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Humphreys L, O'Flaherty C, Ambrosini GL. Public support for obesity prevention policies in Western Australia from 2012 to 2020: Findings from cross-sectional surveys. Health Promot J Austr 2024; 35:701-712. [PMID: 37674287 DOI: 10.1002/hpja.801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/09/2023] [Accepted: 08/19/2023] [Indexed: 09/08/2023] Open
Abstract
ISSUE ADDRESSED This study explored trends in public support for obesity prevention policies in Western Australia (WA). METHODS A series of cross-sectional surveys of a representative sample of WA adults aged 25-49 years (N = 11 534) were undertaken between 2012 and 2020 as part of an evaluation of the LiveLighter® mass media campaign, a component of a statewide healthy lifestyle education and promotion programme. Computer-assisted telephone interviews were used to gauge support for a range of obesity prevention initiatives that could be implemented by government. RESULTS A majority of respondents supported a range of obesity prevention policies, including taxes on sugary drinks, urban planning regulations, food labelling and packaging regulations, restrictions on advertising and sponsorship, bans on the sale and marketing of unhealthy food and drink in retail environments and support for education and campaigns. Obesity prevention policies were highly supported by women, people with a healthy weight, and those who had completed secondary school. Support for regulation was high compared to other studies. Notably, there were significant increases in support between baseline and 2020 for 'taxing soft drinks and using the money to reduce the cost of healthy food' (72% cf. 80%) and 'restricting junk food promotions/advertisements on public transport' (73% cf. 83%). CONCLUSIONS There is substantial public support for regulatory action on obesity prevention in WA, providing strong rationale for government interventions to improve nutrition and reduce obesity. The LiveLighter® programme may have contributed to increases in support for obesity prevention policies in WA. SO WHAT?: There is potential to implement robust obesity prevention policies in WA.
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Affiliation(s)
- Lauren Humphreys
- Public and Aboriginal Health Division, Western Australian Department of Health, Perth, Australia
| | - Ciara O'Flaherty
- Public and Aboriginal Health Division, Western Australian Department of Health, Perth, Australia
| | - Gina L Ambrosini
- Public and Aboriginal Health Division, Western Australian Department of Health, Perth, Australia
- School of Population and Global Health, The University of Western Australia, Perth, Australia
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Serrano-Fuentes N, Rogers A, Portillo MC. Beyond individual responsibility: Exploring lay understandings of the contribution of environments on personal trajectories of obesity. PLoS One 2024; 19:e0302927. [PMID: 38718062 PMCID: PMC11078422 DOI: 10.1371/journal.pone.0302927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 04/13/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION Reversing the upward trajectory of obesity requires responding by including the multiple influences on weight control. Research has focused on individual behaviours, overlooking the environments where individuals spend their lives and shape lifestyles. Thus, there is a need for lay understandings of the impact of environments as a cause and solution to obesity. This research aimed to understand the influence of environments on the adoption of health practices in adults with obesity and to identify lay strategies with which to address environmental barriers to behaviour change. METHODS Nineteen adults with a history of obesity living in the United Kingdom were interviewed through video conferencing between May 2020 and March 2021. Semi-structured interviews and socio-demographic questionnaires were used, and data analysed through hermeneutic phenomenology informed reflexive thematic analysis. RESULTS Three main themes were created: living with convenience and normalcy: the increased accessibility of unhealthy food, people interacting with digital media for positive practice change, and the need to prioritise prevention in schools, the National Health Service and the food industry. CONCLUSIONS The food environment was the major barrier, while interactions with social media was the most important opportunity to adopt healthy practices. The National Health Service was considered an obesogenic environment, something relevant since it has been traditionally recognised as an obesity management system. The perceptions from individuals with a history of obesity provide new suggestions on the influence of previously overlooked environments to design more adequate and effective interventions and policies that consider, more than in the past, the environments where people spend their lives.
