Key Concepts in US Government, Policymaking, and Public Health

Posted on Nov 7, 2025 in Police Sciences and Public Security

Foundations of US Government and Policy

The Three Branches of Government

  • Legislative Branch: Composed of the House and Senate, this branch creates and passes laws.
  • Executive Branch: Enforces laws and includes the President, executive orders, and agencies (e.g., HHS, CDC).
  • Judicial Branch: Interprets laws and includes courts and the power of judicial review to assess the constitutionality of policies.

Key Governance Concepts

  • Federalism: A system where power is divided between the national and state governments.
  • Preemption: Occurs when a higher level of government limits or overrides the authority of a lower one (e.g., federal law overriding state law on tobacco regulations).

Mechanisms of Policymaking

Direct and Indirect Policy Levers

  • Executive Orders: Directives from the President that manage the operations of the federal government, often used to direct agencies or respond to crises.
  • Ballot Measure: Legislation, such as a proposition or referendum, that is proposed and voted on directly by the public, enabling citizen participation in policymaking.
  • Litigation: The process of taking legal action. Courts can be used to influence, challenge, or shape policy decisions, as seen in tobacco settlements.

Policy Development Frameworks

The Policy Cycle

  1. Agenda Setting: Identifying and prioritizing public issues for government attention.
  2. Policy Formulation: Developing and drafting possible solutions to the identified problems.
  3. Policy Adoption: The decision-making process where policies are formally chosen and enacted.
  4. Policy Implementation: The process of executing and managing adopted policies.
  5. Policy Evaluation: Assessing the outcomes and effectiveness of a policy.

Bardach’s Eight-Fold Path

  1. Define the problem
  2. Assemble evidence
  3. Construct alternatives
  4. Select criteria
  5. Project outcomes
  6. Confront trade-offs
  7. Decide
  8. Tell your story

The Political Landscape

Political Ideologies and Parties

  • Ideology: A coherent set of ideas and beliefs about how society should work.
  • Conservatism: Favors limited government, personal responsibility, and traditional values.
  • Liberalism: Supports government action to achieve equal opportunity and address social inequalities.
  • Political Parties: Organized groups with shared ideologies that seek to influence policy and win elections.

Agendas, Stakeholders, and Coalitions

  • Systemic Agenda: All issues that the public perceives as deserving of government attention.
  • Institutional Agenda: The set of issues that policymakers are actively considering.
  • Stakeholder: Any individual or group affected by or influencing a policy, including policymakers, advocacy groups, communities, and the private sector.
  • Stakeholder Analysis: The process of identifying key stakeholders to determine their interests and levels of power or influence on a policy.
  • Networks and Coalitions: Alliances of stakeholders who collaborate to influence policy outcomes and strengthen advocacy through shared goals.
  • Institutions: Established organizations or systems that govern society (e.g., Congress, the CDC).

Ethical and Public Health Considerations

Core Ethical Principles

  • Autonomy: Respecting an individual’s right to make their own decisions.
  • Beneficence: Acting in the best interest of others and promoting well-being.
  • Nonmaleficence: The principle of “do no harm” by avoiding actions that cause injury.
  • Public Good: The benefit or well-being of the community as a whole.

Public Health Intervention Strategies

  • Upstream Interventions: Focus on structural and social determinants of health, such as policy reform and access to education.
  • Downstream Interventions: Address individual behaviors and immediate health issues, such as medical treatment and screening.
  • Population Approach: Targets entire populations for health improvement (e.g., broad vaccination campaigns).
  • Targeted Approach: Focuses on high-risk groups or individuals (e.g., services for low-income housing residents).

The Intersection of Politics and Public Health

An ethical tension often arises between public health and politics. Public health focuses on evidence-based strategies for collective well-being, while politics involves negotiation, power, and competing interests. This divide is evident in differing approaches to health policy:

  • Liberal Approaches: Tend to support more government intervention to promote public health and health equity.
  • Conservative Approaches: Tend to prefer limited government involvement, emphasizing individual accountability and market-based solutions.

Tools for Policy and Program Design

Impact Assessment Methods

  • Health Impact Assessment (HIA): A tool used to evaluate the potential health effects of a policy before it is implemented.
  • Health Equity Impact Assessment (HEIA): A tool that specifically examines how a policy might affect health disparities among different population groups.
  • Health Equity: The principle of striving for fairness and justice in health outcomes for all people.

Goal-Setting and Knowledge Application

  • SMART Technique: A framework for designing effective goals that are Specific, Measurable, Achievable, Relevant, and Time-bound.
  • Knowledge Translation: The process of moving research evidence into practical use to inform policy and practice.