Who runs public health? A mixed-methods study combining qualitative and network analyses

Kathryn Oliver*, Frank De Vocht, Annemarie Money, Martin Everett

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

26 Citations (Scopus)

Abstract

Persistent health inequalities encourage researchers to identify new ways of understanding the policy process. Informal relationships are implicated in finding evidence and making decisions for public health policy (PHP), but few studies use specialized methods to identify key actors in the policy process.

We combined network and qualitative data to identify the most influential individuals in PHP in a UK conurbation and describe their strategies to influence policy. Network data were collected by asking for nominations of powerful and influential people in PHP (n 152, response rate 80), and 23 semi-structured interviews were analysed using a framework approach.

The most influential PHP makers in this conurbation were mid-level managers in the National Health Service and local government, characterized by managerial skills: controlling policy processes through gate keeping key organizations, providing policy content and managing selected experts and executives to lead on policies. Public health professionals and academics are indirectly connected to policy via managers.

The most powerful individuals in public health are managers, not usually considered targets for research. As we show, they are highly influential through all stages of the policy process. This study shows the importance of understanding the daily activities of influential policy individuals.

Original languageEnglish
Pages (from-to)453-459
Number of pages7
JournalJournal of Public Health (United Kingdom)
Volume35
Issue number3
DOIs
Publication statusPublished - Sep 2013

Keywords

  • decision-making
  • evidence-based policy
  • public health policy
  • social network analysis

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