Achieving health objectives and protecting different populations’ health is impossible without timely and justified health policies based on high-quality evidence. Such policies are decisions and initiatives aimed at implementing changes to the existing care provision practices in order to benefit stakeholder groups and protect the rights of providers and consumers. It is possible to single out two basic types of healthcare policies, such as regulatory and allocative policies, that seek to improve public health in different ways. This essay discusses health policies, the determinants of health, and the connections between the two.
The key difference between regulatory and allocative health policies is presented by the focus on behaviors or resources. Regulatory policies are the government’s tools to impose limitations on some groups’ behaviors and regulate them (Shi, 2014). Importantly, to ensure compliance with the prescribed norms, such policies introduce sanctions against those violating the rules, including fines, civil/criminal liability, and so on (Shi, 2014). Unlike allocative policies, regulatory policies demand the fulfillment of specific instructions to meet public health objectives (Tan et al., 2017). Regulatory policies can be competitive and protective, and statewide tobacco and alcohol policies exemplify governments’ attempts to regulate behaviors impacting health (Tan et al., 2017). In contrast, allocative policies involve the actual provision of goods, services, or pecuniary resources to different populations (Shi, 2014). For instance, in Malaysia, some allocative policies involve free vaccination against the human papillomavirus for teenage girls (Tan et al., 2017). Depending on the subtype, allocative policies spread benefits and resources or redistribute them to protect the most vulnerable groups and maintain justice (Shi, 2014). Actually, both types of policies help to meet health objectives, but they do it in different ways.
To sort out priorities and make forward-looking and effective decisions, health policymakers are expected to have a profound knowledge of the phenomenon of health and what makes people healthy. The determinants of health can be defined as factors that have an impact on individuals’ health situations and opportunities to improve them (Rasanathan et al. 2015; Shi, 2014). These factors are extremely diverse and refer to the conditions in which people grow and live, as well as the most prominent trends in resource and power distribution (Rasanathan et al., 2015). The determinants of health are divided into two categories based on their stability. As an example, some determinants, including sex, genotype, and age, are unchangeable and do not depend on people’s behaviors and choices. Also, there is a number of modifiable determinants of health, such as people’s lifestyle choices, social/economic/environmental conditions, and the accessibility of services and goods (Shi, 2014). As Rasanathan et al. (2015) state, factors that define health are not static and interact with each other closely. Therefore, any person’s health situation is dependent on these determinants and the details of interactions between them.
Strong connections between health policies and the determinants of health find manifestation in the determinants of health policy or specific factors that describe policies and the need for their implementation. The currently known determinants of health policy are singled out by analogy with the determinants of health, which explains obvious similarities between them. To begin with, apart from categorizing the determinants of health based on the degree of their modifiability, modern health theorists utilize the four-category framework to distinguish between the large groups of such factors. According to the mentioned framework, any determinant of health falls into one of the following categories: a person’s health status, the environment, individual characteristics, and medical care (Shi, 2014). In other words, the model describes the phenomenon of health and being healthy at the systems level and considers any factors that interact to produce a state of mental and physical well-being.
Basically, the determinants of health policy take the framework discussed above to the next level and apply this systemic approach to the policymaking process. To some extent, the framework for the determinants of health policy places an average of people’s individual factors in the context of political decision-making and resources needed to eliminate or reduce threats to health. Thus, the broad or general determinants of health policy are presented by the core health issues, social and cultural norms impacting people’s perceptions of these issues, and the political system (Shi, 2014). Additionally, the narrow determinants of health policy give consideration to the links between individual stakeholders or interested groups and the available administrative and pecuniary resources (Shi, 2014). With that in mind, just like the determinants of health, the determinants of health policy take cognizance of the interplay between people and systems and the resulting effects on health.
To sum it up, regulatory and allocative policies are different in terms of whether they aim to achieve health objectives by distributing/redistributing resources or regulating behaviors. The determinants of health are individual and environmental factors that affect people’s physical and mental well-being and the ability to improve health. By analogy with health determinants, there are the determinants of health policy that describe different components influencing health policy development and implementation.
References
Rasanathan, K., Damji, N., Atsbeha, T., Drisse, M. N. B., Davis, A., Dora, C.,… Montesinos, E. V. (2015). Ensuring multisectoral action on the determinants of reproductive, maternal, newborn, child, and adolescent health in the post-2015 era. BMJ, 351, 36-41.
Shi, L. (2014). Introduction to health policy. Chicago, IL: Health Administration Press.
Tan, H. S., Puganeswary, T., Zaza Hulwanee, M. Z., Nuurain Amirah, M. R., Ebrahim Mohammed, A. E., Amir Faisal, M. K., … Juni, M. H. (2017). Use of epidemiological evidence for policy development. International Journal of Public Health and Clinical Sciences, 4(3), 1-13.