This publish continues the dialogue that begins in What’s politics? It informs a chat on prevention for Public Well being Affiliation Australia Preventive Well being Convention 2025 ‘Prevention is Political’
The politics of prevention includes (1) deciding who’s accountable for (2) translating the obscure idiom ‘prevention is best than treatment’ into concrete selections about what prevention is, what coverage options and processes would change, and the way a lot of a precedence it ought to be.
For instance, our e-book Why Isn’t Authorities Coverage Extra Preventive? (free Introduction and Conclusion) compares two methods to make sense of prevention and provoke political debate.
First, in public well being, prevention can discuss with a particular agenda to forestall or scale back non-communicable illnesses (NCDs) related to smoking, alcohol, unhealthy meals, inactivity or weight problems, or air pollution. For instance, ‘complete tobacco management’ includes excessive state intervention to supply a set of coverage devices, akin to rules on tobacco merchandise, how corporations can promote, and the place folks might smoke; taxes and duties to lift the value; providers to assist folks cease (or be handled for ill-health); and well being training (together with stark messages on merchandise) (e.g. within the UK).
The politics of tobacco contains debate on (1) how you can body the problem, akin to a authorized product with financial worth or a dangerous substance contributing to an epidemic of NCDs and well being inequalities, and (2) how far the state ought to intervene, from solely giving data to prohibiting behaviour. In international locations just like the UK and Australia, maybe this debate has been received, but it surely took a long time to translate proof into coverage, and there stays excessive contestation every time a authorities proposes a brand new instrument, akin to to ban smoking in vehicles with kids or elevate the smoking age every year.
Second, prevention could be a extra ambiguous agenda for coverage change and policymaking reforms, together with Well being in All Insurance policies but in addition wider social coverage or preventing-spending initiatives throughout authorities. In Why is well being enchancment coverage so tough to safe? and new analysis we relate key obstacles to progress – prevention coverage’s lack of readability, congruity, and capability – to unresolved and contested selections.
Deciding what prevention means (‘readability’)
The politics of prevention contains (1) the extent of state accountability and intervention (what coverage devices to make use of), and (2) the allocation of assets to ranges of prevention or particular social teams.
For some, prevention symbolises an ethical agenda to assist social justice: there ought to be excessive state intervention to forestall or scale back poor outcomes (akin to unwell well being) and inequalities (such because the unequal unfold of NCDs). State intervention might embody taxing and spending to scale back financial inequalities, or the reallocation of public providers to mitigate their impression. There could also be an specific coverage to scale back inequalities in relation to components akin to race or ethnicity, gender, or incapacity (akin to laws to problem discrimination).
For some, prevention symbolises extra pragmatic or urgent goals, akin to to scale back demand on public providers. It’d contain excessive state intervention to affect enterprise and social behaviour, a push to combine public providers, or a deal with giving folks extra details about how you can enhance their very own wholesome behaviour. Decreasing well being inequalities could also be a major purpose or byproduct of such insurance policies.
There may be additionally some doubt about which stage of prevention to prioritise: major prevention, or essentially the most bold ‘upstream’ complete inhabitants measures; secondary prevention, to establish interventions for teams prone to hurt; and, tertiary prevention, to forestall current circumstances getting worse. You may agree with all three, however allocating extra assets to at least one suggests fewer assets for an additional.
Rising political points might also range by sector, akin to to focus on the allocation of tertiary assets in keeping with age in healthcare (e.g. providers for older folks) or the secondary prevention downside of figuring out at-risk teams in social coverage (e.g. early intervention for kids and fogeys).
Deciding what ought to change (‘congruity’)
Prevention will be bought as a radical various to the established order or a way to mainstream prevention in routine authorities enterprise.
The unconventional agenda is clearly ‘political’, together with a direct problem to the coverage options and processes contributing to poor and unequal outcomes.
Nonetheless, agendas like HiAP, and preventive goals in public service integration, typically search to depoliticise this course of, akin to to stress pragmatism and win-win options primarily based on attempting to mainstream public well being or match prevention concepts into present authorities routines. Right here, we might deal with ‘political astuteness’ to attach new goals to the agendas of elected politicians, the ‘micropolitics’ of cooperation when skilled and organisational guidelines or cultures collide, or one type of policymaking undermining one other (e.g. Godziewski on the EU guidelines and norms that undermine HiAP by favouring financial goals and together with trade actors in public well being coverage).