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Affiliation(s)
- Nestor Serrano-Fuentes
- NIHR ARC Wessex, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Anne Rogers
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Mari Carmen Portillo
- NIHR ARC Wessex, School of Health Sciences, University of Southampton, Southampton, United Kingdom
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3
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Azaad Moonesar I, Al-Alawy K, Gaafar R. Taxing sugar-sweetened beverages: Knowledge, beliefs and where should the money go? Heliyon 2024; 10:e28226. [PMID: 38638996 PMCID: PMC11024569 DOI: 10.1016/j.heliyon.2024.e28226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/10/2024] [Accepted: 03/13/2024] [Indexed: 04/20/2024] Open
Abstract
Background The Sugar-Sweetened Beverage (SSB) industry consciously and subconsciously influences consumers to buy its products. Countering unhealthy messaging and behaviour could be tackled through the SSB levy and allocation of revenue toward healthy lifestyle programs. Given the limited information in the UAE on demographic and consumer knowledge and beliefs and allocation of SSB levy, we conducted a study to explore this further. The study objectives were to a) explore the association between demographic factors (nationality, income and education) with knowledge and beliefs for SSB and b) explore participants' views on allocating SSB levy toward healthy lifestyle programs. Methods A cross-sectional study of adults in the United Arab Emirates. Results The findings suggest knowledge was high for Sugar-Sweetened Beverages (SSB), obesity, and diabetes (1,231, 96.1%), and there was a high awareness of SSB tax (1,066, 83.2%). Knowledge and beliefs about Sugar-Sweetened Beverages were statistically significant for two demographic factors. There was support for the tax revenue to be spent on government programs and greater support for spending to be directed toward specific healthy lifestyle programs such as school health programmes (514, 39.8%), children's diet and nutrition programmes (497, 38.5%), physical activity programmes (480, 37.2%), among others. Conclusions The findings shed light on the influence demographic factors have on knowledge and beliefs, public health gaps and potential areas for SSB levy expenditure. Further research is needed to understand how best to implement healthy lifestyle programs within the community to optimise coverage, cost-effectiveness, and health outcomes.
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Affiliation(s)
| | - Khamis Al-Alawy
- Mohammed Bin Rashid School of Government, Dubai, United Arab Emirates
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4
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Ku LJE, Moo CC, Li YC, Chang YH, Hsu YH, Huang YC, Lu CL, Li CY. Support for a hypothetical sugar-sweetened beverage tax in Taiwan. Health Promot Int 2024; 39:daae028. [PMID: 38568731 DOI: 10.1093/heapro/daae028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
Sugar-sweetened beverages (SSBs) are drinks that contain added sugar or sweeteners and provide calories with no additional nutrients, and some countries have imposed additional taxes on the SSBs to reduce consumption, which is considered an SSB tax policy. This study used a cross-sectional online survey to examine the patterns of public support for an SSB tax in Taiwan. The sample included 1617 adults aged ≥ 20 years, who answered the survey questionnaire between May 2020 and April 2021. The respondents were recruited using convenience sampling, but sampling weights were applied to represent the Taiwanese population. Generalized ordered logit models with sampling weights were used to examine the correlates of public support for an SSB tax. Results showed that ~60% of the respondents supported the SSB tax and 47% perceived the tax to be effective. The respondents who were aware of the perceived health risks of SSBs or those who believed that one should be partly responsible for the health impact of SSBs were more likely to show support for the SSB tax. In adjusted regression models, both one's perceived risk and perceived responsibility of SSBs were positively associated with the perceived effectiveness of the SSB tax after sociodemographic characteristics were controlled. These research findings show evidence that there is public support for implementing an SSB tax to reduce SSB consumption in Taiwan.
