State Health Policy What s the Message and Who s Listening? Ellen Jones, PhD (ABD), CHES

Transcription

1 State Health Policy What s the Message and Who s Listening? Ellen Jones, PhD (ABD), CHES

2 Art and Science

3 Science of Communicating Health Policy 46 million people $128 billion $81 billion medical 750,000 hospitalizations 9,500 deaths

4 Health Policy Approaches Self management Physical activity Weight control Early diagnosis/mgt

5 Art of Communicating Health Policy Message Messenger Receiver

6 Factors in Communication Literal Messages/Content Speaker Method and Manner Listener Metamessages Day 2-20

7 Assumptions Evidence-based message Willing to share messenger role Want to understand receivers

8 Health Policy Approaches Self management Physical activity Weight control Early diagnosis/mgt

9 Examples State Health Agency Health Promotion Programs State Colorado Program/Issue Prenatal Plus (Low birth-weight) Effect In 2003, 3,516 received PP services; at the end of 2003, the 9.6% prevalence of low birth weight was significantly lower that the projected 13.3%. For every $1 spent for PP, $2.48 was saved Medicaid costs. Kentucky Fayette County Vending Machine Program (childhood overweight) Healthy beverage consumption increased from 21% to 72%; Pepsi sponsored fitness day and donated 5 Mt. bikes Vending machine sales increased by $40,000.

10 And Yet. Evidence alone doesn t change policy or environments

11 This is Not a New Problem: The Case of Scurvy 1601 Lancaster shows that lemon juice supplement eliminates scurvy among sailors 1747 Lind shows that citrus juice supplement eliminates scurvy 1795 (194 years AFTER discovery) British Navy implements citrus juice supplement Source: Mosteller, Science 1981; 221:881

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13 How Do Policy Makers Come to Decisions?

14 National Conference of State Legislatures (NCSL) Provides a Revealing Profile of our State Legislatures (2004) There are 50 different formulas for designing a legislature. Being a legislator means more than attending sessions and voting on laws. It includes assisting constituents, studying issues during the interim and campaigning while they are out of the state house.

15 Red States Time 80% Comp $68,599 Staff 8.9 White States Time 70% Comp $35,326 Staff 3.1 Blue States Time 54% Comp $15,984 Staff 1.2 AK NJ CA NY IL OH FL PA NA WI MI AL KY OR AZ LA SC AK MD TN CO MN TX CT MO VI DE NE WA HA NC IA OK GA WV ID MT IN NH KS ND ME SD MS UT NV WYO NM RI VT

16 Sorian & Baugh Study 97 Legislators (health committees) 97 Legislative staff (health) 98 State Agency heads (health related)

17 Findings 53% skim 35% never get to 27% read for detail

18 Findings Continued Relevancy Ease of reading 65% read printed material 27% read electronic material

19 Sources of Information 48% named a professional association 21% named a state group 21% named a foundation 19% named a government agency 14% named think tanks 14% named health care associations 6% named universities

20 Study Implications 1. Don t underestimate the audience. 2. Relevance to current debates. 3. Layer information. If research is to be useful to policy makers, short is better than long, bullets are better than paragraphs, and a picture really is worth a thousand words.

21 Kansas Health Institute Healthier Kansans through informed decisions

22 Top Six Public Health Activities Perceived to be Important by Legislators 1. Preventing epidemics and the spread of disease 2. Providing immunizations to children 3. Providing health care services to poor children 4. Inspecting hospitals and nursing facilities 5. Bioterrorism response 6. Enforcing clean water regulations

23 Sources of Public Health Information: Legislators Your government support staff The Kansas Department of Health and Environment Advocacy groups Lobbyists Other legislators Individual citizens in your district University researchers Your ow n healthcare provider Information from the Internet Other scientific experts New spaper reports Your local health department Other healthcare providers in your district Party leadership Television or radio reports 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Frequently Occasionally Never

24 Preferred Ways to Receive Information Talking one-on-one w/ informed indiv. Reading brief summary material Receiving testimony at hearing Forums/seminars lasting 1-3 hours News media articles/reports Reading in-depth articles or reports Watching videotapes Conferences lasting 1 day or longer Legislator Commissioner

25 Length of Written Information Ideal length of written materials you read to help you make policy decisions (Legislators) 18% 4% 5% 1 page or less 23% 2 or 3 pages 4 to 10 pages 50% As long as necessary Other

26 Adequacy of Available Information 7% 2% 30% Never Sometimes Usually Always 61% In making policy decisions, would you say you have enough reliable information on public health never, sometimes, usually, or always? (Legislators)

27 Lessons to be Learned Martha M. McKinney- Community Health Solutions Inc. - KY LAW OF POLITICAL ADVANTAGE Policy makers will support the health issues that provide the cost political benefit at the least possible cost. LAW OF RATIONAL IGNORANCE Policy makers who think they understand a health issue will tend to ignore data and research. LAW OF SUSPECT DATA Policy makers and practitioners will question the applicability of research done somewhere else. IRON LAW OF PARTISANSHIP As political competition rises, the opportunities for research to inform decisions falls.

28 Relevance, Relevance, Relevance! Importance of local context. Influence of the source. Receptivity of audience. Capacity and culture of the organization.

29 Themes from Interviews and Literature Key drivers for politicians: (1) votes, (2) money, (3) media Constituents matter if they want it, I listen.

30 Themes Pay attention to the current debates if it is Medicaid, tie your issue to that. Collaborate, don t get sideways with other health constituents

31 Themes Put a face on the cause or issue I rely on personal relationships people and groups I can count on. District homogeneity is a powerful predictor of legislative behavior

32 Effective Advocacy State and Local

33 Communication?

34 Communication? Yes for constituents and insiders No for intermediaries Richardson and Cooper, The Policies Studies Journal (vol 34, no 1, 2006)

35 Effective Written Communication Re-frames the question Ties into local context Comes from trusted source Includes policy actions Short Tells where to learn more

36 Success Stories Issue Intervention Impact

37 Program Success Writing the Story Format of stories -- Paragraphs or bullets -- Phrases or sentences -- Photos -- Quotes/personal testimonials

38 Upstream Success Stories Share the early stages of your program Focus on intent illustrate who the program intends to serve Verify program description Highlight partners

39 Midstream Success Stories Demonstrate progress, share program growth Focus on examples of how program will ultimately achieve its goals Include anecdotal evidence and/or data showing early change

40 Downstream Success Stories Show results Illustrate program impact Goal is to catch the attention of your audience and leave them desiring more information

41 Clarity is Critical

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43 Growth Chart Average 5-year Revenue Growth for Minority-owned Businesses 334 Percent Increase in Revenue Year List Published Hispanic/Latino Asian American African American Native American Not actual data for visual demonstration only

44 Growth Chart Average 5-year Revenue Growth for Minority-owned Businesses 334 Percent Increase in Revenue Year List Published Hispanic/Latino Native American Not actual data for visual demonstration only

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46 Showing the Story

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48 Planners Need Actionable Insights Make complex and distant issue seem real and immediate No matter how stimulating the message, people won t act unless they perceive a return on their investment

49 Planners Need Actionable Insights WIIFM Clear action steps Understand cost/benefit

50 6 Components Goals Resources People Targets and agents Strategy Tactics KS Community Toolbox

51 Conclusion Relationships matter Policy is an art & a science Relevance Clear messages, stories Actionable insights Relationships matter

52 YOU Are the best Communications Link In policy change!

53 Questions?