Public health is in the spotlight of public and political concern, providing a unique window of opportunity for its revitalization and restoration as a pillar of the Canadian health care system. The establishment of a Federal Public Health Agency is a critical first step. The public health community has identified key challenges toward this renewal. However, public health ethics have received little attention and, when addressed, have focussed almost exclusively on communicable diseases. The ethical issues inherent in public health transcend infectious diseases and are distinct from clinical and research ethics. Identifying and addressing ethical issues at the heart of public health, including the public interest and the common good, as well as fundamental issues related to the core functions of public health will be essential if this revitalization of public health is to be achieved. While legal and regulatory reforms are necessary, they will not be sufficient to adequately address fundamental questions of the valuing of public health or the ethical issues in public health. Elements of a research agenda on the ethical foundations of public health reform are identified here.
The aim of this study was to describe trends in attitudes to alcohol control policies in Norway over a period of 50 years and to discuss how these trends relate to developments in alcohol policy.
Survey data from 17 national population surveys, national statistics and previous publications were applied to describe trends in attitudes to alcohol control polices (access to alcohol and price) and changes in these policies over the period 1962 to 2012.
From 1962 to 1999, an increasing proportion of the population reported that regulations on availability of alcohol were too strict and that alcohol prices were too high, whereas in the 2000s this trend was reversed and support for existing control policies increased. Although the pillars of Norwegian alcohol policy--high prices, restricted access and a state monopoly on retail sales-remained, control policies were gradually relaxed throughout the entire period.
Relaxation of strict alcohol control policies in Norway in the first four decades were probably, in part, the result of increasingly liberal public opinion. The subsequent reversed trend in opinions with increasing support for control policies may be due to several factors, for example, consumer-oriented changes in the monopoly system, increased availability and affordability, increased awareness of alcohol-related harm and the effectiveness of control policies. Thus, the dynamics of policies and attitudes may well change over time.
A framework of policy development is presented that identifies the role various forms of knowledge can play in the policy formation process. The framework is based upon the premise that public health and health promotion issues should be addressed within an analysis of policy change that considers concepts of interactive and critical knowledge in addition to scientific knowledge. Progress in developing meaningful health policy will require accepting the validity of these various forms of knowledge and developing frameworks that see experts and citizens working together to develop and achieve public health and health promotion goals.