health professionals frequently hear objections to work involving policy.
"Government should just educate people” or "You've got to teach them while they
are young.” The trouble with education-only efforts is they take place in a
vacuum. Without the neighborhood, school, and family support, education goes no
further than the exit to the classroom. Support could include sidewalks,
designated walking or rolling routes to school, bike racks, and physical activity
and play time during school hours. Such neighborhood and school efforts require
policy (e.g, each child will have 20 minutes of recess each day), environmental
(e.g., sidewalk markers designating routes to school), and systems (an emphasis
on promoting physical activity for children from before school to after) to
reinforce educational messages.
children are taught to "eat healthily” while in some schools candy is used to
illustrate math problems and junk food sales to teach commerce. Substituting
non-food items (or dried beans) in math can be a policy change by the school principal as part of an overall systems change of encouraging healthy
eating. It's a way of practicing "do as I say AND as I do.”
are bombarded with health claims from the specious to the well-researched but two
health ideas that are almost universally accepted are (1) Get physical
activity, and (2) Eat fruits and vegetables. Again we know that various modes
of education get the message out, but how well does the person's environment
support these ideas? Does the workplace have vending machines that offer
apples? Do the town's streets have bicycle lanes?
environmental, and systems changes are designed to make the healthy choice the
easy choice. Our modern society wasn't engineered with health in mind, and our
collective health is paying the price. No U.S. state has an obesity prevalence
of less than 20 percent of the population (United Health Foundation, America's Health Rankings 2011).
prevention professionals have long worked in policy and environmental change.
Smoke-free workplaces, parks, and public areas are more effective at reducing
tobacco consumption than gathering 15 individuals in a room to teach them how
to stop smoking. Importantly, these measures also reduce secondhand smoke
exposure, whereas educating people who smoke that their smoke harms others
produces limited results.
promotion programs have been moving toward policy, systems, and environmental
change approaches for many years. These approaches do not replace the need for
individually aimed health promotion but they do fill a critical gap. Public
health agencies are positioned to see the community-based changes needed to
support health and collaborate with private groups to make them happen.
in the Systems Change for Health courses offered by DHPE, the term
"policy” refers to a range of approaches, actions or interventions that are
part of the policy process. The policy process can occur at the local, state,
or national levels. Policies include workplace rules, insurance provisions,
limitations businesses accept, local ordinances, joint use agreements (such as
allowing the use of school facilities for community physical activity programs),
changes to built environments (such as traffic calming measures and safer
walking routes to schools), school board decisions, agreed upon ways of doing
business, and state guidance—in addition to state or federal regulations, and
local, state, or federal laws. This series of courses take participants through
a broad spectrum from defining and framing problems to evaluating the