Advertisement

Canadian Journal of Public Health

, Volume 108, Issue 2, pp e199–e204 | Cite as

A surgical intervention for the body politic: Generation Squeeze applies the Advocacy Coalition Framework to social determinants of health knowledge translation

  • Paul KershawEmail author
  • Eric Swanson
  • Andrea Stucchi
Innovations in Policy and Practice

Abstract

SETTING: The World Health Organization Commission on the Social Determinants of Health (SDoH) observes that building political will is central to all its recommendations, because governments respond to those who organize and show up. Since younger Canadians are less likely to vote or to organize in between elections, they are less effective at building political will than their older counterparts. This results in an age gap between SDoH research and government budget priorities. Whereas Global AgeWatch ranks Canada among the top countries for aging, UNICEF ranks Canada among the least generous OECD (Organisation for Economic Co-operation and Development) countries for the generations raising young children.

INTERVENTION: A surgical intervention into the body politic. Guided by the “health political science” literature, the intervention builds a non-profit coalition to perform science-based, non-partisan democratic engagement to increase incentives for policy-makers to translate SDoH research about younger generations into government budget investments.

OUTCOMES: All four national parties integrated policy recommendations from the intervention into their 2015 election platforms. Three referred to, or consulted with, the intervention during the election. The intervention coincided with all parties committing to the single largest annual increase in spending on families with children in over a decade.

IMPLICATIONS: Since many population-level decisions are made in political venues, the concept of population health interventions should be broadened to include activities designed to mobilize SDoH science in the world of politics. Such interventions must engage with the power dynamics, values, interests and institutional factors that mediate the path by which science shapes government budgets.

Key Words

Knowledge translation health policy social determinants of health 

Résumé

LIEU: La Commission des déterminants sociaux de la santé (DSS) de l’Organisation mondiale de la santé observe que la création d’une volonté politique est au cœur de toutes ses recommandations, car les gouvernements répondent à ceux qui s’organisent et qui sont visibles. Comme les jeunes Canadiens sont moins susceptibles de voter ou de s’organiser entre les élections, ils réussissent moins bien à susciter une volonté politique que leurs compatriotes plus âgés. Cela creuse un fossé des âges entre la recherche sur les DSS et les priorités budgétaires gouvernementales. Global AgeWatch classe le Canada parmi les meilleurs pays où vieillir, mais l’UNICEF le classe parmi les pays les moins généreux de l’OCDE (Organisation de coopération et de développement économiques) envers les générations qui élèvent de jeunes enfants.

INTERVENTION: Une intervention chirurgicale dans le corps politique. Guidée par la documentation sur la «science politique de la santé», cette intervention crée une coalition à but non lucratif pour faire de la mobilisation démocratique apolitique fondée sur la science afin d’inciter les responsables des politiques à traduire la recherche sur les DSS des jeunes générations en investissements budgétaires gouvernementaux.

RÉSULTATS: Les quatre partis nationaux ont intégré les recommandations de principe de l’intervention dans leurs plateformes électorales de 2015. Trois d’entre eux ont fait référence à l’intervention, ou en ont consulté les responsables, durant l’élection. L’intervention a coïncidé avec l’engagement de tous les partis à opérer la plus grande hausse annuelle des dépenses en faveur des familles avec enfants en plus d’une décennie.

CONSÉQUENCES: Comme de nombreuses décisions au niveau des populations sont prises dans l’arène politique, il faudrait élargir le concept des interventions en santé des populations pour inclure des activités visant à mobiliser la science des DSS dans le monde de la politique. De telles interventions doivent aborder la dynamique du pouvoir, les valeurs, les intérêts et les facteurs institutionnels qui aplanissent la voie à la science pour qu’elle puisse influencer les budgets gouvernementaux.

Mots Clés

application des connaissances politique de santé déterminants sociaux de la santé 

