Beyond Evidence Based Policy in Public Health: The Interplay of Ideas

Building on the significant and growing interest in evidence-based policy, this book explores the relationship between research and policy for two prominent public health concerns: health inequalities and tobacco control. It is based on original research, drawing on over a hundred interviews with key informants (including ministers, civil servants and researchers) who have grappled with health inequalities and tobacco control concerns over the past three to four decades. As such, the book provides insiders’ perspectives on the relationship between public health research and policy, both before and during the rise of ‘evidence-based policy’. Both case study topics have featured highly on the UK’s policy agenda during this period, and between them, they provide an important contrast: whilst tobacco control is often held up as a positive example of the influence of research on policy and health (albeit over a relatively long time-frame), there is a great deal of confusion about the role that health inequalities research played in policy during the post-1997 era and much pessimism about the failure of such policies to successfully reduce health inequalities. This contrast enables the book to consider how the relationship between research and policy functions in contrasting contexts.In addition to the book’s use of extensive empirical data, the key feature that distinguishes it from existing texts concerned with the relationship between evidence and policy is the claim that it is ideas, rather than evidence, which are the appropriate unit of analysis for studying this relationship. Whilst this may seem a relatively simple distinction, the book argues that it is also essential as it draws attention to the malleability of knowledge, highlighting how ideas transform as they move. This enables the book to convincingly explain why innovative ideas can travel beyond academia but nevertheless fail to inspire policy change, and why, occasionally, research-based ideas completely transform the way researchers, policymakers and the public think about particular issues. Between them, the case studies demonstrate that ideas are particularly prone to change as they move between actors (who interpret and use new ideas according to their existing values and views) and institutions (the organisation of which causes them to act as filters, facilitating the influence of some ideas whilst blocking the path of others). Through this analysis, the book illustrates how policy influences research (as well as the other way round) and considers the role of research funders in facilitating this influence. Exploring public health academics’ accounts of their efforts to work with, and resist, particular policy paradigms, the book challenges popular approaches to ensuring the utility of research which centre on the need for greater collaboration between research producers and users, arguing instead that the fruitfulness of collaboration depends on the conformity between existing policy and research narratives. This analysis is used to challenge the simplistic dualism between ‘Mode 1’ (traditional, intellectual) and ‘Mode 2’ (problem-solving, applied) research, as the book argues that it may be more helpful to think about the need for public health research which addresses short, medium and long-term goals than to suppose research is either ‘applied’ or ‘intellectual’.In sum, the most important aspects of this book are:• The claim it is ideas, rather than evidence, which represent the appropriate unit of analysis in studies exploring the relationship between public health research and policy;• The attention given to exploring how policy influences research (as well as the other way round) and to considering the role of research funders in mediating the relationship between research and policy;• The use of extensive, qualitative data (from interviews and documentary analysis) to support and illustrate all of the key claims;• The comparative analysis of the relationship between evidence and policy for two distinct and very different public health concerns: tobacco control and health inequalities. This allows the author to provide context-specific recommendations as to how the relationship between public health research and policy might be improved;• The consideration given to the role of advocacy and lobbying in the relationship between public health evidence and policy.