L34 - PA A Wicked Policy Problem

• What is a ‘Wicked Problem’?

  • The issues are not easily defined
  • Malignant (in contrast to benign)
  • Vicious (like a circle)
  • Tricky (like a leprechaun)
  • eg climate change, poverty, youth obesity, crime
  • Solutions are tricky
  • Trade-offs, policy surprises & (un)intended consequences
  • Athletics track for World Championships are fast, but likely to cause injury in users afterwards bc/ are too hard for regular use
• What is a 'Wicked Problem'?

  • Problems difficult to solve
  • Wicked as are circular - as when try to solve it, more problems occur from it
  • Difficult to nail down the problem
  • Any interpretation - has different solutions; may not always align
• Wicked Problems: Solution ‘Bike Back’

  • Problem:
  • Cobra snake bites/deaths in Delhi
  • Rats/disease in Vietnam
  • Rabbits/overgrazing in NZ
  • Too many snakes/rats/rabbits?
  • Solution:
  • Reverse effects: breeding more snakes;
  • Cutting off tails & ears, to gather more bounties
  • Attempts to fix wicked problems, often result in new ones ‘rearing their heads’
• Wicked Problems: Solution ‘Bike Back’

  • Once try to solve problem, solution bites back
  • Pay to kill pests, so they breed them to have more to kill, to make more money
  • New problems arise
  • eg bunnies, regions give money for tails, one for ears (so had 2 ways of income or just bunnies still alive just without ears or tails) - problem not solved
• So… Why is PA a Wicked Problem?

  • There are multiple interpretations of the problem
  • People are ill-informed about the benefits of exercise & PA & need to be sold on the idea
  • Individuals face barriers:
  • Not enough time
  • Not enough money
  • Not enough appealing/suitable programmes on offer
  • Not enough facilities
  • Not enough self confidence
  • Consumer society discourages PA
• So… Why is PA a Wicked Problem?

  • Not a simple thing
  • Interpret problem in cognitive nature (psychology) - social psych
  • Difficult is when trying to solve it which one do we focus on, what is more true than the other
  • Everyone know exercise is good
  • Motivation - still doesn’t tell us enough, how do we interpret that motivation
  • Can’t induce people to exercise that their body should look a certain way
  • Can’t attribute cause in same way for everyone
  • What one can we do something about?
• So… Why is PA a Wicked Problem?

  • Disagreements about problem
  • Not know that exercise is good
  • Too ashamed to exercise or not ashamed enough?
  • How can we know the difference bw/ barriers & excuses or rationalisations
  • Construction by government or by you
  • How can we know which of the causes is more true?
  • In terms of public policy/health promotion - is this a problem at all, individual vs everyone
  • Are sedentary behaviours a public problem at all? Depends on who you ask!
• Whose Problem is it?

  • Wicked problems are highly contentious bc/ there is always disagreement about who should do something about it!
  • Is PA:
  • An individual responsibility?
  • Individual - got info that is good, your decision
  • A family responsibility?
  • A government responsibility?
  • Schools
  • District Health Boards
  • Territorial Local Authorities
  • A commercial or private sector responsibility?
  • The responsibility of civil society organisations (e.g. clubs)?
• Whose Problem is it?

  • Public? - people making choices like that affect my taxes
  • If it is a collective problem, who will take care of it?
  • Important to note interpretation of problem isn’t value free (is bias)
  • Every expert says align with their expertise
  • What's generally not considered a problem is the private sector (gym), does not see obesity as problem but as an opportunity for their business
• Solutions & Policy Instruments

  • Carrots, sticks & sermons
  • How can government agencies & other organisations get more people to be active?
  • The ‘carrot’ → Rewards
  • eg additional funding to indice providers to ‘lift their game’
  • Carrot = if given resource use it
  • The ‘stick’ → Punishments
  • eg compulsory fitness?
  • eg taxes on ‘harmful’ goods
  • Stick = more difficult; can’t force someone to exercise (compulsory for primary school)
  • The ‘semon’ → Appeals to be good
  • eg public information campaigns?
  • Sermon - eat something when you drinking (alcohol + food = more calories, contradiction)
• Solutions & Policy Instruments:

  • Public policy - through tools (tax - very powerful tool), access to resources, has money & power/authority
• Carrots: Rewards & Incentives:

  • Job promotions or appointments based on fitness
  • Subsidies for gym memberships
  • Tax credits to offset costs of memberships &/or equipment
  • Closer parking spaces for the fit?
• Carrots: Rewards & Incentives:

  • Follows basis of built environment (same fundamental idea)
  • Build environment in way someones got to exercise
  • These things do exist
  • Firefighters - fitness test required
  • Tax credits - if register for club can get rebate from what you spend for that club, subsidy (encourage people to be more active)
• Subsidising Participation: Reducing Cost Barriers:

  • Exposure Events
  • Festival clinics, low intensity one-off taster events
  • Might be wicked, tricky or contentious?
  • Considered to be low engagement programmes
  • “We note particularly strong growth in medium & low engagement programmes over the course of the investment period, but an overall decline in high engagement participants”
  • “[Organisation x] “ran comprehensive exposure programmes nationally… made up of Skills Sessions & Festival Days” but saw declines in high engagement & club memberships
• Subsidising Participation: Reducing Cost Barriers

  • Subsidy to reduce barrier of cost & promote PA
  • Sport NZ - distributes money
  • Side effect/wickedness of this - give money for sport, then do exposure event, no idea what happens after that (if continue)
  • Looks good for government - solving problem?
  • Takes organisations away from what they were designed to do (for regular participants)
  • Number of sustained participants decline, while on paper looks good from exposure event number
• Uptake & Effectiveness of the Children’s Fitness Tax Credit in Canada: the rich get richer

  • Tax credit tends to reward those already with high income
  • As can afford it to begin with
  • Need certain level of education
• The ‘Stick’:

  • Compulsory instruments
  • Vehicle use tax?
  • Warrant of Fitness (cars & people?)
  • Compulsory PE in schools/workplaces?
  • Weight charges on aircraft? Stand up desks?
  • Why are compulsory instruments ‘wicked’?
• The ‘Stick':

  • Side effects of the stick
  • One instrument never quite enough - multiple/subsequent instruments required (eg smoking)
  • Tax, shame, discourage places to do it, ban from inside bars/restaurants
  • Big difference for stopping someone, and inducing someone to do something
  • Harder to get someone to do something than stop something
  • People will reject
  • Every rule some will disagree/against them
  • People who are harmed by tax (eg sugar drink tax) will affect their benefit/business
• The ‘Sermon’:

  • Does lowering the threshold of ‘PA’ (to include gardening & house cleaning) really help?
  • Ads/Posters - don’t lead to change in behaviour
  • How do they measure if they work?
  • Self-reported, phone people & ask if familiar with it
• The NZ Medical Journal: Evaluation of the national ‘Push Play’ campaign in NZ - creating population awareness of PA

  • Recognise the brand recognition
  • Cheap to run, even though don’t work in way think will work, do other things in political sense keep problem in public agenda, to lead to interventions
• Why has Push Play made a Comeback?

  • It's time to Push Play - Again, Aotearoa
  • Needed to show they were doing something
• Procedural Instruments: Green Prescription

  • Procedural instruments like this coordinate activities &/or directs traffic
  • Connects providers, sets the stage, for initiatives to be built
  • Green prescription: canterbury scratched it (no money towards it)
• Wickedness of Coalitions as Procedural Instruments:

  • On the disestablishment of the ANA:
  • “The work of ANA will be missed by many in the public health nutrition & PA sector
  • Missed as a connector of people”
  • It was the centre of a “spider’s web” of contributing players
  • “Was driving further away from why we were actually set up in the first place
  • “Set up to support & advocate & collaborate with members & organisations But we were competing for the same limited funding”
• Wickedness of Coalitions as Procedural Instruments:

  • Collusion of organisations
  • Doesn’t do anything for individual - doesn’t change behaviour
  • Wicked problems - require complex web of providers to address it
  • In competition for money - for organisations it was meant to help (not good as such)
• Can PA Policies & Programmes Create New Problems:

  • 1.Does promoting PA create more inequity? Will higher income earners take more advantage of subsides?
• Can PA Policies & Programmes Create New Problems:

  • 2. Can PA promotion create as much CO2 as it claims to reduce?
  • Companies want you to buy shoes, kayaks, bikes, waterproof jackets, watches, wetsuits - do those who exercise buy/consume more?
  • PA tends to be aquarted with consumption - to be fit have to purchase stuff
  • If everyone was out in outdoors they would be purchasing the stuff they need
  • Not true necessarily but something to think about
• Can PA Policies & Programmes Create New Problems

  • 3. Might programmes that encourage exercise amongst a particular race, gender, sexuality discourage societal integration or cultural understanding?
  • Programmes for diverse groups - is there a side effect of that
  • Is that really good for creating a diverse society
• Can PA Policies & Programmes Create New Problems

  • 4. Could making a pedestrian city (with fewer cars & more public transport) make people time poor & therefore less likely to exercise?
  • Takes time (walking/PA)
• The Political Instruments:

  • The dismal truth is that often [problems & solutions] never combine
  • Solutions may seek problems, decision-makers seek solutions, & problems seek decision-makers… problems are recognised but ignored, solutions shelved for want of the right problem, & decision-makers grow tired of sifting through the existing agenda