Deciding between goals and setting priorities (‘capability’)
Getting high-level assist for an agenda like ‘prevention’ might look like a win. Nonetheless, a authorities’s rhetorical dedication to a brand new agenda can sign (1) honest and energetic assist, or (2) the need to make use of a buzzword as an alternative choice to motion.
Certainly, it’s common in public well being and social coverage analysis to narrate this downside to politics: a scarcity of ‘political will’ to show a brand new dedication into concrete motion when (1) politicians face opposition from vested pursuits, and/or (2) their greater dedication to ‘neoliberalism’ (to favour financial progress and restrict state intervention) overshadows their dedication to scale back inequalities.
On this case, insights from coverage course of analysis relate to the necessity to make an analytical separation between:
- the precise political motion (or inaction) that undermine progress, and
- the systemic limits to coverage change when policymakers interact in a fancy policymaking surroundings over which they’ve restricted understanding and management.
In different phrases, what are the dynamics that may undermine progress (in the direction of integration or coherence) even when prevention is backed by essentially the most honest and energetic politicians? This thought-exercise helps to keep away from the idea that any lack of progress is brought on by poor politics or low-energy politicians.
We might also mix 1 and a couple of to establish the impact of high-level political selections on preventive policymaking. For instance, in ‘Westminster’ techniques, the macro-political selection is to take care of and prioritise excessive stakes accountability through frequent elections, with main knock-on results together with: devoting most political consideration, assets, and efficiency administration to short-term success in relation to high-profile providers akin to healthcare. This focus comes on the expense of prevention, particularly if the story is of funding for the long-term that struggles to suit into short-term measures of success (e.g. within the UK).
Now learn on:
I additionally made pretty comparable factors as a part of an ANZSOG tour again within the day, together with: Prevention is best than treatment, so why aren’t we doing extra of it?
This publish continues the dialogue that begins in What’s politics? It informs a chat on prevention for Public Well being Affiliation Australia Preventive Well being Convention 2025 ‘Prevention is Political’
The politics of prevention includes (1) deciding who’s accountable for (2) translating the obscure idiom ‘prevention is best than treatment’ into concrete selections about what prevention is, what coverage options and processes would change, and the way a lot of a precedence it ought to be.
For instance, our e-book Why Isn’t Authorities Coverage Extra Preventive? (free Introduction and Conclusion) compares two methods to make sense of prevention and provoke political debate.
First, in public well being, prevention can discuss with a particular agenda to forestall or scale back non-communicable illnesses (NCDs) related to smoking, alcohol, unhealthy meals, inactivity or weight problems, or air pollution. For instance, ‘complete tobacco management’ includes excessive state intervention to supply a set of coverage devices, akin to rules on tobacco merchandise, how corporations can promote, and the place folks might smoke; taxes and duties to lift the value; providers to assist folks cease (or be handled for ill-health); and well being training (together with stark messages on merchandise) (e.g. within the UK).
The politics of tobacco contains debate on (1) how you can body the problem, akin to a authorized product with financial worth or a dangerous substance contributing to an epidemic of NCDs and well being inequalities, and (2) how far the state ought to intervene, from solely giving data to prohibiting behaviour. In international locations just like the UK and Australia, maybe this debate has been received, but it surely took a long time to translate proof into coverage, and there stays excessive contestation every time a authorities proposes a brand new instrument, akin to to ban smoking in vehicles with kids or elevate the smoking age every year.
Second, prevention could be a extra ambiguous agenda for coverage change and policymaking reforms, together with Well being in All Insurance policies but in addition wider social coverage or preventing-spending initiatives throughout authorities. In Why is well being enchancment coverage so tough to safe? and new analysis we relate key obstacles to progress – prevention coverage’s lack of readability, congruity, and capability – to unresolved and contested selections.
Deciding what prevention means (‘readability’)
The politics of prevention contains (1) the extent of state accountability and intervention (what coverage devices to make use of), and (2) the allocation of assets to ranges of prevention or particular social teams.
