Exploration of the functions of Health Impact Assessment in real world-policy making

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BRUSSELS-CAPITAL HEALTH & SOCIAL OBSERVATORY Exploration of the functions of Health Impact Assessment in real world-policy making International Conference on Health Impact Assessment, Geneva, October 2013

Introduction and context Brussels Health and Social Observatory Global missions Key strengths Role of policy support in the field of poverty politics Scientific support for the development, implementation and application of a Social Impact Assessment tool

Impact Assessment: rooted in a rational vision of the policy process? Corresponding with a rational model of policy decision-making Rational model of policy decision-making: searching for maximizing solutions to complex problems through the gathering of policyrelevant information and the application of scientific methods to assess the potential impact of different policy options Howlett & Ramesh 2003 3

Impact Assessment: rooted in a rational vision of the policy process? (2) Conception of a linear policy process Agenda-setting Policy Evaluation Policy Formulation Policy Implementation Decision- Making 4

Impact Assessment: rooted in a rational vision of the policy process? (3) Function of IA within the rational model Ex post evaluation Agenda-setting Policy Evaluation Policy Formulation Intermediate evaluation Policy Implementation Decision-Making Ex ante evaluation 5

Contestation of the rational model Based on at least two assumptions: On the policy process On the role and utilization of knowledge within the policy process The rational model of decision-making has been fundamentally challenged for at least three decades of research in different disciplines 6

Contestation of the rational model (2) «Most studies appear to come and go without leaving any discernible mark on the direction or substance of policy. Policy makers seem to ignore the results of evaluation and go on with policies that they chose for other reasons [ ] The problem-solving model of research use probably describes a relatively small number of cases» Weiss (1979) «[Policy practice] has, for the most part, been more about muddling through rather than a process in which the social or policy sciences have had an influential part to play» Parsons (2002) «Analysis rarely informs policy in the simple linear manner envisaged by the technical-rational model» Owens et al. (2004) 7

Explanation for the limited application of Impact Assessment? Does this explain the fact that IA is failing to live up to the high expectations? Large gap between high expectations and implementation in practice Little direct influence on pending decisions (Hertin et al. 2007) Particularly in the case of complex policy subsystems; high constraints on decision-makers (a.o. wickedness of the problem) (Howlett & Ramesh 2003) 8

Looking for the wrong kinds of influence? Scenario of dashed hopes and rekindled appreciation «[ ] looking for the wrong kinds of influence in the wrong place and at the wrong time» Research, which did not affect the decisions for which it was intended, could turn out to be important in the longer term (Weiss, 1999) 9

Different types of knowledge utilization Different types of knowledge utilization, corresponding to different functions of Impact Assessment: Instrumental use Political or symbolical use Conceptual learning Instrumental and conceptual learning can be distinguished by the level at which learning occurs 10

Conceptual learning or enlightnement Defined as «the percolation of new information, ideas and perspectives into the arenas in which decisions are made» «Slow trickle of enlightement», is hard to see, invisible to the naked eye Will not lead to immediate changes, but can provide opportunities for policy change, by modifying the way problems are defined: «It helps to change the parameters within which policy solutions are sought. In the long run, along with other influences, it often redefines the policy agenda» (Weiss, 1999) 11

Understanding mechanisms of policy change: the Advocacy Coalition Framework Sabatier & Jenkins-Smith 1993 & 1999; Sabatier & Weible 2007 Premise: policy subsystems (or domains) as most useful unit of analysis for understanding policy change (1) Normative dimension: Public policies as belief systems Policy-making process (within a subsystem) led by «advocacy coalitions», each sharing a set of values, normative and causal beliefs 12

Understanding mechanisms of policy change: the Advocacy Coalition Framework (2) Belief systems are composed of three levels: Deep core Policy core beliefs Secondary aspects (2) Cognitive dimension Policy change via learning Gradual accumulation of evidence 13

Conceptual learning or enlightnement Analyse the conditions for conceptual learning and enlightenment Abandon «the quest for a positivist yellow brick road leading to a promised dry ground», in which IA has a role of «draining the swamp» (Parsons 2002) By focusing on the rational and instrumental function, we underestimate the real impact that IA can have on the process of decision-making 14

Sources Hertin, J., Turnpenny, J., Jordan, A. et al. (2007) Rationalising the policy mess? Ex ante policy assessment and the utilisation of knowledge in the policy process. Forschungsstelle Für Umweltpolitik, Freie Universität Berlin. Howlett, M. & Ramesh, M. (2003) Studying public policy. Policy cycles and policy subsystems. Oxford University Press Owens, S., Rayner, T. & Bina, O. (2004) New agendas for appraisal: reflecions on theory, practice and research. Environment and Planning 36, 1943-1959. Parsons, W. (2002) From Muddling Through to Muddling Up - evidence Based Policy Making and the Modernisation of British Government. Public Policy and Administration 17[3], 43-60. 15

Sources (2) Sabatier, P.A. & Jenkins-Smith, H.C. (1993) Policy Change And Learning: An Advocacy Coalition Approach Boulder, Colorado, Westview Press. Sabatier, P. A. & Jenkins-Smith, H. C. (1999) "The Advocacy Coalition Framework. An Assessment," In: Theories of the policy process, P. A. Sabatier, ed., Boulder Colorado: Westview Press, pp. 117-166. Sabatier, P. A. & Weible, C. M. (2007) "The Advocacy Coalition Framework. Innovations and Clarifications," In: Theories of the policy process, P. A. Sabatier, ed., Boulder Colorado: Westview Press, pp. 189-220. 16

Sources (3) Weiss, C. H. (1977) Research for policy's sake: the enlightenment function of social research. Policy Analysis 3, 531-545. Weiss, C. H. (1979) The many meanings of research utilization. Public Administration Review 39[5], 426-431. Weiss, C. H. (1980) Knowledge Creep and Decision Accretion. Science Communication 1[3], 381-404. Weiss, C. H. (1999) The Interface between Evaluation and Public Policy. Evaluation 5[4], 468-486. 17

BRUSSELS-CAPITAL HEALTH & SOCIAL OBSERVATORY Exploration of the functions of Health Impact Assessment in real world-policy making Gille FEYAERTS Brussels Health and Social Observatory ULB, Ecole de santé publique gfeyaerts@ggc.irisnet.be 02/552.01.57