Public Health & Policy: Decision-Making Driven by Equitable Health

A great baseline understanding of public health functions begins by grappling with the Center for Disease Control (CDC)’s framework of the 10 Essential Public Health Services¹. This framework helps to delineate the general aim of public health as working towards promoting the health of people in all communities in an equitable way. Of the various avenues working toward this goal, ‘policy development’ is a key area that provides the structure and clarity needed to act, make change, and implement meaningful plans. These plans (which eventually become law and policy) build upon research, evaluation, and assessment and are driven by circumstances that produce new understanding. 

Health policy exists to cultivate these plans, and to establish pathways for professionals to take their work and propose evidence-based solutions to improve or change the health of communities. Public health cannot operate without health policy; it is not feasible to implement policies without ensuring there is effort around the management of these policies. Therefore, oftentimes, health policy and management are grouped together into one distinct area. This fusion can be further confusing, yet it speaks to the two areas’ similarity in helping as guiding forces to structurally keep public health systems running smoothly. 

Within the CDC framework¹, health management could potentially merge within other avenues (such as assurance or even assessment). However, given how much health policy and management go in tandem with one another, it makes sense to consider it as part of the more structural, administrative, systems-oriented side of public health. As such, studying these overlapping fields is a great area to enter the realm of public health; these essential areas serve as a backbone and anchor in many ways.

Health policy has evolved as public health grows more prominent and well-understood. Now, more than ever before, there is an understanding of the concept of how health policy can impact all communities. Recent developments in the field, especially post COVID-19, have shed light on the pervasive inequities within health opportunities and outcomes many face. Health equity is no longer seen as a perspective in the future of the field, but rather it has become a building block on which all successful public health endeavors must stand. As a result of substantial attention and subsequent allocated resources, research has focused on amplifying the understanding of historical health inequities. This shift is long overdue and will certainly require continual momentum and effort to make the needed change of incorporating equity in all aspects of public health. 

Excitingly, health policy now often requires the inclusion of health equity, which in effect leads to increased effort even by organizations and companies that might not otherwise focus on this work. Health in All Policies² is an example of this kind of work growing in popularity and comprehension. The COVID-19 pandemic demonstrated the need for bolstered policy-making that emphasizes equity and is clearly adapted to the pre-existing structures that cause inequities. This is a crucial moment within public health policy given that we are building upon what was previously understood as policy and introducing a new, evolved form. 

Understanding how to tackle issues that might not be solved by one mandate, law, policy, or other must use the resources that other areas of public health practice offer to make informed decisions for all.

What really is public health policy, and what does one do within the field? This question is not simply answered, as we have alluded to above, given how ubiquitous health policy is in all realms of public health. Policy can take many forms, and therefore often is differently defined and structured depending upon the organization, role, branch of work, and beyond. A commonly used term for those working within public health policy is the title “policy analyst” or “public health analyst.” A strong working definition from the Bureau of Labor Statistics describes this role, “Policy analysts—also called researchers, scholars, and fellows—work to raise public awareness of social issues, such as crime prevention, access to health care, and protection of the environment. And in the solutions they propose, these policy analysts hope to influence government action.³” 

A health policy analyst often performs duties that relate to an organization’s guidelines and regulations. This can be at the government-level, within a hospital system, as part of a non-profit, or any other entity that performs acts related to public health and health policy. Health policy analysts are a key role within the realm of Health Policy and Management, but there are many others that serve similar functions and require the same set of skills and educational background. Becoming a health policy analyst often requires a secondary degree, such as an MPH, a JD, or another graduate degree like a Master of Public Policy. 

Depending upon the intended role you might have as a health policy professional, we highly recommend connecting with those already in the field to gain exposure and guidance on where you might begin learning. Any experience one can gain at any policy level will be paramount to better understanding the nature of health policy and what might be the best fit.

Public health policy practitioners often have research as a quintessential aspect of the role and work. Understanding existing policies in depth is paramount to informing future policy decisions. Therefore, this kind of work requires tenacity, curiosity, and integrity. To thrive, one must feel comfortable with asking tough questions, and be able to parse apart fact from opinion. These skills can be developed over time. 

The nature of approaching policy analysis has a clear structure, and while not fully uniform in the path one must take, having a strong outline of where to begin start by defining the problem and complexity of the policy options before you.⁴ Health policy work can feel like a fusion of research and advocating; the two operations go hand-in-hand to thoroughly examine what policies might be most effective in specific situations, communities, and environments. 

Generally, the options for pursuing studies in public health policy are at the graduate level. With healthcare occupations projected to grow 13% from 2021 to 2031, health policy is likely to have parallel growth given its pervasive ability to affect all areas of public health.⁵ Policy analysis often is grouped within Political Science job positions, which is expected to grow 6% over the same time period.⁶ Promising advances have also led to an increase in awareness of the utility of this field, and more broadly of policy analysis, within public health. Health equity implementation is a new horizon for this field. 

Ideally, as this awareness has helped inform the public to see public health as the quintessential field that it is, so, too, will it encourage increased funding streams to better support the work. There are many exciting areas of growth within the practice of health policy, and now is a great time to move forward and pursue a career within public health. Start here with our advice on how to choose the best MPH programto fit your needs!