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Social determinants of health and health equity policy research: Exploring the use, misuse, and nonuse of policy analysis theory

机译：健康与健康公平政策研究的社会决定因素：探讨政策分析理论的使用，滥用和不使用

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Despite a dramatic growth in SDH/HE (social determinants of health/health equity) public policy research and demonstrated government interest in promoting equity in health policies, health inequities are actually growing among some populations and there is little evidence that "healthy public policies" are being adopted and implemented. Moreover, these issues are typically failing to even reach governments' policy agendas, which is a critical step towards serious debate and the identification of policy options. This systematic review pursues three main objectives. First, is to identify barriers to SDH/HE issues reaching the government policy agenda. Second, to evaluate the characteristics of peer-reviewed research articles that utilize common policy analysis theories. And third, to determine the extent to which the SDH/HE literature utilizes common policy analysis theories. Our systematic review, conducted in June 2012, identified 6200 SDH/HE related articles in the peer-reviewed literature; however, only seven articles explicitly used a commonly recognized policy analysis theory to inform their analysis. Our analysis revealed that the SDH/HE policy literature appears to be focused on advocacy rather than analysis and that the use of policy analysis theory is extremely limited. Our results also suggest that when such theories are incorporated into an analysis they are often not comprehensively employed. We propose explanations for this non-use and misuse of policy analysis theory, and conclude that researchers may have greater influence in helping to get SDH/HE issues onto government policy agendas if they gain a greater understanding of the policy process and the value of incorporating policy analysis theories into their research. Using a policy analysis lens to help identify why healthy public policies are typically not being adopted is an important step towards moving beyond advocacy to understanding and addressing some of the political barriers to reforms.
机译：尽管SDH / HE（健康/健康公平的社会决定因素）公共政策研究显着增长，并显示出政府对促进健康政策公平性的兴趣，但实际上某些人群中的健康不平等现象正在加剧，几乎没有证据表明“健康的公共政策”正在被采用和实施。此外，这些问题通常甚至都没有达到政府的政策议程，这是进行认真辩论和确定政策选择的关键一步。这项系统的审查追求三个主要目标。首先，要确定阻碍SDH / HE问题达到政府政策议程的障碍。第二，评估利用共同政策分析理论的同行评审研究文章的特征。第三，确定SDH / HE文献在多大程度上利用通用的政策分析理论。我们于2012年6月进行的系统评价在同行评审文献中发现了6200篇SDH / HE相关文章;但是，只有七篇文章明确地使用了公认的政策分析理论来进行分析。我们的分析表明，SDH / HE政策文献似乎侧重于倡导而非分析，并且政策分析理论的使用极为有限。我们的结果还表明，将此类理论纳入分析时，通常不会对其进行全面采用。我们提出对这种不使用和滥用政策分析理论的解释，并得出结论，如果研究人员对政策过程和整合的价值有了更深入的了解，他们可能在帮助将SDH / HE问题纳入政府政策议程方面发挥更大的影响力政策分析理论进入他们的研究。使用政策分析的角度来帮助确定为什么通常不采用健康的公共政策是迈向从倡导转向理解和解决改革的某些政治障碍的重要一步。

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