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Affiliation(s)
- Li-Jung Elizabeth Ku
- Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Rd., Tainan, 701, Taiwan
| | - Cherl Cy Moo
- Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Rd., Tainan, 701, Taiwan
| | - Yueh-Chen Li
- Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Rd., Tainan, 701, Taiwan
| | - Ya-Hui Chang
- Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Rd., Tainan, 701, Taiwan
| | - Yuu-Hueih Hsu
- Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Rd., Tainan, 701, Taiwan
| | - Yi-Chin Huang
- Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Rd., Tainan, 701, Taiwan
| | - Chin-Li Lu
- Graduate Institute of Food Safety, National Chung Hsing University, No. 250, Kuo Kuang Rd., Taichung, 402, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Rd., East Rd., Tainan, 701, Taiwan
- Department of Public Health, College of Public Health, China Medical University, No. 100, Section 1, Jingmao Rd., Taichung, 406, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, No.500, Lioufeng Rd., Taichung, 413, Taiwan
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5
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Tang CS, Mars M, James J, Appleton KM. Associations between attitudes towards and reported intakes of sugars, low/no-calorie sweeteners, and sweet-tasting foods in a UK sample. Appetite 2024; 194:107169. [PMID: 38113982 DOI: 10.1016/j.appet.2023.107169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/02/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023]
Abstract
Public health initiatives are currently aiming to lower free sugar intakes for health benefits, but attitudes towards sugars, their alternatives such as low/no-calorie sweeteners (LNCS), and towards sweet-tasting foods may be hampering efforts. This work investigated associations between attitudes towards and the reported intakes of sugars, LNCS and sweet-tasting foods, and identified latent attitude profiles in subpopulations of adults in the United Kingdom. A total of 581 adults completed a questionnaire assessing their usual intake of sugars, LNCS and sweet-tasting foods, attitudes towards these foods and various demographic characteristics. Six principal components explained 39.1% of the variance in the attitude responses, named: 'Personal Impact', 'Personal Management', 'Apathy', 'Negativity', 'Perceived Understanding' and 'Perceived Nonautonomy'. Personal Impact was negatively associated with reported consumption of sugar-food and sweet-tasting food groups more frequently (smallest β = -0.24, p < .01). Personal Management was positively associated with reporting adding sugar and consuming sugar-food and sweet-tasting food groups more frequently (smallest β = 0.14, p < .01). Three latent classes of participants with distinct patterns of attitudes were identified, labelled: 'Feeling Ill-equipped' (n = 52), 'Actively Engaged' (n = 162) or 'Unopinionated' (n = 367). Individuals who were classed as Actively Engaged reported adding LNCS more frequently than those classed as Feeling Ill-equipped (t(212) = -2.14, p<.01), who reported consuming sweet-tasting food groups more frequently than those classed as Unopinionated (t(417) = 2.65, p < .01). These findings suggest the need for personalised approaches within public health initiatives, to reduce free sugar intakes.
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Affiliation(s)
- Claudia S Tang
- Department of Psychology, Faculty of Science and Technology, Bournemouth University, Poole House, Talbot Campus, Bournemouth, BH12 5BB, UK; Consumer Culinary Experience Team, Kraft Heinz Research & Development Center, Nijmegen, 6534 AD, the Netherlands.
| | - Monica Mars
- Sensory Science and Eating Behaviour Group, Division of Human Nutrition, Wageningen University and Research, Wageningen, 6708 WE, the Netherlands.
| | - Janet James
- Department of Nursing Science, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth Gateway Building, St. Pauls Lane, Bournemouth, BH8 8GP, UK.
| | - Katherine M Appleton
- Department of Psychology, Faculty of Science and Technology, Bournemouth University, Poole House, Talbot Campus, Bournemouth, BH12 5BB, UK.
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Soares Guimarães J, Pauzé E, Potvin Kent M, Barquera S, Jáuregui A, Sacks G, Vanderlee L, Hammond D. The relationship between parent's self-reported exposure to food marketing and child and parental purchasing and consumption outcomes in five countries: findings from the International Food Policy Study. J Nutr Sci 2023; 12:e123. [PMID: 38155804 PMCID: PMC10753451 DOI: 10.1017/jns.2023.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 08/29/2023] [Accepted: 09/21/2023] [Indexed: 12/30/2023] Open
Abstract
Food and beverage marketing influences children's food preferences and dietary intake. Children's diets are also heavily influenced by their family environment. The aim of this study was to assess the relationship between parent's self-reported exposure to unhealthy food marketing and a range of outcomes related to children's desire for and intake of unhealthy foods and beverages. The study also sought to examine whether these outcomes varied across different countries. The analysed data are from the International Food Policy Study and were collected in 2018 using an online survey. The sample included 5764 parents of children under 18, living in Australia, Canada, Mexico, the United Kingdom, or the United States. Binary logistic regressions assessed the link between the number of parental exposure locations and children's requests for and parental purchases of unhealthy foods. Generalized ordinal regression gauged the relationship between the number of exposure locations and children's consumption of such items. Interaction terms tested if these associations varied by country. Parental exposure to unhealthy food marketing was positively associated with parents reporting child purchase requests and purchase outcomes; and differed by country. Increased parental exposure to unhealthy food marketing was associated with slightly lower odds of children's weekly consumption of unhealthy foods, and this association varied by country. In conclusion, parental report of a greater range of food marketing exposure was associated with a range of outcomes that would increase children's exposure to unhealthy food products or their marketing. Governments should consider developing more comprehensive restrictions on the marketing of unhealthy foods.
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Affiliation(s)
| | - Elise Pauzé
- School of Interdisciplinary Health Sciences, University of Ottawa, Ottawa, Canada
| | - Monique Potvin Kent
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Simón Barquera
- Center for Nutrition and Health Research, INSP, Cuernavaca, Mexico
| | | | - Gary Sacks
- School of Health and Social Development, Deakin University, Victoria, Australia
| | - Lana Vanderlee
- School of Nutrition, Université of Laval, Quebec City, Canada
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
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7
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Rogers NT, Pell D, Mytton OT, Penney TL, Briggs A, Cummins S, Jones C, Rayner M, Rutter H, Scarborough P, Sharp S, Smith R, White M, Adams J. Changes in soft drinks purchased by British households associated with the UK soft drinks industry levy: a controlled interrupted time series analysis. BMJ Open 2023; 13:e077059. [PMID: 38052470 PMCID: PMC10711915 DOI: 10.1136/bmjopen-2023-077059] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/21/2023] [Indexed: 12/07/2023] Open
Abstract
OBJECTIVE To determine changes in household purchases of drinks 1 year after implementation of the UK soft drinks industry levy (SDIL). DESIGN Controlled interrupted time series. PARTICIPANTS Households reporting their purchasing to a market research company (average weekly n=22 091), March 2014 to March 2019. INTERVENTION A two-tiered tax levied on soft drinks manufacturers, announced in March 2016 and implemented in April 2018. Drinks with ≥8 g sugar/100 mL (high tier) are taxed at £0.24/L, drinks with ≥5 to <8 g sugar/100 mL (low tier) are taxed at £0.18/L. MAIN OUTCOME MEASURES Absolute and relative differences in the volume of, and amount of sugar in, soft drinks categories, all soft drinks combined, alcohol and confectionery purchased per household per week 1 year after implementation. RESULTS In March 2019, compared with the counterfactual, purchased volume of high tier drinks decreased by 140.8 mL (95% CI 104.3 to 177.3 mL) per household per week, equivalent to 37.8% (28.0% to 47.6%), and sugar purchased in these drinks decreased by 16.2 g (13.5 to 18.8 g), or 42.6% (35.6% to 49.6%). Purchases of low tier drinks decreased by 170.5 mL (154.5 to 186.5 mL) or 85.8% (77.8% to 93.9%), with an 11.5 g (9.1 to 13.9 g) reduction in sugar in these drinks, equivalent to 87.8% (69.2% to 106.4%). When all soft drinks were combined irrespective of levy tier or eligibility, the volume of drinks purchased increased by 188.8 mL (30.7 to 346.9 mL) per household per week, or 2.6% (0.4% to 4.7%), but sugar decreased by 8.0 g (2.4 to 13.6 g), or 2.7% (0.8% to 4.5%). Purchases of confectionery and alcoholic drinks did not increase. CONCLUSIONS Compared with trends before the SDIL was announced, 1 year after implementation, volume of all soft drinks purchased combined increased by 189 mL, or 2.6% per household per week. The amount of sugar in those drinks was 8 g, or 2.7%, lower per household per week. Further studies should determine whether and how apparently small effect sizes translate into health outcomes. TRIAL REGISTRATION NUMBER ISRCTN18042742.
