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Reprint Article
Transcending the Rational Model:
How to Turn Research Data Into Policy
[Editor’s
Note: The news article this month reporting on the UCLA study
about how research evidence can be made more useful for public health
brought to mind several earlier articles published in The Epidemiology
Monitor over the years. One in particular seemed relevant to the UCLA
findings and it is reprinted below. It provided the perspective of
Bill Sederburg, PhD, former chair of the health policy committee
in the Michigan state legislature. He spoke in 1993 to a group of CDC
conference attendees in Salt Lake City. Links to other policy and data
utilization topics published in the Monitor over the years are
provided below. Learn and enjoy.]
Scientists are trained to believe that rational decision-making is the
best model to follow, but the rational model doesn’t always apply in
the legislative community, said Bill Sederburg, PhD, former
chair of the health policy committee in the Michigan state
legislature, speaking at the 7th National Conference on Chronic
Disease Prevention and Control in Salt Lake City recently.
The
rational model is ineffective for politicians because they operate in
a different environment than does the scientist, said Sederburg, who
is currently the director of Public Opinion Research for Public Sector
Consultants. Instead, politicians depend on an “intuitive” model for
decision-making: they scan the political horizon for problems or
problems are presented to them; they evaluate their options based on
previous experience, and then they assess the political reaction to
the decisions that could be made.
Sederburg said scientists should be aware of the impediments to
rational decision-making. For example:
• When
there is no consensus on the problem, there can be no consensus on the
solutions
• The
outcome of the political process is compromise, not maximization
•
Legislators are generalists, not experts. “It isn’t what’s true, it’s
what the public thinks is true,” says Sederburg.
•
Evaluation standards are different; politicians are evaluated strictly
on image.
•
Politicians look to health issues for political payoffs rather than
rational solutions.
But
these differences can be transcended, according to Sederburg, who
offered the following suggestions for bridging the gap between the
rational or medical model and the intuitive or political model:
• Make
data understandable. Present information with as much visual material
as possible, such as with slides and charts.
• Use
outside expertise to validate your opinion. While trying to get seat
belt legislation passed in Michigan, for example, Sederburg depended
on data from the Centers for Disease Control and Prevention (CDC)
which showed every dollar spent on promoting the use of seat belts
would save $105 in health care costs. “The CDC is the nation’s number
one validating institution when it comes to health issues,” he said.
“People hear (the CDC’s data) and they say, ‘it must be true’.”
• Drop
the medical jargon. Words such as “correlations,” “regression
analysis” and “paradigms” only confuse your issue. “A paradigm is what
you need to buy a cup of coffee,” the chairman of his appropriations
committee once told him, said Sederburg.
• Use
the press to influence public opinion. “If you can affect public
opinion, you can affect what goes on within the institution of the
legislature,” Sederburg said.
One last
piece of advice was to try to understand that change is incremental.
• You
don’t maximize change, you make small steps along the way, he said.
Published January 1993 ■
Other data and policy
articles from the Epi Monitor:
1. Why
Epidemiology is Underutilized as a Tool For Decision-Making in Health
Services
https://bit.ly/2OrRA6v
2.
Community Members, Epidemiologists, and Political Leaders: Essential
Partnership For Sound Health Policy
https://bit.ly/2pTl3HO
3.
Translating Epi Data Into Public Policy is Subject of Hopkins
Symposium
https://bit.ly/2pWK44R
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