New ideas are often the starting point for change, and that is true
in public health as well as in other parts of society. A new
publication from the Robert Wood Johnson Foundation, To
Improve Health and Health Care
, reflects on how innovative
ideas supported by the Foundation have moved into the
The authors, David Colby and Stephen Isaacs, identify four key
elements of an idea in the process of policy change in public
1. the idea is seen by a substantial portion—or at least
an influential portion—of the population as a potential solution
to a pressing problem;
2. the political system is receptive to the adoption of
new ideas—especially when legislation is the means of spreading
3. the evidence is strong that an idea is workable and
perhaps cost-effective; and
4. committed advocates keep the idea in the forefront and
fight for its widespread adoption.
One thought that strikes me about this framework is that it is not
all about being on the cutting edge. The process depends upon the
work of trailblazers, to be sure, but it doesn’t end there.
Change depends upon people who keep up
the field of public health as a whole.It depends upon people who
are tuned in and engaged in adapting policies from other cities,
counties and states to their own political and cultural
Change depends upon researchers who collect evidence to demonstrate
the existence of problems in public health and upon researchers who
assess the effectiveness of proposed solutions.
Most importantly, it depends upon connections and dialogue between
and among all of these people, including practitioners and
researchers and advocates and policy-makers and lawyers.
This is true whether you’re working to become the first county
public health department in your state to seek voluntary
accreditation. Or if you’re part of a coalition working to become
the thirty-second state in the nation to adopt a primary seat belt
law. It’s also true if you’re a clinic or a hospital seeking to
implement an electronic health record system to better treat
patients while protecting their privacy. It’s true from
development to implementation to enforcement.
We can all
help to popularize and implement public health
ideas that save lives and improve the quality of life.This information was developed by Jill Krueger,
senior attorney for the Network for Public Health Law – Northern
Region at the Public Health Law Center.The Network for Public Health Law provides information and
technical assistance on issues related to public health. The legal
information and assistance provided in this document does not
constitute legal advice or legal representation. For legal advice,
readers should consult a lawyer in their state.