Public deliberations
Evidence Ratings
Scientifically Supported: Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.
Some Evidence: Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.
Expert Opinion: Strategies with this rating are recommended by credible, impartial experts but have limited research documenting effects; further research, often with stronger designs, is needed to confirm effects.
Insufficient Evidence: Strategies with this rating have limited research documenting effects. These strategies need further research, often with stronger designs, to confirm effects.
Mixed Evidence: Strategies with this rating have been tested more than once and results are inconsistent or trend negative; further research is needed to confirm effects.
Evidence of Ineffectiveness: Strategies with this rating are not good investments. These strategies have been tested in many robust studies with consistently negative and sometimes harmful results. Learn more about our methods
Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.
Evidence Ratings
Scientifically Supported: Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.
Some Evidence: Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.
Expert Opinion: Strategies with this rating are recommended by credible, impartial experts but have limited research documenting effects; further research, often with stronger designs, is needed to confirm effects.
Insufficient Evidence: Strategies with this rating have limited research documenting effects. These strategies need further research, often with stronger designs, to confirm effects.
Mixed Evidence: Strategies with this rating have been tested more than once and results are inconsistent or trend negative; further research is needed to confirm effects.
Evidence of Ineffectiveness: Strategies with this rating are not good investments. These strategies have been tested in many robust studies with consistently negative and sometimes harmful results. Learn more about our methods
Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.
Disparity Ratings
Potential to decrease disparities: Strategies with this rating have the potential to decrease or eliminate disparities between subgroups. Rating is suggested by evidence, expert opinion or strategy design.
Potential for mixed impact on disparities: Strategies with this rating could increase and decrease disparities between subgroups. Rating is suggested by evidence or expert opinion.
Potential to increase disparities: Strategies with this rating have the potential to increase or exacerbate disparities between subgroups. Rating is suggested by evidence, expert opinion or strategy design.
Inconclusive impact on disparities: Strategies with this rating do not have enough evidence to assess potential impact on disparities.
Strategies with this rating have the potential to decrease or eliminate disparities between subgroups. Rating is suggested by evidence, expert opinion or strategy design.
Health factors shape the health of individuals and communities. Everything from our education to our environments impacts our health. Modifying these clinical, behavioral, social, economic, and environmental factors can influence how long and how well people live, now and in the future.
Public deliberations bring people with diverse backgrounds, values, and perspectives together to engage in dialogues about a topic of public concern, such as complex social issues or policies. Participants are provided with balanced information about a topic before discussion. Dialogues are inclusive, respectful, and open to different opinions. Facilitators or moderators often prompt participants to share underlying values behind an opinion and explore different positions. Public deliberations can be implemented at the national, state, or local level and use face-to-face, online, or combined modes. Public deliberations can also be implemented in various designs or methodologies; examples include Citizens’ Initiative Reviews, deliberative polling, citizen juries, and citizen’s assemblies1, 2.
What could this strategy improve?
Expected Benefits
Our evidence rating is based on the likelihood of achieving these outcomes:
Decreased political polarization
Improved knowledge of public issues
Potential Benefits
Our evidence rating is not based on these outcomes, but these benefits may also be possible:
Increased civic participation
Increased political participation
Increased political self-confidence
What does the research say about effectiveness?
There is some evidence that public deliberations decrease polarization on public issues3, 4, 5 and increase issue knowledge among participants4, 6, 7, 8. Public deliberations that are facilitated and involve diverse participants (in terms of gender, race and ethnicity, opinions, or political affiliation) are more likely to have depolarizing effects than deliberations that involve participants that are similar to each other and are not facilitated3.
Deliberative polling, a type of public deliberation, may decrease polarization in policy attitudes between participants when the pros and cons of policy proposals are discussed in moderated small groups with diverse perspectives4, 9, including between Republican and Democratic participants10. Facilitated small group deliberations also appear to change participants’ opinions about climate and energy policies, resulting in decreased polarization11 and increase their knowledge and understanding of such policies after a deliberation4, 8. A study of a high school civics education program shows that small group deliberations are more likely to reduce polarization of students’ attitudes on public policies than a team debate12. Public deliberations, including online deliberations, can increase participants’ knowledge of public issues6, 7.
