Punctuated Equilibrium Model for Influencing Public Policies: Practical Implications for Public Health

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We will start at 2 p.m. EST For the audio, please join the teleconference: Canada & USA 1-866-827-6872 Code: 1952702# For callers from other countries please follow instructions here: http://www.ncchpp.ca/6 45/Instructions.ccnpps?id _article=1353 Punctuated Equilibrium Model for Influencing Public Policies: Practical Implications for Public Health Webinar November 20, 2018 National Collaborating Centre for Healthy Public Policy

Can you hear us? We are talking right now... If you can t hear us: For audio, you can use your computer s speakers or headset, or dial in to the teleconference line by dialling: The teleconference toll-free number - Canada & USA: 1-866-827-6872 Enter the teleconference code 1952702# For participants calling from outside of Canada or the US, please check the instructions on this page: http://www.ncchpp.ca/645/instructions.ccnpps?id_article=1353 2

Our team for this webinar Marianne Jacques: moderator Mylène Maguire: logistics and technical support Mathieu Masse-Jolicoeur: presenter Jennifer Levy: presenter 3

To ask questions during the presentation Please use the chatbox at any time. Your questions will be raised during the Q&A period. We are recording this webinar, including the chat, and we will be posting this on our website. 4

Declaration of real or potential conflicts of interest Presenters: Mathieu Masse-Jolicoeur Jennifer Levy Have no real or potential conflict of interest related to the material that is being presented today. 5

The National Collaborating Centres for Public Health 6

National Collaborating Centre for Healthy Public Policy (NCCHPP) Our mandate Support public health actors in their efforts to promote healthy public policies Our areas of expertise The effects of public policies on health Generating and using knowledge about policies Intersectoral actors and mechanisms Strategies to influence policy making 7

Mathieu Masse-Jolicoeur Research officer at the Direction régionale de santé publique de Montréal du CIUSSS Centre-Sud-de-l'Île-de-Montréal Lecturer, Université du Québec à Montréal, and École nationale d'administration publique

Introduction Public policy unit of the Montreal DRSP (regional public health department) Background information Participation in the drafting of advisories and white papers Strategic scanning Influence support Interventions involving strategic actors Community of practice for health-related public policy

Attendees (Work and organizations) 80 70 60 Type of organization 120 100 Work involve devlopping public policy 50 80 40 30 20 60 40 10 20 0 Federal government Provincial government Local or regional government Indigenous organisation Not-for-profit organization University or Research centre Other 0 Often Sometimes Never N/A

Attendees (Knowledge) Level of Knowledge Knowledge stems from... 100 90 80 70 60 50 40 30 20 10 0 100 90 80 70 60 50 40 30 20 10 0 Advanced Intermediate Low Formal sources Practical experience Both

Agendas and Instability in American politics Baumgartner and Jones (1993) The authors analyze five major subsystems over a long period of time (90 years): The Tobacco Industry Auto safety Nuclear energy Pesticides and agriculture Municipal urban planning

POLITICAL SUBSYSTEMS Power has a tendency to be distributed among specialized subsystems Each subsystem draws together a small number of concerned actors These subsystems are highly autonomous and largely unconstrained by public opinion and democratic forces Decisions made by subsystems are often considered more technical or routine

Question 1: In your opinion, how many of the 5 subsystems studied by Baumgartner and Jones remain stable? 0 1 2 3 4 5 I don t know

The punctuated equilibrium theory stability Time stability stability Aims to reconcile long periods of equilibrium and sudden punctuations in an integrated model

Incrementalism: in systems that are in equilibrium, changes take the form of small advances and marginal changes to allocations Critical events Occur when a sectoral issue attracts the attention of the "macro-policy" environment Change Stable subsystems that enjoy a monopoly of power and a consensus at the level of values Time

Conflict expansion Process which may explain the destruction of these subsystems As the circle of participants grows, the risk that the associated subsystem will collapse also increases Media attention represents a risk for a subsystem in equilibrium

The importance of tracking media coverage Media attention: Have many articles on the policy been published? Has there been a change in the number of articles observed? Media tone: Do media reports support or oppose the existing policy? Has there been an observable change in the media coverage?

