ARCHIVED - Public Involvement


A population health approach promotes participation of all Canadians in developing strategies to improve health. The approach ensures appropriate opportunities for Canadians to have meaningful input into the development of health priorities, strategies and the review of outcomes.

A population health approach engages citizens through the public involvement process, which recognizes the role, contribution and shared accountability of stakeholders, citizens and governments in the development of sound and effective public policies. Involvement refers to the level of participation along a continuum. All levels of the continuum are valid, depending on one's objective, need and desired level of public influence. Public is defined as individuals, consumers, citizens and special interest groups such as environmental, health, consumer and voluntary groups, and industry, scientific and professional associations.

Public involvement embraces a continuum of activities

Communication: At times, a commitment to inform and educate is all that is needed to address concerns or convey results. At other times it is part of the preparation for a future involvement exercise, e.g. consultation booklets. An important first step at the beginning of every public involvement process is providing clear, accurate, accessible information in order for the public to fulfill its right and responsibility to be informed about the issues, to represent its views, to learn from others and, where necessary to work with others to find common ground.

Consultation: Generally, consultation is chosen when there is a need to gather views of stakeholders and/or provide opportunities for dialogue on major issues or activities which affect them directly or in which they hold a significant interest. At this stage, it is still possible for views to be considered in joint decision making, partnership in action on solutions, or the shaping of policy directions.

Citizen Engagement: On a broader level, Canadians are "engaged" as an important partner in determining future policy or program directions which involve significant value-laden trade-offs at a societal level. At this level, citizens and groups have accepted the challenge of coming up with solutions among themselves and working with government toward their implementation. At other times, government may be invited as a participant in a role that is more one of facilitator or enabler in a community or publicly driven process.

A benefit of public involvement is that public confidence in decision making and information sharing is increased as those Canadians who are most affected by a health issue contribute to possible solutions early in the planning process. Meaningful public involvement yields other value-added benefits which include:

  1. Building relationships based on trust, transparency, accountability, openness and honesty.
  2. Integrating a wider range of public needs, interests and concerns into decision making.
  3. Resolving problems more effectively, through collaborative means.
  4. Ensuring that decisions and solutions incorporate perspectives, knowledge and technical expertise that would not otherwise be considered.
  5. Placing issues and projects within a broader technical, social, cultural or ethical context.
  6. Increasing the level of public acceptance and ownership of local level decisions and policies.

A population health approach places people at the center. It views citizens as active participants in creating and maintaining health across the life span and in varied settings.

Actions and Considerations for Public Involvement

Capture the public's interest

Population health approaches not only inform the public of health as a matter of legitimate concern, but aim to generate interest and excitement about health within the public consciousness. Examples of successful consciousness raising by the environmental movement can serve as a model for the population health approach to generate interest and excitement about health within the public consciousness. A population health approach aspires to place health and its associated determinants as relevant and sustainable concepts in the public's imagination; as goals to be esteemed by current and future generations. Population health approaches aim for broad-based public acceptance and endorsement of a health determinants agenda.

By engaging citizens, population health approaches advance the health literacy of individuals and communities. Public education campaigns on health-related issues are a common way to foster health literacy. Such campaigns draw upon social marketing concepts and make effective use of various communications mediums including print, television, radio and the Internet. A population health approach also considers the level of literacy among populations in the development and implementation of population health strategies and interventions to ensure broad acceptance and endorsement.

Employ effective public involvement strategies

Population health approaches identify and apply strategies and matching activities along the public involvement continuum to answer the question: "What is my need, and what is the best strategy to address it?" Examples of strategies and matching activities are as follows:

  • Level 1: Inform and educate through communication tools such as fact sheets, information kits, and web pages.
  • Level 2: Gather information and views through listening activities such as workbooks, focus groups and interactive web sites.
  • Level 3: Discuss with or involve stakeholders to encourage discussion to influence final outcomes. Consult through activities such as bilateral meetings with stakeholders, advisory committees, consultation documents, Delphi method, interviews and questionnaires, community surveys, workshops, and town or regional meetings.
  • Level 4 (plus 3): Engage citizens to encourage them to talk to each other and to shape policies and decisions that affect them. Use activities such as consensus-building and partnering activities, consultative conferences and seminars, summits and forums, study circles, and round tables.
  • Level 5 (plus 4): Partner to empower citizens and groups to come up with the solutions and implement the solutions among themselves. Include various enabling and capacity-building activities.

Decisions to involve citizens at the higher level of the continuum are guided by assessments of whether issues involve potential conflicts in values or identity, difficult choices or tradeoffs, or have a major impact on citizens.

The selection of public involvement strategies is also dependent on a number of factors. They include:

  1. the nature and complexity of the issues;
  2. the goal and phase of the policy-making processes;
  3. the expected level of participant influence and involvement;
  4. participant profiles (i.e. the mix of citizens versus group representatives);
  5. the previous experience of facilitators with public involvement techniques;
  6. time lines, financial costs, human resources, and expertise;
  7. the degree of intersectoral collaboration required; and
  8. the level of support for public involvement processes from stakeholders and partners.
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