For some, prevention symbolises an ethical agenda to assist social justice: there ought to be excessive state intervention to forestall or scale back poor outcomes (akin to unwell well being) and inequalities (such because the unequal unfold of NCDs). State intervention might embody taxing and spending to scale back financial inequalities, or the reallocation of public providers to mitigate their impression. There could also be an specific coverage to scale back inequalities in relation to components akin to race or ethnicity, gender, or incapacity (akin to laws to problem discrimination).
For some, prevention symbolises extra pragmatic or urgent goals, akin to to scale back demand on public providers. It’d contain excessive state intervention to affect enterprise and social behaviour, a push to combine public providers, or a deal with giving folks extra details about how you can enhance their very own wholesome behaviour. Decreasing well being inequalities could also be a major purpose or byproduct of such insurance policies.
There may be additionally some doubt about which stage of prevention to prioritise: major prevention, or essentially the most bold ‘upstream’ complete inhabitants measures; secondary prevention, to establish interventions for teams prone to hurt; and, tertiary prevention, to forestall current circumstances getting worse. You may agree with all three, however allocating extra assets to at least one suggests fewer assets for an additional.
Rising political points might also range by sector, akin to to focus on the allocation of tertiary assets in keeping with age in healthcare (e.g. providers for older folks) or the secondary prevention downside of figuring out at-risk teams in social coverage (e.g. early intervention for kids and fogeys).
Deciding what ought to change (‘congruity’)
Prevention will be bought as a radical various to the established order or a way to mainstream prevention in routine authorities enterprise.
The unconventional agenda is clearly ‘political’, together with a direct problem to the coverage options and processes contributing to poor and unequal outcomes.
Nonetheless, agendas like HiAP, and preventive goals in public service integration, typically search to depoliticise this course of, akin to to stress pragmatism and win-win options primarily based on attempting to mainstream public well being or match prevention concepts into present authorities routines. Right here, we might deal with ‘political astuteness’ to attach new goals to the agendas of elected politicians, the ‘micropolitics’ of cooperation when skilled and organisational guidelines or cultures collide, or one type of policymaking undermining one other (e.g. Godziewski on the EU guidelines and norms that undermine HiAP by favouring financial goals and together with trade actors in public well being coverage).
Deciding between goals and setting priorities (‘capability’)
Getting high-level assist for an agenda like ‘prevention’ might look like a win. Nonetheless, a authorities’s rhetorical dedication to a brand new agenda can sign (1) honest and energetic assist, or (2) the need to make use of a buzzword as an alternative choice to motion.
Certainly, it’s common in public well being and social coverage analysis to narrate this downside to politics: a scarcity of ‘political will’ to show a brand new dedication into concrete motion when (1) politicians face opposition from vested pursuits, and/or (2) their greater dedication to ‘neoliberalism’ (to favour financial progress and restrict state intervention) overshadows their dedication to scale back inequalities.
On this case, insights from coverage course of analysis relate to the necessity to make an analytical separation between:
- the precise political motion (or inaction) that undermine progress, and
- the systemic limits to coverage change when policymakers interact in a fancy policymaking surroundings over which they’ve restricted understanding and management.
In different phrases, what are the dynamics that may undermine progress (in the direction of integration or coherence) even when prevention is backed by essentially the most honest and energetic politicians? This thought-exercise helps to keep away from the idea that any lack of progress is brought on by poor politics or low-energy politicians.
We might also mix 1 and a couple of to establish the impact of high-level political selections on preventive policymaking. For instance, in ‘Westminster’ techniques, the macro-political selection is to take care of and prioritise excessive stakes accountability through frequent elections, with main knock-on results together with: devoting most political consideration, assets, and efficiency administration to short-term success in relation to high-profile providers akin to healthcare. This focus comes on the expense of prevention, particularly if the story is of funding for the long-term that struggles to suit into short-term measures of success (e.g. within the UK).
Now learn on:
I additionally made pretty comparable factors as a part of an ANZSOG tour again within the day, together with: Prevention is best than treatment, so why aren’t we doing extra of it?
This publish continues the dialogue that begins in What’s politics? It informs a chat on prevention for Public Well being Affiliation Australia Preventive Well being Convention 2025 ‘Prevention is Political’
The politics of prevention includes (1) deciding who’s accountable for (2) translating the obscure idiom ‘prevention is best than treatment’ into concrete selections about what prevention is, what coverage options and processes would change, and the way a lot of a precedence it ought to be.
For instance, our e-book Why Isn’t Authorities Coverage Extra Preventive? (free Introduction and Conclusion) compares two methods to make sense of prevention and provoke political debate.
First, in public well being, prevention can discuss with a particular agenda to forestall or scale back non-communicable illnesses (NCDs) related to smoking, alcohol, unhealthy meals, inactivity or weight problems, or air pollution. For instance, ‘complete tobacco management’ includes excessive state intervention to supply a set of coverage devices, akin to rules on tobacco merchandise, how corporations can promote, and the place folks might smoke; taxes and duties to lift the value; providers to assist folks cease (or be handled for ill-health); and well being training (together with stark messages on merchandise) (e.g. within the UK).
The politics of tobacco contains debate on (1) how you can body the problem, akin to a authorized product with financial worth or a dangerous substance contributing to an epidemic of NCDs and well being inequalities, and (2) how far the state ought to intervene, from solely giving data to prohibiting behaviour. In international locations just like the UK and Australia, maybe this debate has been received, but it surely took a long time to translate proof into coverage, and there stays excessive contestation every time a authorities proposes a brand new instrument, akin to to ban smoking in vehicles with kids or elevate the smoking age every year.
Second, prevention could be a extra ambiguous agenda for coverage change and policymaking reforms, together with Well being in All Insurance policies but in addition wider social coverage or preventing-spending initiatives throughout authorities. In Why is well being enchancment coverage so tough to safe? and new analysis we relate key obstacles to progress – prevention coverage’s lack of readability, congruity, and capability – to unresolved and contested selections.
Deciding what prevention means (‘readability’)
The politics of prevention contains (1) the extent of state accountability and intervention (what coverage devices to make use of), and (2) the allocation of assets to ranges of prevention or particular social teams.
For some, prevention symbolises an ethical agenda to assist social justice: there ought to be excessive state intervention to forestall or scale back poor outcomes (akin to unwell well being) and inequalities (such because the unequal unfold of NCDs). State intervention might embody taxing and spending to scale back financial inequalities, or the reallocation of public providers to mitigate their impression. There could also be an specific coverage to scale back inequalities in relation to components akin to race or ethnicity, gender, or incapacity (akin to laws to problem discrimination).
For some, prevention symbolises extra pragmatic or urgent goals, akin to to scale back demand on public providers. It’d contain excessive state intervention to affect enterprise and social behaviour, a push to combine public providers, or a deal with giving folks extra details about how you can enhance their very own wholesome behaviour. Decreasing well being inequalities could also be a major purpose or byproduct of such insurance policies.
There may be additionally some doubt about which stage of prevention to prioritise: major prevention, or essentially the most bold ‘upstream’ complete inhabitants measures; secondary prevention, to establish interventions for teams prone to hurt; and, tertiary prevention, to forestall current circumstances getting worse. You may agree with all three, however allocating extra assets to at least one suggests fewer assets for an additional.
Rising political points might also range by sector, akin to to focus on the allocation of tertiary assets in keeping with age in healthcare (e.g. providers for older folks) or the secondary prevention downside of figuring out at-risk teams in social coverage (e.g. early intervention for kids and fogeys).
Deciding what ought to change (‘congruity’)
Prevention will be bought as a radical various to the established order or a way to mainstream prevention in routine authorities enterprise.
The unconventional agenda is clearly ‘political’, together with a direct problem to the coverage options and processes contributing to poor and unequal outcomes.
Nonetheless, agendas like HiAP, and preventive goals in public service integration, typically search to depoliticise this course of, akin to to stress pragmatism and win-win options primarily based on attempting to mainstream public well being or match prevention concepts into present authorities routines. Right here, we might deal with ‘political astuteness’ to attach new goals to the agendas of elected politicians, the ‘micropolitics’ of cooperation when skilled and organisational guidelines or cultures collide, or one type of policymaking undermining one other (e.g. Godziewski on the EU guidelines and norms that undermine HiAP by favouring financial goals and together with trade actors in public well being coverage).
