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Linkages: knowledge, decision making and election results It is satisfying to be able to offer a very readable series of papers this month on the subject of knowledge exchange in public health. Our three conscientious guest editors, David Hunter, Rosemary Rushmer and Allan Best,1 have pulled together a most enlightening minisymposium on this subject, which we are confident our readers will find very valuable, from explaining the sometimes confusing and complex language and terminology associated with the topic, to exploring the theoretical and practical uses of knowledge exchange in public health. Knowledge exchange is not the only entity beset by challenges concerning language: so is Public Health. What is a minisymposium we hear you ask? Well, it is simply a series of papers on a common topic, which we publish in a single issue of the journal. Why we call such a series a minisymposium has never been entirely clear, but, in modern speak, the name has traction and so we retain it. For this issue we thank our guest editors and at the same time would remind all our readers that we welcome proposals from other aspiring guest editors for future minisymposia or themed issues of Public Health. Whilst knowledge exchange might legitimately be described as a rational affair, by the time this issue of Public Health reaches your doormat or digital interface, we in the UK, along with 400 million voters across Europe,2 will have gone through a curious democratic process of elections for our representatives in the European Parliament. There is no way that we want to predict the outcome of these elections, which will by ‘now’ be widely known to any readers who are interested in such things. What we do know, however, is that voting decisions are influenced substantially by emotion and subjectivity, and are not the rational processes that we might assume. Deciding what is best for whom comprises a complex series of questions and most voters are likely to consider some of the issues that affect their daily lives, but not all. The information readily available to voters is skewed towards what representatives of different parties want voters to know: whilst we are fortunate to live in a relatively open democratic society, rather a lot of the information that is readily accessible to most people comes from a particular perspective and is neither objective nor independent. How to distinguish between fact and rhetoric is always a problem in the pre-election period. It is for us, those exposed to such information, to sort out what is fact, and what is interpretation, either biased or unblemished. That is all very difficult and, of course, takes no
account of those voters who simply have a gut feeling about how to cast their vote, a decision which may be entirely free of evidence of any sort. Many people vote ‘because they can’, which is a simple statement of belief in democracy: for those Europeans whose countries have emerged from behind the Iron Curtain within a generation, it is a particularly powerful statement. As firm believers in democracy, we support a fair and open electoral process and would remind ourselves of the simple observation that, along with other similar democracies, our country gets the elected representatives that it deserves. A further consideration, with regard to Europe, is the extent to which our representatives have real influence over decision making. Indeed, some of the UK's representatives may abstain from any decision making following their election, which seems rather to negate the purpose of being there, adding to the difficulty of explaining the electoral system. We would prefer to think that those we elect will roll up their sleeves and argue for what is best for mankind and the planet, but no, some may prefer to opt out of such debate while claiming to represent the interests of our people (and being remunerated for the privilege). The Parliament in Europe has the opportunity to change lives for the better e to support the achievement of United Nations' goals, including the 2525 targets [to reduce premature deaths from non-communicable diseases by 25% relative to 2010 levels by 2025]3 and other global goals for health, which seldom feature in election manifestos, but which, as a public health community, we know are crucial for the future wellbeing of people across Europe and worldwide. So we can at least hope that in the UK and across the whole of Europe, there was sufficient rational thinking and access to accurate and comprehensible information for voters to have achieved the European Parliament that the world deserves and needs.
1. PUHE2062. 2. European Parliament. The importance of voting. Available online at: http://www.elections2014.eu/en/top-stories/content/ 20140428TST45332/html/The-importance-of-voting; 2014 (last accessed 05 May 2014).
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3. Kontis V, Mathers CD, Rehm J, Stevens GA, Shield KD, Bonita R, Riley LM, Poznyak V, Beaglehole R, Ezzati M. Contribution of six risk factors to achieving the 25 25 noncommunicable disease mortality reduction target: a modelling study. Lancet; 3rd May 2014;. http://dx.doi.org/10.1016/S01406736(14)60616-4.
F. Sim P. Mackie The Royal Society for Public Health, John Snow House, 59 Mansell Street, London E1 8AN, UK E-mail address: [email protected]
(F. Sim) Available online 17 June 2014 http://dx.doi.org/10.1016/j.puhe.2014.05.012 0033-3506/© 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
In this issue As you will see from reading our Guest Editorial and the series of papers that follows it, this month's issue is dominated, unapologetically, by a great collection of papers on knowledge exchange in public health. We are treated to some fascinating expositions on critical topics in public health, for the effective delivery of which knowledge exchange and brokering is a vital element. It is demonstrated and argued that progressing from the generation of data to the co-production of useable information at the front line is the rational way forward to ensuring positive impact on population health outcomes. In addition to the knowledge exchange papers, we are fortunate to be able to include in this issue a paper on the determinants and implicit relationships between physical activity and healthy diet and a paper which offers healthy food for the soul - on ethical decision making in public health e where is your moral compass?