Defining health policy big P and little p November 2013

Summary

This script delves into the intricacies of health policy, highlighting its role as a social construct influenced by cultural values and rhetoric. It distinguishes between 'big P' and 'little P' policies, emphasizing the impact of authoritative government decisions on health at various levels. The script also underscores the importance of policy in shaping public health achievements, such as vaccination mandates and food safety regulations, and calls for public health professionals to understand and engage with these policies to improve health outcomes.

Takeaways

• 🏛️ Policies are socially constructed and reflect our values and priorities, influencing various aspects of health and well-being.
• 🌐 The role of policy in public health achievements, such as safer foods and control of infectious diseases, is crucial in shaping population health outcomes.
• 📊 Policy acts as both a structural determinant of health and a strategy to improve health through advocacy or development.
• 🌟 Health policy is defined as authoritative decisions and actions taken by governments at various levels that pertain to health.
• 🔍 Health policy includes the structures and functioning of government, decisions, rules, goals, regulations, and behaviors that affect health directly or indirectly.
• 🌐 Policy experiences can differ significantly among individuals and populations, highlighting the importance of understanding policy target populations.
• 📚 The distinction between 'Big P' and 'Little P' policies is based on who implements them, with Big P being formal laws and regulations, and Little P being administrative actions to implement Big P.
• 🛡️ Big P policies, such as federal laws and court rulings, establish policy bodies and frameworks, while Little P policies involve the implementation and management of these frameworks.
• 🛠️ Examples of Big P policies include vaccination mandates and motor vehicle safety laws, which aim to increase access and safety through policy requirements.
• 🔑 Little P policies, such as state-level health system organization and Medicaid funding, can have a significant impact on individuals' ability to access and navigate health services.
• 🛑 The impact of policies can be seen in real-world scenarios, such as the challenges faced by non-English speakers in accessing health information and services.

Q & A

What is the primary focus of the discussion in the provided transcript?

The primary focus of the discussion is on health policy, including its definition, the distinction between big P and little P policy, and how policies are socially constructed and impact public health.

What are the two forms of policy mentioned in the transcript?

The two forms of policy mentioned are big P policy and little P policy, which differentiate based on who is implementing or establishing the policy.

How are policies described in the context of being socially constructed?

Policies are described as socially constructed phenomena that reflect our values and are expressed through culturally specific rhetoric and symbology.

What is an example given in the transcript to illustrate the concept of socially constructed policies?

Sexual health education is given as an example, where it is encouraged at the federal level but determined at the state and local level, reflecting cultural values and priorities.

What are some of the top public health achievements of the 20th century mentioned in the transcript?

Some of the top public health achievements include safer and healthier foods, control of infectious diseases, family planning, vaccinations, and motor vehicle safety.

What is the role of policy in the context of vaccination as discussed in the transcript?

The role of policy in vaccination is to increase access through mandates and funding, such as school entrance requirements for vaccinations.

How does the transcript define health policy?

Health policy is defined as authoritative decisions made and actions taken by governments at various levels that pertain to health, including structures, functioning, actions, outcomes, and their implications.

What is the difference between big P and little P policy in terms of implementation?

Big P policy refers to formal laws, rules, and regulations established by policy bodies like state and federal governments, while little P policy refers to the administration's actions to implement big P policy, including regulations, funding, and organizational aspects.

How does the transcript suggest that policy affects different target populations?

The transcript suggests that policy affects different target populations by illustrating how policies like Medicaid expansion or health information in English can impact individuals differently based on their circumstances.

What is the significance of the distinction between big P and little P policy in understanding the impact of policies?

The distinction is significant because it helps to understand who is responsible for policy creation and implementation, and how these policies can have varying impacts, regardless of whether they are big P or little P.

Can you provide an example from the transcript where a little P policy has a significant impact?

An example is the fragmented state health systems and the fact that programs don't communicate with one another, which can greatly impact women who are uninsured and need cervical cancer screening and follow-up.

What is the role of the US Preventive Services Task Force (USPSTF) in policy as mentioned in the transcript?

The USPSTF is considered a big P policy entity because it acts on behalf of the federal government, creating guidelines and recommendations that have a significant impact on health policy.

How does the transcript describe the relationship between policy and public health achievements?

The transcript describes policy as a structural determinant of health that influences the distribution and effects of social and other factors across populations, playing a role in major public health achievements.