Introducing Paul Cairney, who applies theory-driven research on politics and policymaking to real world problems. He works with Dr Emily St Denny and Heather Mitchell on the politics of preventive health and health equity policy. As policy scholars, they are interested in the gap between people’s expectations for policy and actual practices and outcomes. I spoke to Paul about their latest research, published on Open Research Europe (ORE).
What is your research about?
This new research is about the global health equity agenda called Health in All Policies (HIAP). It treats health inequalities – or the unequal spread of ‘non-communicable diseases’ – as inequitable. It also generates evidence to explain their ‘social determinants’, seeks high-level political support for policy change, and pursues that change in cooperation across, and outside of, government departments. We want to know how HIAP advocates and researchers use policy theories to explain, and try to close, an ‘implementation gap’.
What inspired you to investigate this?
Our interest in health equity policy feeds into a larger Horizon 2020 project called IMAJINE, which is about equity and justice in relation to geography. The European Commission is exploring how to define and improve ‘territorial cohesion’, referring initially to an economic measure (regional disparities in relation to GDP). It will then focus on other areas, including equal access to public services. The interesting thing about HIAP is that most of its advocates challenge this focus on healthcare services, highlighting instead the role of unequal income and wealth, occupations, education, housing, and access to safe and healthy environments.
What impact will this have?
“Our aim is to encourage researchers and practitioners to step back and reflect on global progress to date.”
We describe the idea of a HIAP ‘playbook’ and suggest that it is not working as intended. We also warn HIAP advocates against using policy theories simply to update the playbook. Instead, these theories should encourage us to interrogate trade-offs and engage with the political dilemmas that cannot simply be solved by more research.
What are the next steps?
Our wider team aims to compare the pursuit of equity in health with other sectors. Paul is working with Dr Sean Kippin to apply the same research approach (i.e. qualitative systematic review) to studies of education equity policy. This will also be submitted to ORE.
Why did you choose to publish with Open Research Europe?
We were drawn to its flexibility and speed. The relatively large 20,000 word limit allowed us to do justice to the 113 articles in the review. The pre-print publication, coupled with flexible open access, allowed us to share the initial results quickly, encourage some debate during open peer review, and update our findings in relation to future work.
