How APHA policy statements are developed

APHA policy statements help guide the work of the Association. But how are APHA policy statements developed and adopted? For answers, we reached out to the leaders of the Joint Policy Committee, or JPC — the APHA body charged with overseeing the annual process. JPC co-chairs Ayanna V. Buckner, MD, MPH, FACPM, chair of the Science Board; Tara Hayden, MHSA, chair of Education Board; and Martha C. Romney, RN, MS, JD, MPH, chair of the Action Board, explain below.

Q: What are APHA policy statements and how are they developed?

APHA policy statements describe and endorse a defined course of action around current or future public health issues in a manner that reflect APHA’s goals, aims and objectives. The policy statements range from legislation and regulations desired to needed new policies of non-governmental organizations and private enterprises. Policy statements help to shape APHA’s stance on a variety of public health topics reflecting the depth and the diversity of interests and expertise among APHA’s members. The policy statements serve as a regular source of information to many, including APHA staff, members, Affiliates, partners, policymakers and other stakeholders.

Proposed policy statements only become official APHA policy statements after approval by the APHA Governing Council at the Annual Meeting. APHA members, individually and/or as members of APHA components, are encouraged to develop policy statement proposals on key public health topics, including issues that APHA annually identifies as policy statement gaps or policy statements that need updating. Members and components are strongly encouraged to work collaboratively across APHA member groups when developing policy statement proposals to ensure the proposals contain input from all relevant member groups and experts within the Association. APHA members, including APHA Sections, Special Primary Interest Groups, Caucuses and Affiliates, also review proposed policy statements and submit comments and recommendations, which are forwarded to the APHA Science Board and the APHA Joint Policy Committee to consider in their reviews of each proposed policy statement. The Joint Policy Committee, or JPC, which is composed of Science Board, Action Board and Education Board members, considers the Science Board review as well as the feedback from the APHA members as part of its initial assessment and collectively makes a determination as to whether the draft policy statements are accurate, evidence-based and meet the standards outlined in the APHA Proposed Policy Statement Submission Guidelines.

Authors are notified by letter regarding the JPC’s assessment of whether the proposed policy statement has met the APHA Proposed Policy Statement Submission Guidelines criteria. When proposed policy statements have partially met or have not met the criteria, the JPC’s letter to the authors includes recommendations for revising the proposal. Proposed policy statement authors have an opportunity to consider the JPC’s recommendations, revise the proposals and submit them for another review by the JPC. JPC members and APHA staff are available to discuss the assessments and recommended revisions with authors.

During the APHA Annual Meeting, public hearings are held on proposed policy statements. The hearings are intended as an open forum for detailed exploration and discussion of the proposed policy statements among APHA authors and members. The role of the JPC during the hearings is to listen to members’ comments but not to debate the policy statements or the JPC assessment. After the hearings, proposed policy statement authors submit a final draft of the proposals for review by the JPC. The committee meets again to review the proposed policy statements and develop final recommendations to present to the Governing Council. The Governing Council considers the JPC’s recommendations and votes on the proposed policy statements.

Q: As a science-based organization, how do we ensure that policy statements are accurate and evidence-based?

APHA policy statements are expected to reflect the latest available scientific research. Per the APHA Bylaws, the Science Board coordinates the development of the scientific basis for the APHA’s professional and policy statement programs. Through this function, the Science Board reviews and evaluates the evidence base of proposed policy statements. The results of the Science Board review of each proposed policy statement are forwarded to the JPC, and the JPC considers the Science Board’s review results as it makes its assessment. The JPC reports its assessment and recommendations for revisions to authors to ensure that policy statements are accurate, evidence-based and meet the standards outlined in the APHA Proposed Policy Statement Submission Guidelines.

Q: What happens if a proposed policy statement is rejected? Does that mean APHA opposes the aim of the policy statement?

If a proposed policy statement is not approved by the Governing Council, that does not mean that APHA opposes the topic or aim of the policy statement. APHA’s policy statements help to shape the organization’s stance on a variety of public health topics, so policy proposals must meet the APHA Proposed Policy Statement Submission Guidelines and reflect the depth and the diversity of interests and expertise among APHA’s members. If a proposed policy statement is not approved, it can be revised to address the JPC’s recommendations and resubmitted in the next year’s policy statement development process — either by the original authors or by others.

Q: Once adopted by the APHA Governing Council, how are policy statements used and what impact do they have?

APHA, in coordination with its members and state and regional Affiliates, works with key decision-makers to shape public policy to address today’s ongoing public health concerns. The policy statements help to inform APHA’s advocacy work. Once policy statements are adopted by the Governing Council, they help to shape the development of legislative, regulatory and media advocacy activities. APHA staff members regularly refer to APHA policy statements as background for determining whether APHA will support or oppose legislation, regulations and other actions based on the research, general position and recommendations included in the policy statements. The policy statements also drive the content of APHA’s legislative and regulatory recommendations including letters and comments sent to Congress, the White House, federal agencies and the judiciary.

APHA members, Sections and Affiliates also use the policy statements to advocate for public health issues in their states and communities.

Additionally, the policy statements are frequently referenced in peer-reviewed literature and white papers, and they inform resource information for the public such as media reports, infographics, fact sheets, other reports and educational webinars and scientific sessions at the APHA Annual Meeting. All of these uses underscore the need for members to submit policy statement proposals on the issues that APHA identifies in its policy statement gaps.