Center for the History and Ethics of Public Health

Evidence and Policy

With Connie Nathanson and Peter Messeri, James Colgrove, with support from the WT Grant Foundation, is examining the circumstances under which state policymakers draw on research evidence when developing health initiatives targeting school-aged children. This project, using nine case studies based on primary documents and interviews, draws on social and political theory to conceptualize and predict forces likely to affect acquisition, interpretation, and use of research around two public health interventions that differ in their evidence base but are both intended to protect children against disease in later life: vaccination against human papillomavirus and prevention of obesity.  Both of these interventions are high on the current agendas of state legislatures as well as in the public eye.

How can child and adolescent health practitioners ensure their interventions are grounded in the best possible evidence? What counts as evidence? These are the questions at the heart of David Johns’ and Ron Bayer’s WT Grant Foundation project. While the importance of evidence-based practice has attained near universal agreement, guidelines from leading authorities on pediatric prevention sometimes differ. This project seeks to understand the history of efforts to advance an agenda of evidence-based practice for children and adolescents by the US Preventive Services Task Force, a key intermediary between scientists and practitioners. The project will produce a contemporary historical narrative on the Task Force and its relationship with another key intermediary, the American Academy of Pediatrics, via document analysis and interviews.

E-cigarettes have sparked fierce debate. Jurisdictions across the United States, acting in the context of a federal regulatory void and wide gaps in knowledge about the safety of e-cigarettes, are trying to decide whether and how to regulate the devices. Amy Fairchild, Ron Bayer, and James Colgrove, with Eric Feldman at the University of Pennsylvania, are completing a Robert Wood Johnson Public Health Law project—a real-time study of policymaking surrounding the politics of these nicotine-based devices that mimic the look and feel of tobacco cigarettes. The study’s goal is two-fold: to advance understanding of the policymaking process, particularly with respect to how scientific research evidence is or is not used by decision makers through case studies of six US cities and the FDA; to identify the key determinants of policy action on this issue, providing a map of the current policy landscape. Funding from the French equivalent of the NIH may position us document and track the politics of harm reduction in a cross national study comparing the US, UK, France, and Sweden.

  • Fairchild, A. & Bayer, R. (2015). Smoke and Fire over E-Cigarettes: Risk, Trade-Offs, and the Politics of Protection. Science. View abstract.
  • Bayer, R., Fairchild, A., Hopper, K. & Nathanson C. (2013). Confronting the Sorry State of U.S. Health. Science. View abstract.
  • Bayer, R., Johns, D. & Galea, S. (2012). Salt: Science, Politics and the Public Health. Health Affairs. View abstract.
  • Bayer, R. & Oppenheimer, G. (2011). Routine HIV Screening — What Counts in Evidence-Based Policy? New England Journal of Medicine. View abstract.
  • Colgrove, J., Abiola, S. & Mello, M. (2010). HPV Vaccination Mandates: Law Making Amid Political and Scientific Controversy. New England Journal of Medicine. View abstract.