Evidence to inform intersectoral policies: a comparison of health and transport sector evidence in support of road traffic injury prevention

Bao, James; Bhalla, Kavi; Bennett, Sara · 2015 · Crossref

DOI: 10.1186/s12961-015-0008-9

archive: archived pipeline: cataloged verified

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Summary

This study investigates whether health and transport sectors employ differing evidentiary traditions when formulating policies for road traffic injury prevention (RTIP). Motivated by the growing emphasis on intersectoral approaches to health, the authors sought to determine if distinct scientific paradigms and values regarding evidence validity might hinder collaborative policymaking. The research focuses on RTIP as a case study due to its significant global burden and the involvement of both health and transport sectors, which historically operate within biomedical/epidemiological and engineering/social science frameworks, respectively. The researchers analyzed 12 influential global policy reports on RTIP published between 2002 and 2013 by the World Health Organization (WHO), the World Bank (WB), and the Organization for Economic Cooperation and Development (OECD). These reports were categorized as health, transport, or mixed based on their publishing institutions. The analysis examined four dimensions: authorship networks, types of research evidence cited, key recommendations, and indicators used. For each report, the authors extracted sectoral affiliations of contributors, categorized citations across seven intervention areas (e.g., alcohol use, road design, speed limits), and identified recommendations and indicators from concluding sections. The results revealed stark differences in authorship and evidence citation practices. Author networks were dominated by the sector of origin; for instance, health reports featured public health experts, while transport reports featured transport sector professionals. Mixed reports showed clustering based on the specific topic addressed. More significantly, the types of evidence cited varied substantially. Health sector reports emphasized observational studies (26.5%) and reviews (19.1%), with a high proportion of citations from peer-reviewed journals (39.7%). In contrast, transport sector reports relied heavily on government agency and organizational reports (69.1%), with minimal use of peer-reviewed literature (4.9%) and no citations of systematic reviews. Despite these divergent evidence bases, the study found no significant differences in the recommendations or indicators used. Recommendations across all sectors were generic, focusing on policy implementation processes rather than specific interventions. Similarly, indicators such as absolute injury counts and fatalities per 100,000 population were used consistently across sectors, while complex measures like disability-adjusted life years were rarely used. The authors conclude that differing valuations of evidence, rooted in each sector’s historical development, may undermine effective intersectoral policymaking. While the sectors converge on recommendations and indicators, their reliance on different types of evidence suggests potential barriers to mutual understanding and legitimacy. To address this, the paper recommends identifying key individuals to bridge sectors, tailoring knowledge translation activities to account for sectoral differences, and adapting messages for different audiences. These strategies aim to facilitate the integration of diverse evidentiary traditions in future intersectoral health initiatives.

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• comparative international
• regulatory evaluation