Evidence-based approach in public health practices is the best alternative and effective measure in advancing public health policy. Evidence-based measure is simply supporting or refuting a claim with scientific data that indicate the claim’s statistical and/or clinical significance or lack thereof. According to Fielding and Briss (2006), evidence-based public health policy is the process of integrating scientific-based interventions with community preferences to improve the quality of life within the population. Based on this approach, they suggested several tools that must be available to reach a better integration outcome, a Type1 through Type3 evidence-based strategies were recommended. The Type1 must include the scientific evidence for the presence of a disease, disease magnitude, severity and preventability. The type 2 includes evidence-based assessment involving specific or current intervention availability, effectiveness or lack thereof. While the type 3 stage is an evidence-based assessment for the feasibility of implementation of an alternative approach (Fielding, & Briss, 2006).

In most part of Europe, comparative study is required in designing evidence-based studies for medicinal or medical or public health intervention (Whitmore, 2004). In contrast, the US public health policy or medical intervention does not require comparative studies for an evidence-based study, hence a placebo or artificial control is used instead of a real-life alternative in an evidence-based study (Whitmore, 2004). Based on this systematic lapse, it is difficult to assess the cost effectiveness and the clinical significant of an intervention (Whitmore, 2004).

Furthermore, the challenges facing evidence-based approach is the feasibility of integrating risk-benefit assessment, cost-efficiency and cost-effectiveness analysis in public health policy within the diverse multicultural and psycho-socio-economic communities. Therefore, recognizing these facts makes it possible to design public health policy based on the community needs and preferences, which may not be a feasible task to accomplish based on the priority of risk-benefit, cost-efficiency and cost-effectiveness analysis.

The risk-benefits assessment weighs the risk of alternative interventions against the benefits. In a better approach, the benefits must outweigh the risks. The cost-efficiency analysis evaluates intervention based on quantity against the cost and the feasibility of the intervention in question. On the other hand, cost-effectiveness analysis is an evaluation based on quality of an intervention weighed against the cost. In other words, the outcome-reach or quality adjusted life years (QALY) must outweigh the cost of the intervention relative to any other available alternatives (Whitmore, 2004).

For instance, according to Fielding and Briss (2006), the walk or bike to school program at the elementary school level is a very active program that aims in reducing obesity among children (Fielding & Briss, 2006). It is clear that the program may not only have statistical significance in keeping kids active and reducing obesity, but the program may have substantial clinical significance in public health issues. However, the program is a community-based sensitive approach. Similarly, the comprehensive pre-school programs for low income children between the ages of 3-5 years old have shown to be effective in improving preparedness to learn. The Task force on community prevention services’ review indicated that13% of children under the program are less likely to be “held back” in grade level and 14% are less likely to go into special education program (Fielding & Briss, 2006). Clearly such program’s benefits outweighed the risks. More importantly, when it can be easily integrated or implemented into other areas, it is cost-efficient and cost-effective in the end.

References

Fielding, J. E., & Briss, P. A. (2006). Promoting evidence-based public health policy. Can we have better evidence and more action? Health Affairs, 25(4), 969–978. doi:10.1377/hlth aff.25 .4.969.  Retrieved from http://content.healthaffairs.org/content/25/4/969.full

Schneider, M.J. (2010). Introduction to public health 4^th ed. Burlington, MA: Jones & Bartlett.

Whitmore, E. (2004). Development of FDA-regulated medical products. Quality Press. Milwaukee, WI.