How do we translate science into public health policy and law?

Abstract

Scientific knowledge concerning effective preventive measures to preserve and protect the health of the public continues to grow exponentially. Methods for assessing the impact of population-based interventions such as policies and laws have also greatly increased in the past decade, including systematic approaches that allow general findings to be drawn from various studies, especially those developed as part of the Guide to Community Preventive Services (Community Guide). However, the translation of the collected scientific evidence gathered to date has been spotty and problematic. Success stories do exist, including community water fluoridation, a significant factor in improvements in reduction of tooth decay over the past 50 years. Even for interventions with a strong science base, such as community water fluoridation, significant barriers to implementation of effective strategies discovered through research remain. Barriers include public misunderstanding of health issues and proposed solutions such as fluoridation; lack of engagement on the part of the media in communicating known effective strategies; and reluctance on the part of policymakers to champion approaches that concern but may not be advocated by their constituencies. The increasing burden of chronic disease places public policymakers into non-traditional roles, such as advocating behavior change as a preventive measure. Science is a critical tool to help legislators and policymakers "connect the dots" between public policies. For example, the elimination or degrading of physical education programs in schools is an important factor in addressing the national epidemic of childhood overweight and obesity in addition to the increase in rates of Type II diabetes among children. This article provides an overview of the past, present, and future associated with translating science into public health policy and law, including a review of tools and strategies to address existing and expanding public health challenges. The article also provides and discusses examples of translating and implementing science-based solutions to address public health problems effectively.