Lessons from policy theories for the pursuit of equity in health, education and gender policy

Abstract

We highlight practical lessons from policy theories on how to promote equity through transformational changes in policymaking. Health, education and gender are at the heart of such equity policy agendas. Their advocates seek transformational changes to: policy, to reject a ‘neoliberal’ paradigm and address the social and economic causes of unfair inequalities, and policymaking, to foster collaboration and holistic government. However, they also report a wide gap between aspirations and outcomes, and many seek insights from policy studies on how to close it. Our aim is to use their common engagement with policy theories to connect their agendas, foster intersectoral dialogue, and ensure that their contributions are greater than the sum of their parts. A common take-home message is to be cautious about any attempt to turn a provocative transformational political project into a technical process containing a ‘toolbox’ or ‘playbook’.

Transformational change through Public Policy

“…4. Drawing insights from the field of Public Policy will never offer detailed instructions (for example, a toolkit or playbook) to create transformational change in all circumstances; instead, it can provide ways to think about the challenges we face and strategies for overcoming them (Cairney et al, 2022). 5.…”

“…5. Studying transformational change from the lens of public policy necessarily involves scholars taking on different roles, from engaged scholarship (Levac et al, 2022) to theory development (Nohrstedt, 2022;Sewerin et al, 2022;Cairney et al, 2022), that each provide unique contributions.…”

“…Similar to one of the scenarios in Nohrstedt (2022), we should also not under-emphasise the impacts of incremental policy change on transformative societal impacts, which resonates with policy drift as one explanation for the US's historic inequities (Hacker and Pierson, 2010). In this vein, Cairney et al (2022) claim that our field's strength is not in telling a policy actor what they should do in a given context through 'toolboxes' or 'playbooks'. The world is far too complex for such generalised recommendations.…”

At the Intersection of Equity and Innovation: Trans Inclusion in the City of Vancouver

“…As Loh and Kim (2021) write, the issue of equity is central to the practice of planning. Although equity suffers from a lack of consistent definition (Cairney et al, 2022), it is typically understood as access in two directions: Access resulting from equitable distribution of resources and services on the one hand, and, on the other, procedural access that transforms the who and the how of decision-making. Joy and Vogel (2021) further describe these two directions of equity with an intersectional lens, underlining the multidimensional experience of social difference and oppression: Equity ensures that human beings in all their intersecting personal, familial, sociopolitical, and geographic differences have access to the opportunities, resources, and supports they need to survive and thrive.…”

Agency in multi-level governance systems: The implementation puzzle and the role of ‘intelligent’ local implementers

“…Countering the mainstream view, however, is a growing body of evidence attesting the inevitability of uncertainties in policy implementation and the non-linearity between policy intentions and implementation. As observed by Cairney et al (2022: 364 original emphasis), ‘[ c ] omplex policymaking systems or environments suggests that policymakers do not fully understand or control policy processes’. This uncovers the need for a more realistic strategy (Cairney, 2015) to ‘embrace complexity’ rather than to try to reduce it through rational simplification (Rhodes et al, 2010; Stoker, 2019).…”