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Defining a Problem in Health Policy Analysis

Instructor: Daniel Murdock

Daniel has taught Public Health at the graduate level and has a Ph.D. in Behavioral Sciences & Health Education.

An important first step in any policy analysis is defining the problem that needs to be addressed. Let's examine the steps that are involved in the problem definition stage of health policy analysis.

Defining the Problem

Tina works as a policy consultant in Washington, D.C. She was recently hired by Senator Smith to advise him on health policy matters. The senator has asked Tina to examine and evaluate the available policy options for addressing the opioid epidemic. To do this, Tina must conduct a policy analysis, which refers to the systematic evaluation of the technical and political implications of public policy alternatives.

An important first step in any policy analysis is defining the problem that needs to be addressed. Before Tina can begin assessing policy alternatives, she first must verify, define, and detail the problem.

Problem definition is a critical first step in the policy analysis process because some issues become problems for health policy to address while others do not. Rigorous problem definition helps policy analysts and decision-makers identify whether a problem can be addressed with a policy solution. To do this, policy analysts need to determine the degree to which potential policy solutions can be considered effective, efficient, and politically feasible.

Identifying stakeholders during the problem definition phase can help bring people together to craft policy solutions.
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Problem definition is also critical because different policy decision-makers may define the same issue as a different kind of problem. For example, some lawmakers may view the opioid epidemic as primarily a public health issue, while others may view it as primarily a law enforcement issue. Tina needs to consider the goals and priorities of Senator Smith to define the problem.

Once the problem is well-defined, Tina needs to verify and detail the problem. To do this, she gathers data, such as health statistics, to determine the magnitude and extent of the problem.

Problem Statements

Policy analysts use problem statements (also known as issue statements) to define a problem. A problem statement is a short paragraph that summarizes the issue to be considered.

Ideally, the problem should be phrased in the form of a question. This helps guide the selection of information to include in the problem statement. Problem statements should also provide some context by identifying the conditions that have created the problem in an introductory clause or sentence.

Following these guidelines, Tina writes the following problem statement:

''The opioid epidemic impacts many Americans who get prescribed opioids for pain management because of chronic pain or following various medical procedures. What can Senator Smith do to reduce unintentional addiction to opioid drugs among individuals seeking medical attention for pain?''

Background

Now that Tina has written her problem statement, her next step is to write a background section for her policy analysis. The background section provides a description of the problem in detail. This section develops the fact base and identifies the existing body of evidence for the problem.

A good background section should include four main elements:

  • Identify who is impacted by the problem.
    • Who is most affected? How and why?
    • Are different population groups affected differently?
  • Place boundaries on the problem.
    • Where does the problem exist?
    • Are there differences in the scope or magnitude of the problem across different regions?
  • Identify how long the problem has existed.
    • What are the historical trends?
    • Has the problem improved or worsened over time?
  • Identify how the problem might change over time.
    • What do forecasts and projections predict will happen in the future?

Landscape

Tina's final step in defining the problem is writing a landscape section for her health policy analysis. The landscape section provides more context for the problem. This section tries to diagnose the problem by identifying the causes of the problem and examining how amenable the problem is to a policy solution.

The landscape section should include five main elements:

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