Public Health Research and Public Management: A Match Made in Heaven?

Next week at UNSW Canberra, a range of international and domestic experts are coming together for a workshop entitled 'Public management and policy implementation for public health policy – new directions for research and practice'. But what is the history of collaboration between these respective academic disciplines? Are they, as the cliche goes, a match made in heaven? Gemma Carey discusses below in advance of the workshop next week.

In the last five years public health (as a field of research and practice) has become focused on issues of social inequality and social disadvantage.  The World Health Organisation has stated that “health inequities … are politically, socially and economically unacceptable”, making it a key area of strategic action through better policy development and implementation. In making this commitment, public health has crossed over into areas traditionally of interest to public policy and public administration scholars.

This includes a focus on wicked-problems and cross-boundary working across different parts of government and between sectors. Indeed, public health has gone so far as to secure international commitment through the World Health Organisation to a specific whole-of-government initiative for promoting health.

At present, though, public health and public administration have many shared interests yet little shared action or research. While public management has long focused on the functioning of government and public policy processes, in the last five years there has been new attention to these issues within public health. 

This interest follows an international push for governments to adopt ‘Health in All Policies’ (HiAP) – a fairly prescriptive whole-of-government approach to addressing health advocated by the World Health Organisation.  While HIAP has been adopted by over 16 countries, little is known about its effectiveness or its broader implications for the functioning of government.

Public management research conducted by those at UNSW Canberra has demonstrated that politically driven structural changes to government departments (as proposed by HiAP) often carry unintended consequences that have negative effects for policy development and implementation. This research suggests that, public health advocacy for structural changes to government – independent of the knowledge base that exists in public management – poses a significant risk.

In return, for public administration and management engagement with public health offers new research and methodological opportunities. The global proliferation of health initiatives such as HIAP offer public administration scholars new opportunities to study intersectoral and inter-governmental (or ‘joined-up’) action across different contexts.

Currently, the majority of research on cross-boundary working in public management is case-based (N=1). This has led to the formulation of vague ‘lessons learned’ which often provide little concrete guidance for day-to-day practice. In particular, the role that institutional norms, differing contexts and historical ‘path dependencies’ in implementation is under-researched and under-theorised due to the very sporadic and highly differentiated nature of joined-up initiatives.

Cross-disciplinary work with public health offers new opportunities for overcoming current methodological limitations in public management. For example, a systematic study of HIAP across jurisdictions and countries has the potential to offer public administration more nuanced insights into what makes for successful joined-up action and the macro and micro factors that influence cross-boundary working. Additionally, public health has the potential to add to the conceptual and theoretical toolbox of public administration.

Perhaps, then, next week is the start of a larger conversation about the possibilities for cross-disciplinary work in this space. Whether the marriage will last, though, only time will tell.

Posted by Luke Craven.