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The CDC Policy Process

Public health is concerned with protecting the health of communities and entire populations. Whether as small as a local neighborhood, or as big as an entire country, policy is one potentially effective way to improve the health of populations.

The CDC policy process includes five domains that often overlap or occur in a different order. However, in an ideal scenario, a problem is defined, potential policy solutions are identified, analyzed, and prioritized, and the best solution is adopted and evaluated.

Public health professionals play an important role in the policy process. CDC grantees and public health partners may find this document useful. We have included the potential role of public health for each of the domains as examples.

“Policy” is defined as a law, regulation, procedure, administrative action, incentive, or voluntary practice of governments and other institutions.

Domain Descriptions

I. Problem Identification

Clarify and frame the problem or issue in terms of the effect on population health.

  • Collect, summarize, and interpret information relevant to a problem or issue (e.g., nature of the problem, causes of the problem)
  • Define the characteristics (e.g., frequency, severity, scope, economic and budgetary impacts) of the problem or issue
  • Describe the characteristics of who the problem or issue affects (e.g., age, race/ethnicity, gender, socio-economic status, education level, etc.)
  • Determine whether there are gaps in the data or if there are areas in need of more information
  • Frame the problem or issue in a way that is factual and easy for the audience to understand

Potential Role of Public Health*:

Collect, analyze, and report data analyses and information related to the problem in an issue brief or report with historical context.

II. Policy Analysis

Identify different policy options to address the problem/issue; Use quantitative and qualitative methods to evaluate the effectiveness, efficiency, and feasibility of the policy options.

  • Research and identify policy options by conducting an environmental scan and engaging stakeholders
  • Describe: a) the health impact of the policy (morbidity and mortality), b) the costs to implement the policy and how the costs compare with the benefits (economic and budgetary impacts), and c) the political and operational factors associated with adoption and implementation (feasibility)
  • Assess and prioritize policy options

Potential Role of Public Health*:

Review literature and conduct an environmental scan to identify and describe policy options; assess policy options according to health impact, feasibility, and economic and budgetary impacts; project potential health, economic and budgetary impacts of policies with economic modeling; identify evidence-based policy solutions and report results of analyses in policy brief or policy impact brief.

III. Strategy and Policy Development

Identify the strategy for getting the policy enacted and how the policy will operate.

  • Identify how the policy will operate and what is needed for policy enactment and implementation (e.g., understand context and identify experience, knowledge, and abilities needed)
  • Determine how to engage stakeholders and policy actors
  • Consider drafting the policy (law, regulation, procedures, actions, etc.) to share with stakeholders for feedback

Potential Role of Public Health*:

Provide science and evidence to inform policy development; draft guidelines, regulations, standards, and organizational policies.

IV. Policy Enactment

Follow internal or external procedures for getting policy enacted or passed.

  • Enact laws, regulations, procedures, administrative actions, incentives, or voluntary practice

Potential Role of Public Health*:

Develop database to monitor and track policy enactment, enact regulations and procedures, publish guidelines and recommendations, administrative actions, incentives and voluntary practices.

V. Policy Implementation

Translate the enacted policy into action, monitor uptake, and ensure full implementation…

  • Translate policy into practice and define standards for implementation
  • Implement regulations, guidelines, recommendations, directives, and organizational policies
  • Identify indicators and metrics to evaluate implementation and impact of the policy
  • Coordinate resources and train personnel to implement policy
  • Assess implementation and ensure compliance with policy
  • Support post-implementation sustainability of policy

Potential Role of Public Health*:

Build capacity of states, territories, tribes, and communities to implement policy (e.g., education, training, technical assistance, guidance); support sustainability of policy after implementation (e.g., continued educational efforts).

Overarching Domain

The following activities should be considered throughout each of the five domains.

Stakeholder Engagement and Education

Identify and connect with decision-makers, partners, those affected by the policy, and the general public.

  • Identify key stakeholders, including those who may support and those who may oppose the policy (e.g., community members, decision-makers, nonprofit, and for-profit agencies)
  • Assess relevant characteristics (e.g., knowledge, attitudes, beliefs, and behaviors; information needs)
  • Implement audience-specific communication strategies and deliver tailored messages and materials
  • Solicit input and gather feedback

Potential Role of Public Health*:

Identify and engage relevant individuals and organizations throughout the process (e.g., provide up-to-date information in an issue, policy, or policy impact briefs); assess needs and gather information throughout the process (e.g., understand how a problem is defined, identify barriers and emerging solutions to policy implementation or enforcement).


Formally evaluate the appropriate steps of the policy cycle, including the impact and outcomes of the policy.

  • Define evaluation needs, purpose, and intended users
  • Conduct an evaluation of prioritized questions (e.g., Assess if the problem was defined in a way that prioritized action; how stakeholders were engaged, if the policy is being implemented as intended, and what the impact of the policy is)
  • Disseminate evaluation results and facilitate use

Potential Role of Public Health*:

Evaluate the process, impact, and outcomes of the policy; build the capacity of others to evaluate policy (e.g., training and technical assistance); disseminate evaluation results.

Examples provided for clarification only. They are not intended to list all of the roles public health can play. Federal law prohibits lobbying related activities by CDC at the federal, state and local level. There may be other restrictions on lobbying related activities of which public health professionals should be aware.