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Affiliation(s)
| | | | - Oliver T Mytton
- MRC Epidemiology Unit, Cambridge, UK
- University College London Great Ormond Street Institute of Child Health, London, UK
| | - Tarra L Penney
- York University - Keele Campus, Toronto, Ontario, Canada
| | - Adam Briggs
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Institute for Health Policy and Clinical Practice, University of Warwick Warwick Medical School, Coventry, UK
| | - Steven Cummins
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Mike Rayner
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Harry Rutter
- University of Bath Department of Social and Policy Sciences, Bath, UK
| | - Peter Scarborough
- NIHR Oxford Biomedical Research Centre, Oxford, UK
- Nuffield Department of Population Health, Centre on Population Approaches for Non-Communicable Disease Prevention, Oxford, UK
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8
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Alvarado M, Adams J, Penney T, Murphy MM, Abdool Karim S, Egan N, Rogers NT, Carters-White L, White M. A systematic scoping review evaluating sugar-sweetened beverage taxation from a systems perspective. NATURE FOOD 2023; 4:986-995. [PMID: 37857862 PMCID: PMC10661741 DOI: 10.1038/s43016-023-00856-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 09/08/2023] [Indexed: 10/21/2023]
Abstract
Systems thinking can reveal surprising, counterintuitive or unintended reactions to population health interventions (PHIs), yet this lens has rarely been applied to sugar-sweetened beverage (SSB) taxation. Using a systematic scoping review approach, we identified 329 papers concerning SSB taxation, of which 45 considered influences and impacts of SSB taxation jointly, involving methodological approaches that may prove promising for operationalizing a systems informed approach to PHI evaluation. Influences and impacts concerning SSB taxation may be cyclically linked, and studies that consider both enable us to identify implications beyond a predicted linear effect. Only three studies explicitly used systems thinking informed methods. Finally, we developed an illustrative, feedback-oriented conceptual framework, emphasizing the processes that could result in an SSB tax being increased, maintained, eroded or repealed over time. Such a framework could be used to synthesize evidence from non-systems informed evaluations, leading to novel research questions and further policy development.
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Affiliation(s)
- Miriam Alvarado
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK.
| | - Jean Adams
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Tarra Penney
- Global Food System and Policy Research, School of Global Health, Faculty of Health, York University, Toronto, Ontario, Canada
| | - Madhuvanti M Murphy
- George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, The University of the West Indies, Bridgetown, Barbados
| | | | - Nat Egan
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Nina Trivedy Rogers
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Lauren Carters-White
- SPECTRUM Consortium, Usher Institute of Population Health Sciences and Informatics, Old Medical School, University of Edinburgh, Edinburgh, UK
| | - Martin White
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
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9
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Toumpakari Z, Valerino-Perea S, Willis K, Adams J, White M, Vasiljevic M, Ternent L, Brown J, Kelly MP, Bonell C, Cummins S, Majeed A, Anderson S, Robinson T, Araujo-Soares V, Watson J, Soulsby I, Green D, Sniehotta FF, Jago R. Exploring views of members of the public and policymakers on the acceptability of population level dietary and active-travel policies: a qualitative study. Int J Behav Nutr Phys Act 2023; 20:64. [PMID: 37259093 DOI: 10.1186/s12966-023-01465-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 05/06/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND There is limited evidence on what shapes the acceptability of population level dietary and active-travel policies in England. This information would be useful in the decision-making process about which policies should be implemented and how to increase their effectiveness and sustainability. To fill this gap, we explored public and policymakers' views about factors that influence public acceptability of dietary and active-travel policies and how to increase public acceptability for these policies. METHODS We conducted online, semi-structured interviews with 20 members of the public and 20 policymakers in England. A purposive sampling frame was used to recruit members of the public via a recruitment agency, based on age, sex, socioeconomic status and ethnicity. Policymakers were recruited from existing contacts within our research collaborations and via snowball sampling. We explored different dietary and active-travel policies that varied in their scope and focus. Interviews were transcribed verbatim and analysed using thematic reflexive analysis with both inductive and deductive coding. RESULTS We identified four themes that informed public acceptability of dietary and active-travel policies: (1) perceived policy effectiveness, i.e., policies that included believable mechanisms of action, addressed valued co-benefits and barriers to engage in the behaviour; (2) perceived policy fairness, i.e., policies that provided everyone with an opportunity to benefit (mentioned only by the public), equally considered the needs of various population subgroups and rewarded 'healthy' behaviours rather than only penalising 'unhealthy' behaviours; (3) communication of policies, i.e., policies that were visible and had consistent and positive messages from the media (mentioned only by policymakers) and (4) how to improve policy support, with the main suggestion being an integrated strategy addressing multiple aspects of these behaviours, inclusive policies that consider everyone's needs and use of appropriate channels and messages in policy communication. CONCLUSIONS Our findings highlight that members' of the public and policymakers' support for dietary and active-travel policies can be shaped by the perceived effectiveness, fairness and communication of policies and provide suggestions on how to improve policy support. This information can inform the design of acceptable policies but can also be used to help communicate existing and future policies to maximise their adoption and sustainability.
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Affiliation(s)
- Z Toumpakari
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK.
| | - S Valerino-Perea
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
| | - K Willis
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - J Adams
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - M White
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - M Vasiljevic
- Fuse - Centre for Translational Research in Public Health, Newcastle, UK
- Department of Psychology, Durham University, Durham, UK
| | - L Ternent
- Fuse - Centre for Translational Research in Public Health, Newcastle, UK
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | - J Brown
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, London, UK
| | - M P Kelly
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - C Bonell
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - S Cummins
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - A Majeed
- Department of Primary Care and Public Health, Imperial College London, London, W6 8RP, UK
| | - S Anderson
- Fuse - Centre for Translational Research in Public Health, Newcastle, UK
- Department of Psychology, Durham University, Durham, UK
| | - T Robinson
- Fuse - Centre for Translational Research in Public Health, Newcastle, UK
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
- The National Institute for Health Research, Applied Research Collaboration Northeast and North Cumbria (NIHR ARC NENC), St Nicholas' Hospital, Newcastle Upon Tyne, Jubilee Road, Gosforth, NE3 3XT, UK
| | - V Araujo-Soares
- Fuse - Centre for Translational Research in Public Health, Newcastle, UK
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Faculty of Behavioural, Management and Social Sciences, Department of Health Technology and Services Research, University of Twente, Twente, The Netherlands
| | - J Watson
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
- South Gloucestershire Council, Badminton Road, Yate, Bristol, BS37 5AF, UK
| | - I Soulsby
- Fuse - Centre for Translational Research in Public Health, Newcastle, UK
| | - D Green
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | - F F Sniehotta
- Fuse - Centre for Translational Research in Public Health, Newcastle, UK
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
- Department for Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - R Jago
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
- Applied Research Collaboration West (NIHR ARC West), The National Institute for Health Research, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, BS1 2NT, UK
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10
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Scheidmeir M, Kubiak T, Luszczynska A, Wendt J, Scheller DA, Meshkovska B, Müller-Stierlin AS, Forberger S, Łobczowska K, Neumann-Podczaska A, Wieczorowska-Tobis K, Zeeb H, Steinacker JM, Woods CB, Lakerveld J. Acceptability of policies targeting dietary behaviours and physical activity: a systematic review of tools and outcomes. Eur J Public Health 2022; 32:iv32-iv49. [PMID: 36444105 PMCID: PMC9897019 DOI: 10.1093/eurpub/ckac053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Successful implementation of health policies require acceptance from the public and policy-makers. This review aimed to identify tools used to assess the acceptability of policies targeting physical activity and dietary behaviour, and examine if acceptability differs depending on characteristics of the policy and of the respondents. METHODS A systematic review (PROSPERO: CRD42021232326) was conducted using three databases (Science Direct, PubMed and Web of Science). RESULTS Of the initial 7780 hits, we included 48 eligible studies (n = 32 on dietary behaviour, n = 11 on physical activity and n = 5 on both), using qualitative and quantitative designs (n = 25 cross-sectional, quantitative; n = 15 qualitative; n = 5 randomized controlled trials; n = 3 mixed-methods design). Acceptability was analysed through online surveys (n = 24), interviews (n = 10), focus groups (n = 10), retrospective textual analysis (n = 3) and a taste-test experiment (n = 1). Notably, only 3 (out of 48) studies applied a theoretical foundation for their assessment. Less intrusive policies such as food labels and policies in a later stage of the implementation process received higher levels of acceptability. Women, older participants and respondents who rated policies as appropriate and effective showed the highest levels of acceptability. CONCLUSION Highly intrusive policies such as taxations or restrictions are the least accepted when first implemented, but respondents' confidence in the relevance and effectiveness of the policy may boost acceptability over the course of implementation. Studies using validated tools and a theoretical foundation are needed to further examine opportunities to increase acceptability.
