Public Health from the Middle-Out: A New Analytical Perspective

Yannai Kranzler, Yael Parag and Nadav Davidovitch
Additional contact information
Yannai Kranzler: Office of Population Health, New Jersey Department of Health, Trenton, NJ 08608, USA
Yael Parag: School of Sustainability, IDC Herzliya, Herzliya 4610101, Israel
Nadav Davidovitch: School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beersheba 8410501, Israel

IJERPH, 2019, vol. 16, issue 24, 1-16

Abstract: Obstacles to collaborative public health frameworks such as Health in All Policies continue to emerge. Partnership-based public health programs present opportunities to study how public servants and practitioners address these barriers in real time. To this end, we utilized “Middle-Out,” a socio-technical analytical approach that highlights the importance of Middle Actors-stakeholders positioned between policymakers and grassroots—to policy diffusion, innovation and collaboration in public health. We conducted participatory observation in administrative settings of Israel’s National Program to Promote Active, Healthy Lifestyle, 30 stakeholder interviews and document analysis. We examined two dimensions of impact from the Middle-Out: Directions of Influence —Middle-Up, Middle-Down and Sideways, and Modes of Influence —Enabling, Mediating and Aggregating. Through Middle-Out’s lens, our analysis transcends visible benchmarks such as legislation and macro-level resource-allocation, focusing, instead, on elusive administrative spaces within which Middle Actors shape policies, steer funding and facilitate continuity. Incorporating Middle-Out into public health’s conceptual toolbox, we conclude, can improve understanding of complex public health policy arenas, increase recognition of critical socio-technical changemakers and catalyze more effective design of policy tools and strategies that specifically harness Middle Actors’ strengths and qualities.

Keywords: public health; collaboration; health in all policies; obesity; middle actors; middle-out (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

Downloads: (external link)
https://www.mdpi.com/1660-4601/16/24/4993/pdf (application/pdf)
https://www.mdpi.com/1660-4601/16/24/4993/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:16:y:2019:i:24:p:4993-:d:295576

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().