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Appears in Collections:Faculty of Social Sciences Journal Articles
Peer Review Status: Refereed
Title: Understanding the unintended consequences of public health policies: the views of policymakers and evaluators
Author(s): Oliver, Kathryn
Lorenc, Theo
Tinkler, Jane
Bonell, Chris
Keywords: Public Health, Environmental and Occupational Health
Issue Date: 6-Aug-2019
Citation: Oliver K, Lorenc T, Tinkler J & Bonell C (2019) Understanding the unintended consequences of public health policies: the views of policymakers and evaluators. BMC Public Health, 19 (1), Art. No.: 1057.
Abstract: Background Public health policies sometimes have unexpected effects. Understanding how policies and interventions lead to outcomes is essential if policymakers and researchers are to intervene effectively and reduce harmful and other unintended consequences (UCs) of their actions. Yet, evaluating complex mechanisms and outcomes is challenging, even before considering how to predict assess and understand outcomes and UCs when interventions are scaled up. We aimed to explore with UK policymakers why some policies have UCs, and how researchers and policymakers should respond. Methods We convened a one-day workshop with 14 people involved in developing, implementing or evaluating social and public health policies, and/or evaluating possible unintended effects. This included senior evaluators, policymakers from government and associated agencies, and researchers, covering policy domains from public health, social policy, poverty, and international development. Results Policymakers suggested UCs happen for a range of reasons: poor policy design, unclear articulation of policy mechanisms or goals, or unclear or inappropriate evidence use, including evaluation techniques. While not always avoidable, it was felt that UCs could be partially mitigated by better use of theory and evidence, better involvement of stakeholders in concurrent design and evaluation of policies, and appropriate evaluation systems. Conclusions UCs can be used to explore the mechanisms underpinning social change caused by public health policies. Articulating these mechanisms is essential for truly evidence-informed decision-making, to enable informed debate about policy options, and to develop evaluation techniques. Future work includes trying to develop a holistic stakeholder-led evaluation process.
DOI Link: 10.1186/s12889-019-7389-6
Rights: Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated. © 2019 BioMed Central Ltd unless otherwise stated. Part of Springer Nature.
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