The Macro Perspective on Health Policy Issues

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The progress of globalization leads not only to the development of global trade and economy but also to the discussion of global health problems which are challenging for many nations. Thus, to look at the health policy issues from the macro perspective means to discuss these issues from the national and global perspectives in the context of creating policies as a result of concentrating on the concrete health problems. From this point, the necessity to find solutions to such health problems as, for instance, obesity, smoking, and the spread of infectious diseases, which are characteristic for different nations, can cause the development of campaigns and policies oriented to health protection within the societies in order to influence and stop negative behaviors and actions.

How Problems Become Policy Issues and How They Result in Creating Health Care Policies

People all over the world face a lot of problems associated with their health and wellbeing. The intensive spread of infectious diseases, the increased number of persons suffering from obesity, and the spread of smoking among adults and adolescents can be discussed as significant health problems which can be considered as policy issues because these tendencies and behaviors should be ceased in order to contribute to protecting the health of nations (Barnoya & Glynn, 2012, p. 7). That is why, the authorities in many countries develop health care policies to provide the decision and solve the health issues, and they also combine their efforts to overcome health issues globally with references to creating the international health protection campaigns and programs (Longest, 2010, p. 8). The creation of health care policies is an important and influential step in changing the negative behaviors of the people within the society.

Smoking as a Controversial Issue and How This Issue Resulted in the Policy’s Creation

One of the most controversial issues is the problem of smoking which is characteristic for American society and for the nations globally. The problem is in the fact that cigarette smoke causes a lot of diseases, and smoking is associated with lethal danger. According to Paoletti and the group of researchers, cigarette smoking is responsible for “90% of all lung cancers and for one third of all cancer-related deaths; it is also responsible for 80% of cases of chronic obstructive lung disease and for about 20% of deaths from heart disease” (Paoletti et al., 2012, p. 213). That is why, smoking is a health issue that requires its resolution with the help of effective policies.

The anti-smoking policies and campaigns accepted in the United States are complex and include several phases. The first anti-smoking campaigns were developed by the federal government to be implemented in states in the 1960s. The national policy and program were proposed later, and it was mentioned that different states could develop and improve them according to their demands (Longest, 2010, p. 253). The policy as the authoritative decision to influence the public’s behavior can be based on different aspects. Thus, the complex anti-smoking program includes the focus on the increased cigarette taxes to affect the consumption, the improved price policies, the banning policies, the health protection campaigns, and the restrictions related to the places where to smoke. Paoletti and the researchers state that “23 states and 493 individual communities in the United States have adopted comprehensive smoke-free laws that prohibit smoking in non-hospitality workplaces, restaurants, and bars” (Paoletti et al., 2012, p. 217). While creating the anti-smoking policies, the federal and state governments concentrated on addressing multiple aspects associated with the people’s smoking behavior to influence the public’s actions and to reduce the smoking behavior among Americans.

Steps in the State and Federal Policy Development Process

The most effective comprehensive state-based program oriented to tobacco control is developed and implemented in California. The main focuses of the program and policy are on reducing the cigar consumption levels and on declining the mortality associated with the issue of smoking. Following the example of the California tobacco-control policy, it is possible to determine the steps in the state and federal policy development process. The first step is in determining the goal and directions to achieve the goal. Thus, the development of the policy project is based on this goal. The next step after the process of developing the first drafts is the discussion of the draft with references to the goal and directions. When the necessary revisions and changes are made, the final variants of policies are debated by the government representatives to improve the policy and prepare it for discussing and implementation in states. The concrete policy can also have additional stages. Thus, the anti-smoking campaign is rather complex, and it consists of several policies and stages which were successfully passed in California. The state authorities paid attention to implementing all the policies associated with the campaign such as the mass media campaign, indoor smoking bans, and tax policies (Chaloupka, Straif, & Leon, 2011, p. 235).

Differentiating between Policy Development and Implementation

To receive the opportunity to evaluate the effectiveness of policies, it is important to differentiate between policy development and policy implementation stages because the effective and well-developed policy can be implemented inappropriately in the concrete state. Focusing on the above-mentioned steps of the policy development, it is necessary to note that the next stage is the effective implementation of the policy in states which means the process of operating the policy in practice. Thus, the US anti-smoking campaign based on many policies is rather effective as the project because of its appropriate development to respond to many controversial issues (York, Pritsos, & Gutierrez, 2012, p. 89).

However, the policy’s effectiveness should be evaluated with references to the aspects of its implementation. For instance, the state of California used a lot of resources to implement all the proposed parts of the anti-smoking campaign when many other states were restricted in their budgets to implement the policy completely or discussed some parts of the policy as irrelevant. That is why, the process of the policy implementation differs from the policy development process because it is practical and based on such factors as the available budget, public opinion, and correlation with the state’s other policies. As a result, the policies developed by the federal and state governments can be improved or changed during the stages of the policy implementation in order to respond to the needs of the concrete state and its population.

How Stakeholders Become Involved in the Process

The next important point to influence the health policy development and implementation is the role of stakeholders in the process. Referring to many researchers on the causes of the lung cancer and other severe diseases, the health care institutions and organizations state that smoking is the negative habit which influences the people’s health drastically. That is why, two main categories of stakeholders with references to the health care issues are health care organizations and the community (Tauras, Huang, & Chaloupka, 2013, p. 4306). The increased rates in mortality caused by smoking, obesity, and infectious diseases as the controversial issues make the public and health care organizations pay more attention to these issues and ask the authorities for active actions in relation to overcoming the problems.

From this point, the first step is the development of the social campaigns and movements which can result in the development of the policies and programs as it was observed regarding the anti-smoking campaign developed in the 1950s-1960s. These stakeholders can become the driving force for the development and further active implementation of the policies oriented to coping with the global and national health problems. Nevertheless, there are also stakeholders who are involved in the process, but they can act against the development of policies. Referring to the anti-smoking campaigns, these actors are producers of cigarettes influenced by the policies and campaigns negatively.

Conclusion

Health care problems such as obesity, smoking, or infectious diseases should be controlled and overcome with references to the national and global efforts because of the problems’ controversial character. The development of policies to be implemented at the federal and state levels in the United States is the first step to resolving the issue as the national problem. Following the example of the anti-smoking campaign and associated policies implemented in different states of the country, it is possible to note that the effectiveness of the policy depends not only on the aspects of the policy development to respond to the goal but also on the aspects of the policy implementation. Differences in the implementation processes which are typical for many states lead to differences in the policy’s effectiveness.

References

Barnoya, J., & Glynn, T. (2012). Reducing global health inequities through tobacco control. Cancer Causes Control, 23(1), 7-9.

Chaloupka, F., Straif, K., & Leon, M. (2011). Effectiveness of tax and price policies in tobacco control. Tobacco Control, 20(2), 235-238.

Longest, B. B. (2010). Health policymaking in the United States. USA: Health Administration Press.

Paoletti, L., Jardin, B., Carpenter, M., Cummings, M., & Silvestri, G. (2012). Current status of tobacco policy and control. The Journal of Thorac Imaging, 27(1), 213-219.

Tauras, J., Huang, J., & Chaloupka, F. (2013). Differential impact of tobacco control policies on youth sub-populations. International journal of environmental research and public health, 10(9), 4306-4322.

York, N., Pritsos, C., & Gutierrez, A. (2012). Legislators’ beliefs on tobacco control policies in Nevada. Journal of Community Health, 37(1), 89-95.

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