Public deliberations may also increase participants’ civic engagement in local communities13 and willingness to participate in politics7. Civic engagement grounded in public deliberations has the potential to create common ground for sustainable community action14. Civic participation may be associated with improved self-reported health, well-being, and emotional health, increased physical activity, and a greater sense of community15. A Michigan-based study indicates that deliberation may not change intention for political participation among participants from underserved communities; the impact may depend on the deliberation’s length and the participants’ decision-making power16. Participating in public deliberations may lead to increased political self-confidence (i.e., the belief of being capable of effective political action)7, 13, 17. Online deliberations may have the potential to increase issue knowledge and change attitudes among participants, though designing online discussion forums that encourage active participation and prevent power imbalance between participants is critical18, 19.
Effects of public deliberations may reach beyond participants and influence the general public. Non-participants who read or are informed of the results of public deliberations (e.g., a statement from a Citizens’ Initiative Review that includes key findings and reasons to vote for and vote against) may have increased issue knowledge20, 21, 22, civic engagement17, political participation17, 20, and political self-confidence in some circumstances23. The impact of public deliberations on voting choices among the general public is unclear22, 24.
For effective and feasible deliberations, researchers recommend employing a skilled facilitator, providing balanced and nonpartisan information, and allowing sufficient time for deliberation25. When sharing deliberation results with the general public, researchers recommend communicating the reasoning behind a deliberative outcome to help the public evaluate policies and make their own decisions26.
How could this strategy advance health equity? This strategy is rated potential to decrease disparities: suggested by intervention design.
Public deliberations have the potential to decrease disparities in civic and political participation by engaging individuals with diverse backgrounds, knowledge, and opinions33. Public deliberations include groups that have been historically marginalized in political processes, address topics relevant to equity, and reflect the belief that people can understand and offer input on complex social issues as equal citizens2, 5. An online survey of voters in the U.S. indicates that people of color, people with low incomes, and younger people are more likely to trust public deliberations than white people, people with higher incomes, and older people22.
Overall, women and people with less education are less likely to make arguments in the face-to-face deliberative process than men and people with more education, but the quality of their arguments is not different34. A study of deliberative polling suggests that there is no participatory difference in online and face-to-face deliberation between men and women as well as individuals with more education and less education35. Another study indicates that for individuals who speak English and have internet access, participation in online deliberations does not vary by participants’ gender, age, or education level36. Organizers can consider how to include individuals with other marginalized identities, such as people with autism and disabilities, into public deliberations37.
What is the relevant historical background?
Thriving democracy requires input from everyone. The U.S. has a long history of excluding people of color, women, and people with low socio-economic status from civic life. Early examples of civic exclusion included overt discrimination based on race, such as the 1896 Plessy v. Ferguson Supreme Court decision which determined that racial segregation was legal38. The Civil Rights Act of 1964 and the Voting Rights Act of 1965 prohibited discrimination based on race, sex, religion, or national origin and guaranteed the right to vote38. More recent examples of civic exclusion include policies that appear more neutral but consistently impact individuals differently based on race and socio-economic status. For example, laws that limit early voting and require voters to show photo ID disproportionately affect those who are Black, Hispanic, and have low incomes39. Current structural barriers include restrictive voting laws, underrepresentation in electoral processes, and being excluded from decision making processes40, 41.
The two-party electoral system in the U.S. contributes to an increasingly polarized political environment42. From 1971 to 2022, political parties in both the House of Representatives and the Senate shifted away from centrist positions, with Republicans becoming more conservative and Democrats becoming more liberal43. There are also substantial differences in political values and views within each party44, and research suggests that the American public is more polarized now than it was in the past45.
Equity Considerations
- What issues of public concern could benefit from public deliberations in your community? How can results from the public deliberation be used to influence decision making?
- How can your community engage people with diverse backgrounds, values, and perspectives in public deliberations? What are barriers to participating?
- What are the guidelines and facilitation needed to insure inclusive, respectful deliberations?
Implementation Examples
Public deliberations have various formats and are implemented at the national, state, or local level. For example, the America in One Room project used the deliberative polling method to engage a nationally representative sample that deliberated on issues important to the 2020 election27. At the state level, Oregon was the first state to establish the Citizens’ Initiative Review program to inform the voting population about ballot measures using a citizen-driven deliberative process28. The Citizens’ Initiative Review process has also been adopted in Arizona, California, Colorado, and Massachusetts29. Portsmouth, NH uses the Portsmouth Listens program to engage local residents in public deliberation about issues facing the community30. Other forms of public deliberations are citizen’s assemblies31 and citizen juries32.
Implementation Resources
‡ Resources with a focus on equity.
Participedia‡ - Participedia. A global crowdsourcing platform for researchers, activists, practitioners, and anyone interested in public participation and democratic innovations.
OECD-Deliberation - Organisation for Economic Co-operation and Development (OECD). Innovative citizen participation and new democratic institutions: Catching the deliberative wave. 2020.
IiDP-Citizens’ assembly - Innovation in Democracy Programme (IiDP). How to run a citizens’ assembly: Handbook.
NCL-Public deliberation resources - National Civic League. Dialogue and public deliberation resources.
Footnotes
* Journal subscription may be required for access.
1 AHRQ-Carman 2013 - Carman KL, Heeringa JW, Heil SKR, et al. The use of public deliberation in eliciting public input: Findings from a literature review. Rockville: Agency for Healthcare Research and Quality (AHRQ); 2013.
2 Blacksher 2012 - Blacksher E, Diebel A, Forest P-G, Goold SD, Abelson J. What is public deliberation? Hastings Center Report. 2012;42(2):14-16.
3 Caluwaerts 2023 - Caluwaerts D, Bernaerts K, Kesberg R, Smets L, Spruyt B. Deliberation and polarization: A multi-disciplinary review. Frontiers in Political Science. 2023;5.
4 List 2013 - List C, Luskin RC, Fishkin JS, McLean I. Deliberation, single-peakedness, and the possibility of meaningful democracy: Evidence from deliberative polls. The Journal of Politics. 2013;75(1):80-95.
5 Curato 2017 - Curato N, Dryzek JS, Ercan SA, et al. Twelve key findings in deliberative democracy research. Daedalus (Journal of the American Academy of Arts & Sciences). 2017;146(3):28-38.
6 Carman 2015 - Carman KL, Mallery C, Maurer M, et al. Effectiveness of public deliberation methods for gathering input on issues in healthcare: Results from a randomized trial. Social Science & Medicine. 2015;133:11-20.
7 Min 2007 - Min S-J. Online vs. face-to-face deliberation: Effects on civic engagement. Journal of Computer-Mediated Communication, 2007;12(4):1369-1387.
8 Canfield 2015 - Canfield C, Klima K, Dawson T. Using deliberative democracy to identify energy policy priorities in the United States. Energy Research & Social Science. 2015;8:184-189.
9 Zhang 2018a - Zhang K. Encountering dissimilar views in deliberation: Political knowledge, attitude strength, and opinion change. Political Psychology. 2018;40(2):315-333.
10 Fishkin 2021 - Fishkin J, Siu A, Diamond L, Bradburn N. Is deliberation an antidote to extreme partisan polarization? Reflections on “America in One Room.” American Political Science Review. 2021;115(4):1464-1481.
11 Ghimire 2021 - Ghimire R, Anbar N, Chhetri NB. The impact of public deliberation on climate change opinions among U.S. citizens. Frontiers in Political Science. 2021;3:1-10.
12 McAvoy 2021 - McAvoy P, McAvoy GE. Can debate and deliberation reduce partisan divisions? Evidence from a study of high school students. Peabody Journal of Education. 2021;96(3):275-284.
13 Knobloch 2015 - Knobloch KR, Gastil J. Civic (re)socialisation: The educative effects of deliberative participation. Politics. 2015;35(2):183-200.
14 McCoy 2002 - McCoy ML, Scully PL. Deliberative dialogue to expand civic engagement: What kind of talk does democracy need? National Civic Review. 2002;91(2):117-135.
15 US DHHS-OASH-HP 2030 CP - U.S. Department of Health and Human Services (U.S. DHHS), Office of Disease Prevention and Health Promotion (OASH). Healthy People 2030. Civic participation.
16 Myers 2020 - Myers CD, Gordon HG, Kim HM, Rowe Z, Goold SD. Does group deliberation mobilize? The effect of public deliberation on willingness to participate in politics. Political Behavior. 2020;42:557-580.
17 van der Does 2023 - van der Does R, Jacquet V. Small-scale deliberation and mass democracy: A systematic review of the spillover effects of deliberative minipublics. Political Studies. 2023;71(1):218-237.
18 Gastil 2018a - Gastil J. The lessons and limitations of experiments in democratic deliberation. Annual Review of Law and Social Science. 2018;14:271-291.
19 Jimenez-Pernett 2023 - Jimenez-Pernett J, Lehoux P, Olry-de-Labry A, Bermudez-Tamayo C. Accounting for power imbalances in online public deliberations. A systematic review of asymmetry measures. Health Policy and Technology. 2023;12(1):100721.