Question 2: In your opinion, what most threatens a stable subsystem? Media attention Media tone Both I don t know

THE PUNCTUATED EQUILIBRIUM MODEL The punctuated equilibrium model builds on the interaction between two key concepts: Policy images Policy venues

POLICY IMAGES Definition: The way a public policy is discussed in public and in the media Other authors refer instead to the framing of a public policy A public policy's image is based on facts, or rather on a set of facts, interpreted through a prism of beliefs and values Facts can be distorted Public policies are compatible with several images There is a tendency to simplify and to choose a single image

A positive policy image A stable subsystem (in equilibrium) focuses on positive facts and ignores negative facts A positive image protects a subsystem The public loses interest in a positive image Consequence: subsystems devote a great deal of effort to strengthening their positive image Warning: the accumulation of unresolved negative facts can put a subsystem at risk of punctuation

A negative policy image A new fact that is judged more negatively and tarnishes a policy's image can surface because of a change in the environment Critical event Action of a strategic actor (and, most of the time, a combination of the two) Powerful and autonomous subsystems can lose control of the policy image that protects them

Analyzing the policy's image For an actor wishing to influence public policy, it may be relevant to be knowledgeable about the policy's image What is the policy's overall image? What facts play a role in generating this image? How are these facts interpreted? (values and beliefs) Do other groups present an alternative image of the policy?

Question 3: Can a public policy's image change depending on the stakes concerned with an issue? Yes No I don t know The example of tobacco: Agriculture: Employment Health: Diseases, cost Insurance: Income (premiums) International business: Exports Tourism: Events sponsorships Etc.

POLICY VENUES Definition: "the institutional locations where authoritative decisions are made" Our societies offer a multitude of policy venues Policy venues associated with a debate can change, or even multiply, over time Some of these policy venues have decision-making abilities, or they can act as public forums and agents of change for a policy image

Question 4: Find the intruder: which of the following institutions is not a policy venue? Court Parliament Parliamentary Committee Municipal council School board council of commissioners Governing board of a public agency None of the above I don t know

Venue shopping For disgruntled groups dissatisfied with a subsystem, it is possible to interest a new policy venue When venue shopping, it is essential to: Understand their context and decision-making rules Determine which policy images these policy venues would prefer to be associated with Ensure that these policy venues have the will and the leverage to expand their field of expertise

How can this model guide public health actors? Policy Image Neutral Negative Positive Indifferent or powerless groups New concerned participants Mobilization of new allies Discontent groups Strategic actions Modification of the image Favoured groups Defence of policy Negative feedback Conflict expansion Venue shopping Inability to protect image Multiplication of policy venues Incremental solution developed by the subsystem in equilibrium Punctuation

Strengthening the policy system (policy defence) Subsystems thrive when images are positive, attention is limited and policy venues are favourable When a policy image is predominantly positive: Specialists can call for autonomy and resources to continue their work Despite the accumulation of negative evidence, governments retain public policies that favour certain actors The involvement of new policy venues is not encouraged While a policy venue remains unchallenged and retains its monopoly in an area of activity, an image change is unlikely

Punctuation, or how a system can be destroyed Subsystems can be destroyed when events or strategic actions weaken a policy's image and strengthen an alternative image External shocks (crises, scandals or natural disasters) can also highlight the inadequacies of a subsystem If the image is overburdened with ethical, social or political issues, new participants may want to get involved Pressure groups, activists, legislative committees, the media, etc. If a policy's image changes, new policy venues and new actors may want to become involved Risks changing the policy's image

Resources The resources needed to control a subsystem are not the same as those required to contest one To keep a system in equilibrium: Financial resources Political support To change a subsystem: Scientific knowledge The qualifications of actors engaged in influence activities (knowledge, perseverance) Support from new actors

Questions?

Punctuated Equilibrium Model for Influencing Public Policies: Perspectives from Local Public Health Jennifer Levy Policy Development Officer Healthy Public Policy, Toronto Public Health November 20, 2018

Presentation Overview Reflections on the Punctuated Equilibrium Model Insights that the model offers Questions about / challenges to model

Reflections on the Punctuated Equilibrium Model Where are public health actors located? Subsystem Public Health Discontented Group

Reflections on the Punctuated Equilibrium Model Policy Venues Municipal Province Public Health Federal Other

Reflections on the Punctuated Equilibrium Model Policy Image

Reflections on the Punctuated Equilibrium Model Policy Image

Reflections on the Punctuated Equilibrium Model Policy Image

Reflections on the Punctuated Equilibrium Model

Reflections on the Punctuated Equilibrium Model Questions?

Wrap up Concluding remarks Webinar evaluation and material Continuing Education Credits Thank you! 43

You re interested in this topic? Visit us at ncchpp.ca for more resources Production of this webinar has been made possible through a financial contribution from the Public Health Agency of Canada through funding for the National Collaborating Centre for Healthy Public Policy (NCCHPP). The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada.