Is there ever enough evidence? The benefits and limits of evidence-based public health policy: the case of the Victorian Children’s Health and Wellbeing Project
Mark Rix and Sheila Matete
Centre for Health Service Development, University of Wollongong
Contact Email:   mrixuow.edu.au

This paper analyses the issues arising from the collection and use of evidence in the formulation of public health policies, now accepted practice in many countries. The reasons for this widespread acceptance are fairly self-evident. An evidence-based approach allows policy makers to proceed on the basis of what is known and what works, rather than guess-work and speculation. This approach thus reduces the risks inherent in policy making in the politically-sensitive area of public health by providing policy makers with a sound rationale for taking a selected course of action. Notwithstanding its strengths and benefits, however, an evidence-based approach has some intrinsic shortcomings. Because it proceeds on the basis of what is known and proven, it has considerable difficulty in dealing with the unknown and untested. It therefore consistently undervalues the importance of risk-taking and experimentation, often the very things that are called for in effective policy making in the public health field. And in situations where there is no evidence or where the evidence is highly unreliable, an evidence-based approach can lead to inaction and passivity even when prompt and decisive action is needed. This paper will take up these themes by considering in detail the case of the recently-completed Victorian Children’s Health and Wellbeing Project. The authors were members of the team from the University of Wollongong’s Centre for Health Service Development contracted to work on the project by the Victorian Department of Human Services.

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