20 Gastil 2018 - Gastil J, Knobloch KR, Reedy J, Henkels M, Cramer K. Assessing the electoral impact of the 2010 Oregon Citizens’ Initiative Review. American Politics Research. 2018;46(3):534-563.
21 Mar 2019 - Már K, Gastil J. Tracing the boundaries of motivated reasoning: How deliberative minipublics can improve voter knowledge. Political Psychology. 2019;41(1):107-127.
22 Mar 2023 - Már K, Gastil J. Do voters trust deliberative minipublics? Examining the origins and impact of legitimacy perceptions for the Citizens’ Initiative Review. Political Behavior. 2023;45:975-994.
23 Knobloch 2020 - Knobloch KR, Barthel ML, Gastil J. Emanating effects: The impact of the Oregon Citizens’ Initiative Review on voters’ political efficacy. Political Studies. 2020;68(2):426-445.
24 Gastil 2016 - Gastil J, Rosenzweig E, Knobloch KR, Brinker D. Does the public want mini-publics? Voter responses to the Citizens’ Initiative Review. Communication and the Public. 2016;1(2):174-192.
25 Ayano 2021 - Ayano T. A survey of methods for evaluating mini-publics. Asia-Pacific Journal of Regional Science 2021;5:1-19.
26 Niemeyer 2011 - Niemeyer S. The emancipatory effect of deliberation: Empirical lessons from mini-publics. Politics & Society. 2011;39(1):103-140.
27 NORC-America in One Room - NORC at the University of Chicago. America in One Room.
28 OR-CIR - Puthenpurayit A. State of Oregon. What is the Citizens Initiative Review Comission?
29 Healthy Democracy-CIR - Healthy Democracy. Citizens’ Initiative Review.
30 Portsmouth Listens - Portsmouth, NH. Portsmouth Listens.
31 PeoplePowered-Citizens’ assemblies - PeoplePowered. Citizens’ assemblies.
32 US EPA-Citizen juries - U.S. Environmental Protection Agency (U.S. EPA). Public participation guide: Citizen juries.
33 Brookings-Bozentko 2021 - Bozentko K, Maciolek A, Reeves RV, Van Drie H. The wisdom of small crowds: The case for using Citizens’ Juries to shape policy. Washington, D.C.: Brookings Institution; 2021.
34 Himmelroos 2017 - Himmelroos S. Discourse quality in deliberative citizen forums – A comparison of four deliberative mini-publics. Journal of Deliberative Democracy. 2017;13(1).
35 Siu 2017 - Siu A. Deliberation & the challenge of inequality. Daedalus (Journal of the American Academy of Arts & Sciences). 2017;146(3): 119-128.
36 Showers 2015 - Showers E, Tindall N, Davies T. Equality of participation online versus face to face: Condensed analysis of the community forum deliberative methods demonstration. In: Electronic Participation. Cham: Springer International Publishing; 2015:53-67.
37 Tabor 2020 - Tabor HK. Civic engagement, autism and deliberative democracy: Prioritizing the inclusion of marginalized perspectives. The American Journal of Bioethics. 2020;20(4):41-43.
38 KFF-History - KFF. How history has shaped racial and ethnic health disparities: A timeline of policies and events.
39 History-Pruitt 2021 - Pruitt S. When did African Americans actually get the right to vote? History. 2021.
40 Pollock 2022 - Pollock EA, Givens ML, Johnson SP. Voting and civic engagement rights are eroding: What does it mean for health and equity? Health Affairs Forefront. March 9, 2022.
41 Pabayo 2021 - Pabayo R, Liu SY, Grinshteyn E, Cook DM, Muennig P. Barriers to voting and access to health insurance among U.S. adults: A cross-sectional study. The Lancet Regional Health - Americas. 2021;2:100026.
42 Pew-Dimock 2020 - Dimock M, Wike R. America is exceptional in the nature of its political divide. Washington, D.C.: Pew Research Center; 2020.
43 Pew-DeSilver 2022a - DeSilver D. The polarization in today’s Congress has roots that go back decades. Washington, D.C.: Pew Research Center; 2022.
44 Pew-Polarization 2019 - Pew Research Center. In a politically polarized era, sharp divides in both partisan coalitions. 2019.
45 Pew-Kiley 2017 - Kiley J. In polarized era, fewer Americans hold a mix of conservative and liberal views. Washington, D.C.: Pew Research Center; 2017.
Related What Works for Health Strategies
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