The conditions for healthy living are shaped by public policies, mediated in their development and implementation by governmental and other organisations. Public policy is a guide to government action in order to alter what would otherwise occur; its purpose is to achieve a more desirable or at least acceptable state of affairs. An understanding of policy making can guide strategic planning so as to affect the direction and pace of policy making in order to improve the prospects for the health of populations; that is, it can increase the odds of designing and reaching health-supporting policy goals by guiding the selection and execution of the means to influence policy decisions.
Political ecology is here defined as those players and relationships that shape decisions about who pays for and who gets what from the determinants of health: education, employment, housing, health services, secure and healthy environments, access to information and to decision-making arenas. The players are the organised groups whose interests are affected by current and prospective policies. These include interest groups such as political parties, the media, bureaucracies, voluntary and commercial organisations. The media are in a unique position among organisations. They are not only conduits, creators and sculptors of information and issues; they are, as large profit-making corporations, interested parties in many types of public policies pertaining to taxation, workplaces, information and economic regulation. They are entrepreneurs and seek to attract audiences and advertisers (OTA, 1993; Cappella and Jamison, 1994).
All these players interact in a climate which arises from current and expected social, economic, political, technological and demographic conditions. That environment has already been influenced by past and current public policies. Thus both formal and non-formal policy-making activities are sensitive to the times and timing of actions undertaken to influence policy making, the timeliness or fit of proposed policies, the resources and strategic skills of the players as well as the concurrent accidents of history and nature (Rochefort and Cobb, 1993; Whiteman, 1985). These ongoing outcomes of policy making, among other things, shape the conditions for health of populations, especially disadvantaged sub-groups.