Evidence, policy and practice in environmental health: An international case study of sun safety

Abstract

<p>The past decade has seen increasing interest in the uncertain and complex problems related to environmental health and global environmental change issues. While this has brought together scientists, policymakers and the public to work towards solutions, relations between the groups are strained due to the differences in how each group recognizes, validates and places limits on evidence and knowledge. This thesis presents a detailed case study of how internationally-accepted information is interpreted, adapted and adopted into specific programs in a single environmental health case study: Sun Safety programs in Australia, Canada and England. Within the broad case study, the project uses a mixed method approach in a series of nested investigations. The first investigation uses critical theory to examine the theoretical relations between scientists, policymakers and the public. It concludes that each group engages in a different form of rationality (scientific, political, and social respectively) that is different yet equally valid. The second investigation uses expert interviews to trace the transfer of evidence and information from an international community of experts (an epistemic community) to national programs in Australia, Canada and England. This investigation concludes that framing and narrative construction are key to how information gets translated and transformed from evidence to policy at the national level. The third nested investigation reports the results of a survey of Public Health Units (PHUs) in Ontario, Canada to show the transfer of evidence and information from national policymakers to local programs for the public. It concludes that the public is playing an increasingly powerful role in defining problems and proposing solutions due, in part, to the rise of information as a commodity in the postmodern world. This thesis concludes that ideology plays a critical role in defining how evidence and knowledge gets translated and transformed in the policymaking process. This work makes substantive and methodological contributions through its use of mixed and complementary methods and through its detailed analysis of an environmental health issue (Sun Safety) in three countries. The thesis' main contributions, however, are theoretical. First, it extends the epistemic community concept to show how international evidence is increasingly influential at the public level through technological advances and greater international flows of information. Second, it develops a framework explicating the different evaluative criteria used by scientists, policymakers and the public in uncertain and complex issues. Both of these contributions will prove useful for future research in complex and uncertain issues such as global environmental change and environmental health problems.</p>