Sidestepping the Stalemate: The Strategies of Public Health Actors for Circulating Evidence into the Policy Process

Abstract

AbstractThe premise of this book is that public health policy is locked in a stalemate between the evidence-based and the politics-driven policy-making perspectives. This chapter argues that local public health actors on the ground develop strategies to work around this stalemate and circulate their evidence into the policy process. These strategies are indicative of a politically savvy conception of the policy process. The argument builds on data from an empirical study of active transportation policies in Montréal and Toronto (Canada) using the Advocacy Coalition Framework (ACF). In several instances, public health actors sidestepped political constraints by circulating their data to non-governmental organizations (NGOs) and citizens or by building “coalitions” with stakeholders sharing similar policy values. We argue that these strategies for circulating evidence show how science and politics are intertwined in local practices. Local public health actors sometimes take the moral high ground but are also keenly attentive and attuned to local politics. The following strategies could help sidestep the stalemate: better connecting public health evidence with practical policy solutions; developing sustained interactions with non-public health actors working with or advocating for these policy solutions and getting the help of boundary actors skilled in connecting problems and solutions across policy sectors.