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Evidence is Not Enough: Towards a democratically legitimate role for evidence in health policymaking

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BRADFORD HILL SEMINAR

There is, according to a much debated recent paper, ‘a perfect storm’ gathering around the concept of ‘evidence-based policy’ (EBP), ‘generated by the insurgence of several concurrent crises’ (Saltelli and Giampietro, 2015: p1). This includes growing public distrust in science and academic expertise following the failings of mainstream economics that were highlighted by the 2008 global economic crisis, as well as broader indicators of public dissatisfaction with traditional policy elites. More specifically, analyses of health policies developed in the UK in an era of EBP rhetoric have struggled to identify concrete examples of EBP . Despite this, researchers and funders concerned with public health seem reluctant to relinquish the idea that policies might one date be ‘evidence-based’ and continue to invest in efforts to ‘translate’ evidence for policy (e.g. Diem et al, 2015), while frequently bemoaning the persistent ‘barrier’ of ‘politics’ (see Pawson, 2006). Employing health inequalities as a case study, this talk will argue that, by failing to move beyond simplistic caricatures of rational scientists battling strategic politicians, proponents of EBP too rarely give sufficient consideration to the complexity of politics or the role of the public in policy debates. On the other hand, while popular theories of policy change offer important insights to politics and policymaking, they say little about the potential for researchers and evidence to inform these processes. Against this backdrop, this paper argues that we need to explore more politically informed, democratically legitimate roles for evidence in policy debates, combining what we know about effective knowledge translation with expertise in policymaking and deliberative processes.

This seminar will be delivered by Dr Katherine Smith, Reader, Global Public Health Unit, School of Social & Political Science, University of Edinburgh.

Chaired by Professor Theresa Marteau, Director of the Behaviour and Health Research Unit, University of Cambridge.

This talk is part of the Bradford Hill seminars at the Cambridge Institute of Public Health series.

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