I Evidence-based policymaking. Opportunities and challenges
Evidence matters (three examples)
- • For most of the second half of the twentieth century, new parents were advised by medical professionals to place babies to sleep on their fronts - with advocates such as the popular paediatrician Dr Benjamin Spock explaining this could reduce the risk of infants choking in their sleep if they were to vomit (Howick 2011). This practice continued for decades while empirical studies were slowly accumulating evidence that, in fact, babies left to sleep on their fronts might be at higher risk of sudden infant death syndrome (SIDS) than back-sleepers. Finally, in 2005, a systematic review of the literature was published which identified the relative risk of SIDS to be nearly three times higher for front-sleepers. The authors of the review argued that, had a more rigorous review of evidence been done in the 1970s, this ‘might have prevented over 10,000 infant deaths in the UK and at least 50,000 in Europe, the USA, and Australasia’ (Gilbert et al. 2005, p. 874).
- • In the 1970s and 1980s, the oil company Exxon was undertaking extensive research on the effect of burning fossil fuels on the environment. According to a recently published investigation of the company’s internal documents, it was found that as early as 1977, Exxon was aware that carbon dioxide emissions from fossil fuel use could lead to significant and potentially harmful climate change (Banerjee, Song and Hasemyer 2015). According to the investigators, rather than disseminating these findings, the company appeared to promote misinformation on the topic in the decades that followed, claiming that climate change science was ‘still controversial’ and funding organisations like the ‘Global Climate Coalition’ that disputed the science of climate change (Banerjee, Song and Hasemyer 2015; Hall 2015). Exxon’s response to the accusations was to argue that the company has had ‘a continuous and uninterrupted commitment to climate change research’ (Onthemedia 2015).
- • In January, 2003, just a few months before the US sent military forces into Iraq, US President George W. Bush built his case for invasion in his annual ‘State of the Union’ address. In the speech, he presented evidence that many took to be illustrative of a compelling and imminent security risk posed by the Iraqi regime, including a particularly powerful 16-word statement that:
‘The British government has learned that Saddam Hussein recently sought significant quantities of uranium from Africa.’ President Bush’s case for war was particularly controversial, however, with accusations soon being made that the administration misled the public through inaccurate, or potentially even deceptive, uses of evidence (cf. Hartnett and Stengrim 2004; Jamieson 2007; Pfiffner 2004). Indeed, only six months after President Bush made the statement above, George Tenet, the Director of the CIA, stated that: ‘These 16 words [about uranium] should never have been included in the text written for the president’ (Tenet 2003).
Evidence matters for public policymaking. Advocates of greater evidence utilisation commonly point to examples like the first one given above to show how more rigorous or more widespread use of evidence could avoid unnecessary harms and help achieve important social policy goals. Evidence tells us ‘what works’. Yet these individuals also particularly fear and lament what is demonstrated in the other two cases - the potential for cherry-picking, obfuscation or manipulation of pieces of evidence, done to serve political goals. The misuse of evidence matters as well and, for evidence champions, the way to address these concerns has been through the use of evidence-based policymaking (EBP), in which policy decisions are expected to follow from rigorous and accurate uses of scientific evidence.
Such calls for policies to be evidence-based have proliferated so widely in the past few decades as to become a movement unto itself, with calls for increased EBP heard within government bureaucracies, academic institutions and the media alike. We also see the embrace of so-called ‘hierarchies of evidence’, which have been seen as ways to rank or prioritise different types of evidence for policy consideration (Nutley, Powell and Davies 2013). These ideas have further led to EBP becoming an expectation against which political actors can be judged, as seen when criticism has been levelled against governments in cases such as the following: the Canadian government pursuing criminal justice policies based on an ‘emotionally satisfying tough stance’ instead of an EBP (Adams 2015); the Indian government establishing a new Ministry of Yoga without evidence of effectiveness (Kumar 2014); or the British government pursuing immigration restrictions based on public perceptions of immigrants abusing the benefits system rather than evidence showing migrants are less likely to claim benefits than nationals (Partos 2014).
We can also see an enormously wide range of policy decisions where calls are made to be ‘evidence-based’. Examples include the American Medical Association (AMA) arguing that: ‘Laws that regulate abortion should be evidence-based and designed to improve women’s health’ (Barnes 2016), the South African government pursuing an ‘evidence-based’ approach to its employment tax policy, or a British Medical Journal commentary arguing that: ‘Dog ownership has unknown risks but known health benefits: we need evidence based policy’ (Orritt 2014).
-  Transcript available from: http://www.washingtonpost.com/wp-srv/onpolitics/transcripts/bushtext012803.html.