References

  1. 1.
    Keating DP, Hertzman C (Eds.). Developmental Health and the Wealth of Nations: Social, Biological, and Educational Dynamics. New York, NY: The Guilford Press, 1999.Google Scholar
  2. 2.
    Global AgeWatch. Global AgeWatch Index. 2013. Available at: http://www.helpage.org/global-agewatch/ (Accessed March 25, 2014).Google Scholar
  3. 3.
    UNICEF. The Child Care Transition: A League Table of Early Childhood Education and Care in Economically Advanced Countries. Innocenti Report Card 8. Florence, Italy: UNICEF Innocenti Research Centre, 2008. Available at: http://www.unicef.ca/portal/Secure/Community/502/WCM/HELP/take_action/Advocacy/rc8.pdf (Accessed July 31, 2009).Google Scholar
  4. 4.
    Vanhuysse P. Intergenerational Justice in Aging Societies: A Cross-National Comparison of 29 OECD Countries. Gütersloh, Germany: Bertelsmann Stiftung, 2013. Available at: www.sgi-network.org/pdf/Intergenerational_ Justice_OECD.pdf (Accessed November 18, 2014).Google Scholar
  5. 5.
    Commission on the Social Determinants of Health. Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health. Final Report of the Commission on Social Determinants of Health. Geneva, Switzerland: World Health Organization, 2008; p. 109. Available at: http://www.who.int/social_determinants/thecommission/finalreport/en/index.html (Accessed January 15, 2010).Google Scholar
  6. 6.
    National Collaborating Centre on the Determinants of Health. Our Work. Antigonish, NS: NCCDH, 2016. Available at: http://nccdh.ca/our-work/ participate-in-policy-development-and-advocacy/ (Accessed December 29, 2016).Google Scholar
  7. 7.
    Kickbusch I. Foreword: We need to build a health political science. In: Clavier C, de Leeuw E (Eds.), Health Promotion and the Policy Process. Oxford, UK: Oxford University Press, 2013; iii–iv.Google Scholar
  8. 8.
    Clavier C, de Leeuw E. Framing public policy in health promotion: Ubiquitous, yet elusive. In: Clavier C, de Leeuw E (Eds.), Health Promotion and the Policy Process. Oxford, UK: Oxford University Press, 2013; 1–22.CrossRefGoogle Scholar
  9. 9.
    Raphael D. Beyond policy analysis: The raw politics behind opposition to healthy public policy. Health Promot Int 2015;30(2):380–96. PMID: 24870808. doi: 10.1093/heapro/dau044.CrossRefGoogle Scholar
  10. 10.
    Mikkonen J, Raphael D. Social Determinants of Health: The Canadian Facts. Toronto, ON: York University School of Health Policy and Management, 2010. Available at: http://www.thecanadianfacts.org/ (Accessed December 24, 2015).Google Scholar
  11. 11.
    de Leeuw E, Breton E. Policy change theories in health promotion research: A review. In: Clavier C, de Leeuw E (Eds.), Health Promotion and the Policy Process. Oxford, UK: Oxford University Press, 2013; 23–42.CrossRefGoogle Scholar
  12. 12.
    Sabatier P. Theories of the Policy Process. Boulder, CO: Westview Press, 2014; p. 208.Google Scholar
  13. 13.
    Weible C, Sabatier P. A guide to the Advocacy Coalition Framework. In: Fischer F, Miller GJ, Sidney MS (Eds.), Handbook of Public Policy Analysis: Theory, Politics, and Methods. Boca Raton, FL: CRC Press, 2006; 123–36.CrossRefGoogle Scholar
  14. 14.
    Kershaw P. Population Aging, Generational Equity and the Middle-Class. Vancouver, BC: Generation Squeeze, 2015. Available at: http://bit.ly/GSMiddleClass (Accessed September 2, 2016).Google Scholar
  15. 15.
    Kershaw P. Measuring the Age Gap in Canadian Social Spending. Vancouver, BC: Generation Squeeze, 2015. Available at: http://bit.ly/GSageGAP (Accessed September 2, 2016).Google Scholar
  16. 16.
    Kershaw P, Anderson L. Federal Favouritism: Why Does the Federal Government Spend Five Times More Per Retiree Than Per Person Under 45? Vancouver, BC: Generation Squeeze, 2015. Available at: http://bit.ly/GSFedFavouritism (Accessed September 2, 2016).Google Scholar
  17. 17.
    Kershaw P. By the Numbers: A Generational Guide to Voting in the 2015 Federal Election. Vancouver, BC: Generation Squeeze, 2015. Available at: http://bit.ly/GSByTheNumbers (Accessed September 2, 2016).Google Scholar
  18. 18.
    Kershaw P, Anderson L. Measuring the age distribution in Canadian social spending. Can Public Admin 2016;59(4):556–79. doi: 10.1111/capa.12193.CrossRefGoogle Scholar
  19. 19.
    Haidt J. The Righteous Mind: Why Good People are Divided by Politics and Religion. New York, NY: Pantheon Books, 2012.Google Scholar
  20. 20.
    Sachs J. Winning the Story Wars: Why Those Who Tell–and Live–the Best Stories Will Rule the Future. Boston, MA: Harvard Business Review Press, 2012.Google Scholar
  21. 21.
    Ganz M. Public narrative, collective action and power. In: Odugbemi S, Lee T (Eds.), Accountability Through Public Opinion: From Inertia to Public Action. Washington, DC: The World Bank, 2011; 273–90.CrossRefGoogle Scholar
  22. 22.
    Ganz M. Why David sometimes wins: Strategic capacity in social movements. In: Messick DM, Kramer RM (Eds.), The Psychology of Leadership: New Perspectives and Research. Mahwah, NJ: Lawrence Earlbaum Associates Inc., 2005; 209–38.Google Scholar
  23. 23.
    Murray P. The secret of scale. Stanford Soc Innovation Rev 2013;(Fall):32–39.Google Scholar
  24. 24.
    Mitton C, Adair CE, McKenzie E, Patten SB, Waye Perry B. Knowledge transfer and exchange: Review and synthesis of the literature. Milbank Q 2007; 85(4):729–68. PMID: 18070335. doi: 10.1111/j.1468-0009.2007.00506.x.CrossRefGoogle Scholar
  25. 25.
    Contandriopoulos D, Lemire M, Denis JL, Tremblay E. Knowledge exchange processes in organizations and policy arenas: A narrative systematic review of the literature. Milbank Q 2010;88(4):444–83. PMID: 21166865. doi: 10.1111/j.1468-0009.2010.00608.x.CrossRefGoogle Scholar
  26. 26.
    Brown TM, Fee E. Social movements in health. Annu Rev Public Health 2014; 35:385–98. PMID: 24328986. doi: 10.1146/annurev-publhealth-031912-114356.CrossRefGoogle Scholar

Copyright information

© The Canadian Public Health Association 2017

Authors and Affiliations

  1. 1.School of Population and Public HealthUniversity of British ColumbiaVancouverCanada
  2. 2.Generation SqueezeVancouverCanada
  3. 3.School of Population and Public HealthUniversity of British ColumbiaVancouverCanada

Personalised recommendations