Deciding between goals and setting priorities (‘capability’)
Getting high-level assist for an agenda like ‘prevention’ might look like a win. Nonetheless, a authorities’s rhetorical dedication to a brand new agenda can sign (1) honest and energetic assist, or (2) the need to make use of a buzzword as an alternative choice to motion.
Certainly, it’s common in public well being and social coverage analysis to narrate this downside to politics: a scarcity of ‘political will’ to show a brand new dedication into concrete motion when (1) politicians face opposition from vested pursuits, and/or (2) their greater dedication to ‘neoliberalism’ (to favour financial progress and restrict state intervention) overshadows their dedication to scale back inequalities.
On this case, insights from coverage course of analysis relate to the necessity to make an analytical separation between:
- the precise political motion (or inaction) that undermine progress, and
- the systemic limits to coverage change when policymakers interact in a fancy policymaking surroundings over which they’ve restricted understanding and management.
In different phrases, what are the dynamics that may undermine progress (in the direction of integration or coherence) even when prevention is backed by essentially the most honest and energetic politicians? This thought-exercise helps to keep away from the idea that any lack of progress is brought on by poor politics or low-energy politicians.
We might also mix 1 and a couple of to establish the impact of high-level political selections on preventive policymaking. For instance, in ‘Westminster’ techniques, the macro-political selection is to take care of and prioritise excessive stakes accountability through frequent elections, with main knock-on results together with: devoting most political consideration, assets, and efficiency administration to short-term success in relation to high-profile providers akin to healthcare. This focus comes on the expense of prevention, particularly if the story is of funding for the long-term that struggles to suit into short-term measures of success (e.g. within the UK).
Now learn on:
I additionally made pretty comparable factors as a part of an ANZSOG tour again within the day, together with: Prevention is best than treatment, so why aren’t we doing extra of it?
This publish continues the dialogue that begins in What’s politics? It informs a chat on prevention for Public Well being Affiliation Australia Preventive Well being Convention 2025 ‘Prevention is Political’
The politics of prevention includes (1) deciding who’s accountable for (2) translating the obscure idiom ‘prevention is best than treatment’ into concrete selections about what prevention is, what coverage options and processes would change, and the way a lot of a precedence it ought to be.
For instance, our e-book Why Isn’t Authorities Coverage Extra Preventive? (free Introduction and Conclusion) compares two methods to make sense of prevention and provoke political debate.
First, in public well being, prevention can discuss with a particular agenda to forestall or scale back non-communicable illnesses (NCDs) related to smoking, alcohol, unhealthy meals, inactivity or weight problems, or air pollution. For instance, ‘complete tobacco management’ includes excessive state intervention to supply a set of coverage devices, akin to rules on tobacco merchandise, how corporations can promote, and the place folks might smoke; taxes and duties to lift the value; providers to assist folks cease (or be handled for ill-health); and well being training (together with stark messages on merchandise) (e.g. within the UK).
The politics of tobacco contains debate on (1) how you can body the problem, akin to a authorized product with financial worth or a dangerous substance contributing to an epidemic of NCDs and well being inequalities, and (2) how far the state ought to intervene, from solely giving data to prohibiting behaviour. In international locations just like the UK and Australia, maybe this debate has been received, but it surely took a long time to translate proof into coverage, and there stays excessive contestation every time a authorities proposes a brand new instrument, akin to to ban smoking in vehicles with kids or elevate the smoking age every year.
Second, prevention could be a extra ambiguous agenda for coverage change and policymaking reforms, together with Well being in All Insurance policies but in addition wider social coverage or preventing-spending initiatives throughout authorities. In Why is well being enchancment coverage so tough to safe? and new analysis we relate key obstacles to progress – prevention coverage’s lack of readability, congruity, and capability – to unresolved and contested selections.
Deciding what prevention means (‘readability’)
The politics of prevention contains (1) the extent of state accountability and intervention (what coverage devices to make use of), and (2) the allocation of assets to ranges of prevention or particular social teams.
