. Policy choices • 4. Policy implementation • 5. Policy evaluation

  10. 1. Assessment of population health • Demography, population dynamics • Descriptive epidemiology: • Measure the health of the population • Identify trends and patterns • Assess health risks • Assess health needs • Identify priority targets for policy development • Analytical epidemiology • Individual-level and population-level causes

  11. 2. Assessment of potential interventions • Identify potential policy interventions • Synthesize existing knowledge regarding their effectiveness • Contribute relevant new research • Assess the potential of each approach

  12. 3. Policy choices • Project impact of potential interventions on the health of the population • Computer simulations of different interventions • Assist the process of consensus development

  13. 4. Policy implementation • Help to set targets for the chosen policies • Inform needs-based resource allocation for health services • Guide development of information systems

  14. 5. Policy evaluation • Assess the impacts of policies • Monitor future health

  15. Epidemiology & Health Policy: three examples • Healthy People 2010 (and Health 21) • goal-setting, targets • Global Burden of Disease • ethical basis, DALYs • Public Health Status and Forecasts in the Netherlands • integrated process

  16. Why epidemiology has had a limited influence • Our fault • Emphasis on aetiologic research • Grime avoidance • Focus on individual-level risk actors • Not our fault • Different backgrounds from policy-makers • Different values • Different time scales • Lack of credibility (often not “real MDs”)

  17. Towards a larger role: relevant expertise • Policy and its formation • Descriptive epidemiology • Population health data • Social determinants of health • Health and disease modelling • Geographical information systems • Multilevel modelling • Population dynamics

  18. Towards a larger role:a developing discipline • Teaching (see course description) • Professional societies • Broadened role for journals • Policy-relevant research • Inequalities in health • Measuring health needs • Multilevel analyses of health • Health and disease modelling • Communication skills, research transfer • Working with policy-makers

  19. Epidemiology for Health Policy: Objectives • To provide students with: • 1. knowledge of how health policy is developed and used; • 2. knowledge of epidemiologic methods relevant to the development of health policy; and • 3. the skills to use that knowledge, in collaboration with policy-makers

  20. Epidemiology for Health Policy: Topics (1) • Policy and Health Policy • Policy Formulation • Ethics, Politics & Communication • Measuring Population Health • Health Burden and Health Needs • Assessing Causation • Assessing Interventions

  21. Epidemiology for Health Policy: Topics (2) • Disease Control • Disease Modelling • Priority-setting • Impact Assessment & Goal-setting • Resource Allocation • Policy Evaluation

  22. Policy-relevant thesis topics • Small-area estimation of health • Adapting “Prevent” to Ontario • Small-area variations in health care • Evaluating a restricted driver licensing policy • Modelling mammographic screening beyond age 69 • Economic burden of breast-feeding • Income inequality and health (two theses, one using multilevel analysis)

  23. Relevant resources: Books • Spasoff, Epidemiologic Methods for Health Policy, 1999 • Brownson/Petitti, Applied Epidemiology, 1998 • Young, Population Health, 1998. • Petitti, Meta-Analysis, Decision Analysis, and Cost-effectiveness Analysis (2nd ed), 2001 • Gray, Evidence-based Healthcare, 1997

  24. Relevant resources: Journals • International Journal of Epidemiology • Journal of Epidemiology and Community Health • British Medical Journal • Journal of Public Health Policy • Public Health Reports • American Journal of Public Health

More Related