Module 1
  Definitions and Concepts

Content Discussion

Development of Healthy Public Policies

Growing evidence that social, economic and environmental factors outside the control of individuals have a profound impact on health has resulted in increasing interest in the development of public policies protecting and promoting health. For example, housing, income support programs, employment, and environmental protection have a direct impact on the health of individuals and communities.

In recognition of the importance of policy, health promoters have created theoretical frameworks for understanding the development of healthy public policy. One such model, Milio’s, is presented.

For more information about the policy development process, including actual examples of efforts to develop healthy public policies, please refer to Module 5.

Milio’s Framework

Nancy Milio, who invented the term "healthy public policy", developed a conceptual framework explaining how effective policies to improve health are developed.

In this framework, policy development passes through distinct stages of initiation, action, implementation, evaluation and re-formulation. These stages are not strictly linear (step-by-step), however, as the development of healthy public policy is seen as a dynamic process, not simply writing a policy statement (Milio, 1987).

The framework identifies four main players who are critical in the development of healthy public policy:

policy holders - politicians and bureaucrats
policy influencers - groups inside and outside of government
the public - audiences, consumers, taxpayers and voters whose opinions will affect the adoption of a policy
the media – that influence both the policy makers’ and public’s understanding of, and attitude towards, the issue

Although policy often appears to be driven by one or more influential individuals, Milio argues that it is the organization or community that should be the focus of analysis. Within organizations and communities, key stakeholders fall into two specific groups: policy keepers who have the mandate for a specific policy, and policy influencers, who have an interest in the issue and may try to influence the speed at which a policy is developed and implemented.

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