For some, prevention symbolises an ethical agenda to assist social justice: there ought to be excessive state intervention to forestall or scale back poor outcomes (akin to unwell well being) and inequalities (such because the unequal unfold of NCDs). State intervention might embody taxing and spending to scale back financial inequalities, or the reallocation of public providers to mitigate their impression. There could also be an specific coverage to scale back inequalities in relation to components akin to race or ethnicity, gender, or incapacity (akin to laws to problem discrimination).
For some, prevention symbolises extra pragmatic or urgent goals, akin to to scale back demand on public providers. It’d contain excessive state intervention to affect enterprise and social behaviour, a push to combine public providers, or a deal with giving folks extra details about how you can enhance their very own wholesome behaviour. Decreasing well being inequalities could also be a major purpose or byproduct of such insurance policies.
There may be additionally some doubt about which stage of prevention to prioritise: major prevention, or essentially the most bold ‘upstream’ complete inhabitants measures; secondary prevention, to establish interventions for teams prone to hurt; and, tertiary prevention, to forestall current circumstances getting worse. You may agree with all three, however allocating extra assets to at least one suggests fewer assets for an additional.
Rising political points might also range by sector, akin to to focus on the allocation of tertiary assets in keeping with age in healthcare (e.g. providers for older folks) or the secondary prevention downside of figuring out at-risk teams in social coverage (e.g. early intervention for kids and fogeys).
Deciding what ought to change (‘congruity’)
Prevention will be bought as a radical various to the established order or a way to mainstream prevention in routine authorities enterprise.
The unconventional agenda is clearly ‘political’, together with a direct problem to the coverage options and processes contributing to poor and unequal outcomes.
Nonetheless, agendas like HiAP, and preventive goals in public service integration, typically search to depoliticise this course of, akin to to stress pragmatism and win-win options primarily based on attempting to mainstream public well being or match prevention concepts into present authorities routines. Right here, we might deal with ‘political astuteness’ to attach new goals to the agendas of elected politicians, the ‘micropolitics’ of cooperation when skilled and organisational guidelines or cultures collide, or one type of policymaking undermining one other (e.g. Godziewski on the EU guidelines and norms that undermine HiAP by favouring financial goals and together with trade actors in public well being coverage).
Deciding between goals and setting priorities (‘capability’)
Getting high-level assist for an agenda like ‘prevention’ might look like a win. Nonetheless, a authorities’s rhetorical dedication to a brand new agenda can sign (1) honest and energetic assist, or (2) the need to make use of a buzzword as an alternative choice to motion.
Certainly, it’s common in public well being and social coverage analysis to narrate this downside to politics: a scarcity of ‘political will’ to show a brand new dedication into concrete motion when (1) politicians face opposition from vested pursuits, and/or (2) their greater dedication to ‘neoliberalism’ (to favour financial progress and restrict state intervention) overshadows their dedication to scale back inequalities.
On this case, insights from coverage course of analysis relate to the necessity to make an analytical separation between:
- the precise political motion (or inaction) that undermine progress, and
- the systemic limits to coverage change when policymakers interact in a fancy policymaking surroundings over which they’ve restricted understanding and management.
In different phrases, what are the dynamics that may undermine progress (in the direction of integration or coherence) even when prevention is backed by essentially the most honest and energetic politicians? This thought-exercise helps to keep away from the idea that any lack of progress is brought on by poor politics or low-energy politicians.
We might also mix 1 and a couple of to establish the impact of high-level political selections on preventive policymaking. For instance, in ‘Westminster’ techniques, the macro-political selection is to take care of and prioritise excessive stakes accountability through frequent elections, with main knock-on results together with: devoting most political consideration, assets, and efficiency administration to short-term success in relation to high-profile providers akin to healthcare. This focus comes on the expense of prevention, particularly if the story is of funding for the long-term that struggles to suit into short-term measures of success (e.g. within the UK).
Now learn on:
I additionally made pretty comparable factors as a part of an ANZSOG tour again within the day, together with: Prevention is best than treatment, so why aren’t we doing extra of it?
