Policy Name:
Advertisement ban to under 12’s
Food labelling
Interventions: C4L and sugar swaps
Aims of the Policy: To ban advertisement to under 12’s to reduce childhood obesity rates. Rates of childhood obesity have increased across over the UK, especially in the most deprived areas of England.
Link between Capital Theory and Scarcity Theory
By using inequality theories to highlight how policies effect individuals on a local level, PEN illustrated a simplified link between Bourdieu’s Capital Theory and Mullainthan and Shafir’s scarcity theory and the food choices / behaviours of people classed as low socioeconomic.
Capital Theory
Individual responsibility (blame) and education for behaviour change (neo-liberalism view)
The capital theory highlights the different physical, economic, sociocultural and food buying choices and opportunities which effect health and wellbeing of those classed as low socioeconomic (Djojosoeparto et al., 2022). Policies have notoriously focused on individual blame and research of behaviour change has leaned towards educating the individual through theories commonly used such as the Theory of Planned Behaviour to support self-efficacy and changing attitudes toward health food choices (Povey et al., 2000).
Policy to enforce healthy foods and education, subsidies, regulation of unhealthy foods
Mobilising social support is costly and ineffective if the environment is not also changed through policy to address inequalities. Deprived areas often have higher quantities of processed cheap foods available and a lack of fresh, low-density foods. Health surveillance can play a part in highlighting community needs to target local level interventions and financial support (Darmon & Drewnowski, 2008). Policies which enforce healthy foods and education within schools, Government subsidies to regulate accessibility of healthy foods for all in shops and regulating unhealthy foods could improve inequalities between communities. Universal structural environment food policies and media campaigns are deemed gold standard to reduce health inequalities for individuals (Caraher & Coveney, 2004).
Policies which ban promotion of unhealthy foods is needed.
Bourdieu’s Theory states that an individual has capital in the form of labour (accumulated material gains) setting their social position in the world, cultural capital refers to values, knowledge, educational status, skills, experiences, and friendship experiences leading to lifestyle embodied, including health habits strongly influenced by social norms of close friendships and family who become part of the individual’s identity and social class (Social capital) (Oncini & Guetto, 2017: Bourdieu, 2018). Studies have evidenced how an individual’s social status is further influenced by exposed media, lower SES groups have a higher exposure to targeted advertising of cheap fast foods and misinformation affecting food and health choices especially in children and adolescence, which reinforce the media feedback loop and setting the viewing of newsfeeds. This digital divide is widening the inequalities gap where policies which ban promotion of unhealthy foods is needed (Kumanyika & Grier, 2006). Puncuated Equilibrium states the amount of accepted evidence plays a part, assessment of similar policies done in other countries plays a part in deciding to provide policy (Bak, & Sneppen, 1993).
Implementation of the ban on promotions of unhealthy foods delayed
In the Uk the Government recently put out a statement to delay the advertising restrictions due to take place Jan 2023 to Jan 2024, due to advertisers, regulators and broadcasters needing more time to restructure (Balogun et al., 2021). This shows the delicate interplay of capitalism, politics and lobbyists and the need to be pleased above the needs of individuals health and wellbeing (Boutaud et al., 2016). Policy actors and Government framing of issue solutions lean towards personal responsibility of dietary choices and shock statistics regarding environmental catastrophe, but very little action in upstream legislation, thus Food policy has reached an equilibrium. In order to achieve meaningful change it would now require shocking research, possible external changes such as contamination of cheap ultra-processed food line supplies causing health problems and scarcity in mass populations or extensive aggressive anti global food company lobbying (Kersh, 2009). There are so many social issues actors can give attention to, they simply to not have the time, resources, and attention so they ignore most and prioritize a few and resources will impact the priorities (True et al., 2019).
The Scarcity Theory
The scarcity theory is the mindset of not having enough. A lack of time, money, choice, support, and opportunity is common within low socioeconomic groups living in often difficult and unpleasant living conditions, working hours and limited choice of nutritious foods and safe spaces to exercise often leading to higher levels of stress and mental health issues. (Darmon & Drewnowski, 2008). Studies have shown parents living in scarcity will often buy unhealthy foods to compensate for other scarcities in the home. It is also apparent that children tend to enjoy bland, beige foods and families on a budget may not have the option to cook good food which children refuse to eat (Swinburn et al., 2011). Many parents’ priority is price reductions and find food labelling ambiguous. In addition, higher SES groups found healthy foods at eye level, near the checkout (Nudge tactics) useful, whereas Low SES groups didn’t on a conscious level, however unconsciously nudging has been found to work in many studies (Pinto et al., 2021).
Policy can widen the inequality gap
Policy can often widen the inequality gap; food labelling has proved to be read by higher SES groups who have the time and energy to do so. Low SES groups who are dealing with difficult living conditions and basic living tasks such as ensuring bills are paid, therefore have less time and energy to spend time reading labels on foods for nutrient information. Food labelling is therefore aiding higher SES groups, who also have buying choice and cognitive bandwidth to engage in research and food label reading (Djojosoeparto et al., 2022)
Discuss how policies are formed.
In the case of food policy, the complex landscape involves food policy, food politics and environmental politics, thus making a very complex issue to tackle. Harold Lasswell, stated “Food policy is deciding who eats what, when and how and with what consequences? (Hajer, 2003). Food policy frames the cycle of how food is produced, grown, processed, distributed, and consumed and the effect it has on the determinants of population health and the environment. Within the cycle there are those who wish to control it through lobbying and global sophisticated tactics. (Keck & Sikkink,1999).
A weighing up on possible effect is also a consideration with punctuated Equilibrium, how difficult is it to create change with policy, i.e., environmental issues are incredibly complex, effecting all other policies (Jones & Baumgartner, 2012). The complex web of interest groups, social forces from Government, supply chain and the public. Involvement is vast from Environmentalists, Epidemiologists, Nutritionists, Economists, Geographers, Historians, Journalists, Political Scientists, Psychologists, PHE Specialists and Sociologists due to impact food security has on the future and survival of the Uk population (Lang et al., 2009).
The distinction of problems Think tanks and actors are having to solve between historic pre- 2000 where nutrients and scarcity were the issues to contemporary issues of high fat / salt, possible contamination due to the control of food chains in the hand of a few companies and a move away from farm investment to targeted social investment to support the growing cohort of disadvantaged in society and environmental catastrophe (Barling et al., 2002).
A lack of policy leaves minority and disadvantaged groups open to stigma, blame and a lack of opportunity
Punctuate Equilibrium highlights the consideration of the amount of power Government have against global companies. The concentration of power of the few Transnationalisation (TNCs) companies of food is a significant problem for all countries, especially the poorer communities within countries. Uk policy has done little to engage in upstream policy since WW2, rather leaning towards neolibertarian politics. Nudge tactics Thaler and Sunstein (2008) was created as subliminal messaging to help people choose healthy foods. Nesta owned behavioural insights team in David Camaron’s office formed a portfolio of T.V and internet commercials, phone apps and educational packages on healthy foods and sugar swaps to support targeted low SES groups from making emotional based food choices in favour of rational, informed decisions (McDermott,2004: Berger et al.,2019: Goodman et al.,2021: Leonard, 2008). The intervention of nudging the children of today will lead to a gradual decrease in obesity tomorrow (Lowenstein, 2017) does not take into account food choice availability, financial choice and the power of psychological ill health / trauma and it’s relationship to food choices (Chauvet-Gelinier et al., 2019: Mulderring, 2018).
Promoting community level grassroots lifestyle change projects based on charity and good will. The production of cheap oil, ultra-processed foods from a few ideological companies referred to as McDonaldisation or Coca-colaisation have prevented choice, especially to those living in deprived areas. Blouin et al., 2009). Unregulated Globalisation has had devastating impact on inequality, food Healthy food choice and the environment. A lack of Policy infrastructure to support local farmers and rural shops has limited food choice for the poor and isolated.
Evidence shows that our choices are constrained by gender, history, income, ethnicity and larger market access and global trends. Since the eradication of small rural shops and exponential influx of supermarkets, the inequality gap has widened for people living in rural areas due to transport and isolation issues and urban areas in poorer communities are flooded with cheap junk food with little choice of fruit and vegetables (Thurber & Fahey, 2009).
Mass pollution and pesticides are causing health outbreaks
Globalisation has devastating effects on environmental landscapes, food travel rose by 30% in 15 years in the UK, greatly increasing pollution. Mass farming has increased the use of damaging pesticides increases health issues, poor land management and the inequality gap has risen exponentially. Global companies have taken over land in poorer companies to grow food for the wealthy, whilst the poor are limited to cheap non nutritious foods. The danger of contaminated food lines is highly likely and environmental disaster is predicted if nothing changes. The WHO has challenged the food industry over the certain foods only to be met with a threats from sugar lobbyists to scupper WHO by ending Government funding (Moragues-Faus & Morgan, 2015).
A lack of structural level policy alongside local level investment to support communities access, cook and maintain a healthy lifestyle.
The Uk has failed to address food choice at a structural level, recommendations for the highly plant based Mediterranean diet, requires shipping in more fresh produce from Mediterranean countries and therefore whole system restructure is required, from farm to plate (Pollard & Booth, 2019).
Punctuated equilibrium talks about the view of the public on the issue and how it is portrayed. On a local level social and voluntary sectors feel Community projects are needed to support education and cooking skills, but they are vastly ineffective if there are no policies addressing healthy food access to those living in poverty (Brothers et al., 2020). As individuals we do have buying power, illustrated when GMO products came onto the market, the public outcry and refusal to buy saw the Governments swift removal (Şanlıer & Sezgin,2020) sadly it was due to profits as opposed to addressing the UK’s health needs, but it does highlight that awareness and support from wealthy groups to lobby for a reduction in cheap foods and continue the fight to support access to fresh fruit and vegetables will create change, moving away from stigma and discrimination of minority and poorer groups which create further divide and apply pressure on Government to implement upstream policy (Pineda et al., 2022).
According to PE monopolies stifle the new image of C4L, food labelling efforts through their advertising. TNC’s global lobbying is sophisticated, ensuring their new food technologies and business strategies such as getting the government to issue their margarine on prescription as a health product which lowers cholesterol succeeds, public awareness is needed to stand up to these companies, much like smoking (Cammies, et al., 2021). The gradual education and awareness and epidemiological evidence changed the public view of smoking, which was sophisticatedly marketed to the masses for years (Savona et al., 2021)
The complexity of the food system and the ongoing uncertainties of the Brexit process create multiple risks and make specific forecasts of its impact difficult to quantify. The food consumed in the UK is the outcome of a complex set of dependencies, interactions, market forces and governance frameworks across a wide range of policy areas. Brexit, for better or worse, means a major structural change in policy and in how people think about the food they eat. Cheap food comes at a price to the environment and public health. (Benton & Bailey, 2019).
there scope to round up activists and anti-product lobbyists / think tanks, media (Jones and Baumgartner, 2005,
Punctuated Equilibrium envisages change when there is scope to round up activists and anti product lobbyists / think tanks and media(Jones and Baumgartner, 2005,. Brexit could also offer a historic opportunity to reassess and reformulate legislation, policies, practices and institutional arrangements that take better account of the needs of different actors in the food system (such as farmers, retailers, consumers, and health-conscious and environmentally aware citizens) in the UK (Benton et al., 2019).
Describe how public policy can be evaluated and analysed?
Advertising restriction is continuously debated. One study used thematic content analysis to explore advocates and actor processes during consultation of the proposed policy on T.V advertisement regulation for children. The study highlighted that scientific evidence is reframed and manipulated to fit different actor narratives, this leads to a watered-down policy outcome which are unlikely to make any effect on public health but pays lip service to activi and the general public, whilst pleasing food producers of unhealthy products (Razavi et al., 2019).
Epidemiological studies linking obesity to poor food choice in obese individuals from disadvantaged social circumstances use predictive models to highlight how targeted investment and support to these areas to achieve equality in healthy food consumption would reduce obesity and the impact positively on services significantly (Hawkes et al., 2015).
Evaluation of policy is notoriously poor in Europe, this has meant assessment of effectiveness, cost / benefit analysis and future guidance and recommendations is limited. Policy Evaluation Network (PEN) has since been set up involving 7 European countries and New Zealand to evaluate health policies and build upon the strengths to yield gold standard recommendations, guidelines, and laws to benefit populations within those countries. Policy actions need to be inclusive and therefore PEN have set equity and diversity guidelines to ensure this (Ahens et al., 2022).
Evaluation may be stalled during times of resource restrictions, such as a change in the economy. Evaluation may be done before outcome results are available to suit Governments need to eliminate a policy, before a change in Government or to avoid embarrassment of predicted results (Campos & Reich, 2019).
Investigation into feedback loops, policy design, implementation (in a variety of contexts), and outcomes to help improve future policies, with emphasis on closing the equality gap by assessing which policies have unintentional negative impact on disadvantaged groups (Brown et al., 2019).
Policy evaluation should encompass:
· A definition of the problem and the solution offered.
· Involvement of stakeholders / community (macro, meso and micro level)
· Ascertain who is in support of the policy
· Assess policy pilot scheme data
· Does it reduce or widen the equality gap (food labelling may widen, has it reduced sodium or fat intake?)
· How was implementation delivered:
o the process (campaign? costs, resources, staff involved)
o The setting (locations, Community / primary care)
o The actions (Strategy and delivery)
· Evaluate
o Intermediate outcomes – a reduction in unhealthy consumption, weight loss, improved health markers, reduction in non-communicable disease.
o Non-health outcomes – social support improving QOL, community connection, healthy food availability (vouchers)
o Unintended harmful consequences such as stigma and psychological distress, isolation, ostracised.
o Sustainability outcomes (basic income entitlement, investment in local farming).
· Assessment of the design and framing of the policy by lobbyists and actors and how that was received by the public and target group, at national, regional and local level
· What was the window of opportunity / tipping point and surrounding circumstances, political landscape at that time.
· Was the policy implemented in the way it was intended at local level
· The re-design should be evidence based, collecting data requires long-term engagement, building relationships and effective communication and joined up working between researchers, policy makers and stake holders. Surveillance from step trackers (stepwise) and health apps for chronic disease are
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