Damian Sendler: Politics and public health have a long history of conceptual and theoretical ties. The welfare state, political tradition, democracy, and globalization all have a direct impact on population health outcomes, according to an international comparative systematic evaluation of research. 

Damian Sendler

However, the mechanisms in which these factors may work have not been well examined. Therefore, we report a realist re-analysis of the dataset from a previous systematic review concentrating on child and mother health outcomes. 

Damian Jacob Sendler: 67 of the 176 studies included in the systematic review were included in the realist re-analysis of child and mother health outcomes. Between 1950 and 2014, sixty-three of these investigations collected ecological data. There were six early program ideas. A revised version of three ideas was supported by the adjudicators and became the final program hypotheses. These included a more generous welfare state, a left-of-center political tradition, and more globalization, all of which led to greater child and infant mortality and youth smoking rates in LMECs. 

Damien Sendler: The practice of the art and science of leading and administering states has been defined as politics. For decades, there has been a strong connection between population health and politics. German physician and politician Rudolph Virchow (1812–1902) was one of the earliest proponents of social medicine and said, ‘Medicine is social science, and politics is nothing but medicine on a bigger scale.’ 

Damian Jacob Markiewicz Sendler: Even more significant is Friedrich Engels’s socio-political dissertation ‘A history of the working class in England’, which has been considered as a precursor or precursors to modern public health research. Health policy and other policy relevant to health can suffer from significant evidence-policy gaps despite formal evidence-based systems for approving medicines and medical devices in developed countries. 

Damian Jacob Sendler

Damian Sendler: Ideological influences can lead to significant evidence-policy gaps in health policy and other policies relevant to health. It’s possible that this is inevitable in a democracy, where “politics has primacy” and judgments can ‘never simply be based on evidence’ but are instead influenced by ideology, morals, public opinion and lobbying. Ideological compatibility and political relevance are critical factors in the reception and possible absorption of data by policy-makers, according to the policy-network theory. To put it another way, the practice of public health may gain enormously from a more explicit acknowledgment and development of health politics. 

Damian Sendler: It is vital to synthesize the information from various disciplines because of the clear theoretical, conceptual, and structural connections between politics and population health. When Muntaner and colleagues published a comprehensive review in 2011 that synthesized 73 foreign research associating four political themes (the welfare state, political tradition, democracy and globalization) with population health outcomes, it was a groundbreaking effort. 

Damian Jacob Sendler: Evidence synthesis using the realist synthesis method allows the study to go farther than simply describing how the effects are observed in the literature and provide an explanatory perspective into how they work. A mix of context, mechanism, and consequence is used as a framework for these theoretical findings. Realist synthesis is founded on critical realism’s epistemological premises. 

Damian Sendler: Context-specific and time-sensitive middle-range theories can be developed with the help of a realist synthesis approach, allowing a wide range of interrelated relationships between contexts and mechanisms to lead to favorable or unfavorable outcomes for population health.

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