Health policy, made better with evidence: Q&A with Professor John Lavis
26 February 2024
Every day, health policymakers are called upon to make decisions that impact systems, services and lives. Ideally, these decisions should be illuminated by relevant and quality research evidence. How, then, can the linkages between evidence and health policy be optimised? Professor John N. Lavis, Director of the McMaster Health Forum and International Scientific Advisor to GERI, shares some expert insights in this quick Q&A.
Policymaking is dynamic and contextual, presenting windows of opportunity for the use of research evidence to raise the bar on how decisions are made and followed through. Specifically, evidence-informed policymaking has emerged as “an approach to policy decisions that aims to ensure that decision-making is well-informed by the best available research evidence".[1] Through this, health policies and interventions can become more effective, efficient and equitable, ensuring that limited healthcare resources are better utilised.[2]
As Singapore approaches super-aged status, the attendant surge in related health and social challenges and increased demands on the healthcare system further underscore the need to optimise linkages between research evidence and spheres of policy and practice.
Recognising this, GERI is building on its translational ageing research by expanding its work in health policy research to support evidence-informed policymaking. Professor John Lavis, a leading global authority in this domain, has been working with GERI as the Institute's International Scientific Advisor, providing capacity-building to researchers involved in ongoing projects to inform national strategies on frailty and dementia in the community.
Professor Lavis directs Canada’s McMaster Health Forum and the WHO Collaborating Centre for Evidence-Informed Policy, and co-leads the Global Commission on Evidence to Address Societal Challenges. He brings to GERI his extensive expertise in supporting policymakers and stakeholders to harness research evidence, citizen values and stakeholder insights to strengthen health and social systems and get the right programmes, services and products to the people who need them.
Ahead of his upcoming visit to GERI, we caught up with Professor Lavis for a quick Q&A.
GERI: It has been 15 years since you founded the McMaster Health Forum. Why are you passionate about working in this intersection of research and policy? What keeps you going?
Professor John Lavis: Conducting high-quality research on its own isn’t enough to influence the ‘big bang’ decisions made by government policymakers or the 1,001 smaller decisions that determine whether the right mix of programmes, services and products equitably get to all those who need them. We need evidence-support mechanisms* that are aligned to advisory and decision-making processes^ and to learning and improvement platforms. The Global Evidence Commission, which I co-lead, is working hard to promote such mechanisms. In Update 2024, you can read about the many ways that we’re building momentum for a step-change improvement. The prospect of making impacts like those we’re now pushing for is what keeps me going.
*These are mechanisms that reliably get whatever forms of existing research evidence needed to answer a given question into the hands of those who need it, when they need it, with any required caveats about its currency (or recency), quality and local applicability. [3] This differs from the traditional research system, which is focused on knowledge creation. [4]
^Examples of advisory and decision-making processes include ministerial briefings, cabinet submissions and budget proposals. [5]
What do you think are the main obstacles and enablers in closing the gap between research evidence and decision-making in health policy?
I don’t tend to think about obstacles because much of what is cited as obstacles are features of a robust democracy, such as politicians having to work within institutional constraints, contend with interest group pressure, reflect the values of their governing party and constituents, and respond to events outside the health sector. The enablers are things like advisory and decision-making processes that have explicit standards for how multiple streams of evidence flow to and are integrated for them, and appointments to advisory processes being made in a way that ensures a mix of subject-matter expertise, evidence-methods expertise, and lived experience. You can read more about this in Update 2024.
In your view, does the field of ageing research in particular bring with it any special challenges and opportunities?
People often think that their area of focus – a sector (like primary care), a category of conditions (like cancer, heart disease or frailty), a category of treatments (like prescription drugs) or population (like the elderly) – is somehow unique. And no doubt some factors matter a bit more, and others a bit less. But to me the 'challenges' tend to be fairly common, and the opportunities are always around the next corner.
In your role as GERI's scientific advisor, you have been speaking with and providing your expertise to our researchers who are engaged in health policy research. How has that been like?
It has been fascinating to hear about the types of questions that GERI researchers have about supporting evidence-informed policymaking. I've learned a lot from reading the questions and preparing for our virtual sessions. I'm really looking forward to meeting the team in person so we can have more interactive discussions.
References
[5] Ibid.