THE IMPACT OF SOCIAL-SCIENCE RESEARCH ON HEALTH-POLICY

The relationship between research and health policy is discussed from a policy process perspective, describing communication problems in the course of policy formulation, implementation and evalution. Policy pr ocess is often expected by researchers to be rational, having logical sequence of steps and the objective evaluation of alternatives based o n scientific knowledge. In fact, policies are often formulated without clear problem identification or based on wrong assumption. The timing of research and policy-making differs. Policy-makers need to respond quickly. Evaluations may be regarded by politicians as embarrassing if they point to a need for significant change. It is not satisfactory t o consider only research and policy-making: their relationship is infl uenced by the media, different interest groups and by the general publ ic. Health policy formulation is embedded in the general policy enviro nment of particular societies. Some countries have a long tradition of consensus-building, while in others health reforms have been formulat ed and introduced in a centralized way. Traditional bio-medical thinki ng influences health policy-makers. The importance of social and polit ical acceptability tends to be overlooked. The paper emphasizes that w e are experiencing an era of scarcity of resources and growing tension concerning allocation decisions. Existing institutions provide insuff icient incentives for policy-makers and researchers to promote public dialogue about such issues. The paper concludes that there is a need f or new approaches to policy development and implementation, new struct ures in policy-making, changes in research financing and co-operation between disciplines and new structures for public participation in pol icy-making. Research should facilitate more open and democratic dialog ue about policy options and the consequences of alternative choices.