What is policy and where do we look for it when we want to research it? Brad Crammond, 1 Gemma Carey 2 1 Michael Kirby Centre for Public Health and Human Rights, Monash University, Melbourne, Victoria, Australia 2 Centre for Public Service Research, Business School, University of New South Wales Canberra, Canberra, Australian Capital Territory, Australia Correspondence to Dr Gemma Carey, Centre for Public Service Research, Business School, University of New South Wales: Canberra, Northcott Dr, Campbell ACT 2612, Australia; g.carey@adfa.edu.au Received 13 June 2016 Revised 14 October 2016 Accepted 3 November 2016 To cite: Crammond B, Carey G. J Epidemiol Community Health Published Online First: [ please include Day Month Year] doi:10.1136/jech-2016- 207945 ABSTRACT Public health researchers are increasingly concerned with achieving ‘upstream’ change to achieve reductions in the global burden of disease and health inequalities. Consequently, understanding policy and how to change it has become a central goal of public health. Yet conceptualisation of what constitutes policy and where it can be found is very limited within this field. Our glossary demonstrates that policy is many headed. It is located in a vast array of documents, discussions dialogues and actions which can be captured variously by formal and informal forms of documentation and observation. Effectively understanding policy and its relevance for public health requires an awareness of the full range of places and contexts in which policy work happens and policy documents are produced. INTRODUCTION Public health researchers are increasingly concerned with achieving ‘upstream’ change to achieve reduc- tions in the global burden of disease and health inequalities. 12 Consequently, understanding policy and how to change it has become a central goal of public health. 3 This turn to policy in public health has spawned many new research areas. One has been to examine closely the political process itself, emphasising its value-laden nature and the contested role of scien- tific evidence in policymaking. 4–7 Another has been to investigate the existing policies for their public health consequences. 8 A third is to quantify healthy policy by counting the ‘healthy’ policies in a juris- diction. 9–12 Across this work on policy attention is given predominantly to the subject matter of policy with rarely any consideration of what policy is, par- ticularly with respect to its form. 10 This is despite an extensive literature in political science and public policy on the nature of the policy process 13–17 and the utility of evidence-based policy. 18–20 Nonetheless, the specifics of policy in the public health literature have been described as ‘somewhat elusive’, with the process of turning proposals into law treated as being ‘best left to politicians’. 8 Policy work can be found in diverse places under diverse titles—beyond official policy documenta- tions. 21 It is worth noting that these exist in a hier- archical relationship, but operate together in a way akin to what public health would term an ‘eco- logical’ perspective. 22 This metaphor helps to understand that many levels of policy must combine in order to achieve even relatively straight- forward outcomes. The current state of tobacco control in countries such as Australia is an excellent example of how policy change has occurred at all available levels in support of a single public health aim. 23 In this glossary, we provide a summary of the dif- ferent types of policy, noting the ways they are rele- vant to public health. We comprehensively outline different forms of ‘policy’ from their most concrete and far reaching (ie, constitutions), through to the more elusive and discursive forms policy can take (ie, policy as discourse or narrative). In so doing, we hope to assist future public health policy research by showing that policy, far from being best left to politicians, can be fruitfully mastered by public health practitioners and researchers. THE CONSTITUTION For many countries, the Constitution is the founding piece of policy. 24 Constitutions set out the powers of government (often separated into different branches), along with the processes of law making. 25 Constitutions are formed when new political orders emerge: either when new nations are brought into being, recent examples are Kosovo and South Sudan; or when old governments are overthrown and replaced, as has happened in Tunisia and Egypt. The terms of a new Constitution are often controversial, not only because they allocate power but also because once in place they are deliberately difficult to change. 26 For public health, constitutions play two relevant roles. Where the Constitution includes a Bill of Rights, those rights may have a bearing on important health issues. The South African Constitution, for example, includes a right to health in its list of funda- mental human rights. In 2002, the Constitutional Court held that inadequate HIV-treatment availability was a breach of South Africans’ human rights, 27 forcing the South African government to make anti- retroviral medications widely available. 28 The right to life, originally interpreted as a freedom from extrajudicial execution, is commonly included in constitutional bills of rights and has also been invoked in the health services context. Uganda is currently debating whether the right to life includes a right to access maternal health ser- vices. The families of two women who died in childbirth have petitioned the Ugandan Constitutional Court, arguing that the lack of maternal health services available in Uganda vio- lates the constitutionally enshrined right to life. This case remains before the Constitutional Court with the Ugandan Supreme Court ruling in October 2015 that they had the jurisdiction to hear the petition. A secondary role of Constitutions is to delineate each level of government’s powers. In federal systems like India, Australia, Canada and the USA, Crammond B, Carey G. J Epidemiol Community Health 2016;0:1–5. doi:10.1136/jech-2016-207945 1 Glossary JECH Online First, published on November 18, 2016 as 10.1136/jech-2016-207945 Copyright Article author (or their employer) 2016. Produced by BMJ Publishing Group Ltd under licence.