Moving Beyond a Lack of Political Will: the case for a political science with public health

As academic disciplines, political science and public health have very different conceptions of politics, the policy-making process, the roles of appointed experts, and global governance. This paper seeks to describe this pattern, offer some explanations as to why it exists, and then make the case for a political science with public health as a way of building bridges between the political science and public health scholars and practitioners. The first part of the paper will review of the surprisingly complex and multiple conceptions of what public health is (e.g., why combine the word ‘public’ and ‘health’) and their differing implications for how politics is understood. I will describe how members of the public health enterprise – the state and non-state actors who work in health promotion, disease prevention, and public health regulation – often assert that ‘public health is political’. In practice, most public health research ignores politics altogether or the gap between government action and scientific evidence is attributed to not understanding the science or a lack of political will. More importantly, public health scholars and practitioners appear to underestimate the recent political and governance challenges that are the subject of a great deal of recent political science research. Within states the right-wing populism, mistrust of elites and experts, and democratic backsliding contribute to an increasingly polarized disagreement about routine public health measures. Between states, global public health action is more challenging in a multi-polar international system if not the outright decline of a rules-based international order. In this context, public health calls for technocratic decision making based on ‘more science’ or a stronger World Health Organization are woefully inadequate if not illiberal. Faced with the truncated public health conception of politics, the second part of the paper makes the case for an approach to building bridges between public health and political science. Drawing on previous research* the paper will make the case for a political science with public health. To begin, I will briefly sketch how political science researchers have much to learn from public health scholars. In what follows I will argue that the public health enterprise can benefit from collaboration with political science to better understand the inherent legitimacy, and limits, of politics and political institutions. But political science theories, concepts, and tools cannot simply be used instrumentally to inform some broader public health goals. However, a simple political science critique of public health theory and practice is equally inadequate. Rather, a political science with public health integrates public health research and engages critically with the central concerns of public health: the use of scientific evidence, health equity, and health essentialism. The paper concludes with an overview of some practical ways of moving to a political science with public health. This includes how to foster interdisciplinary collaboration and strengthen public health training such that ‘politics’ is understood to be something more than an obstacle to evidence-based policy making. *Fafard, P, A Cassola, and E de Leeuw (eds.), Integrating Science and Politics for Public Health. Springer, 2022.