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Affiliation(s)
- Marie Scheidmeir
- Correspondence: Marie Scheidmeir, Department of Health Psychology, Johannes Gutenberg University, Binger Str. 14-16, 55122 Mainz, Germany, Tel: +49 6131 39 39 132, e-mail:
| | - Thomas Kubiak
- Department of Health Psychology, Johannes Gutenberg University, Mainz, Germany
| | - Aleksandra Luszczynska
- Department of Psychology, SWPS University of Social Sciences and Humanities, CARE-BEH Center for Applied Research on Health Behavior and Health, Wroclaw, Poland,Melbourne Centre for Behavior Change, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Janine Wendt
- Department of Internal Medicine, Sports- and Rehabilitation Medicine, University of Ulm, Ulm, Germany
| | - Daniel A Scheller
- Department of Internal Medicine, Sports- and Rehabilitation Medicine, University of Ulm, Ulm, Germany
| | - Biljana Meshkovska
- Department of Nutrition, Institute of Basic Medical Sciences (UiO-PHN), University of Oslo, Oslo, Norway
| | | | - Sarah Forberger
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany
| | - Karolina Łobczowska
- Department of Psychology, SWPS University of Social Sciences and Humanities, CARE-BEH Center for Applied Research on Health Behavior and Health, Wroclaw, Poland
| | | | | | - Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany
| | - Jürgen M Steinacker
- Department of Internal Medicine, Sports- and Rehabilitation Medicine, University of Ulm, Ulm, Germany
| | - Catherine B Woods
- Department of Physical Education and Sport Sciences, Physical Activity for Health, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands,Upstream Team, www.upstreamteam.nl, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Public perception of the tax on sweetened beverages in France. Public Health Nutr 2022; 25:3240-3251. [PMID: 35942709 PMCID: PMC9991787 DOI: 10.1017/s1368980022001665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess in 2021 the acceptance and perception of the French tax on sweetened beverages, following its revision in 2018, and factors associated with a higher level of acceptance. DESIGN A cross-sectional survey within the NutriNet-Santé cohort study. Participants were invited to complete a self-reported questionnaire in March 2021. Weighting was applied to the sample to allow inferences on the French population. Individual characteristics associated with support for the tax were investigated using logistic regression modelling. SETTINGS NutriNet-Santé prospective cohort study. PARTICIPANTS Adults engaged in the NutriNet-Santé cohort, aged 18 years or older (n 28 344), living in mainland France. RESULTS Almost two-thirds (63·4 %) of the participants were aware of the existence of a tax on sweetened beverages, although less than a quarter had specific knowledge regarding its design and the 2018 revision. In turn, 64·7 % of participants expressed a favourable opinion towards the taxation scheme. This proportion was higher if tax revenues were used to finance health-related measures (respectively 68·8 % of favourable opinion if used to finance a reduction in prices of healthy products and 76·4 % if used to finance the healthcare system). Multivariable analyses showed that support towards the tax varied among subgroups of the population. Groups who tended to be less financially affected by the measure and those who perceived sugar-sweetened beverages as having detrimental effects were more likely to support the tax. CONCLUSION The revised French sugar-sweetened beverage tax appeared to be favourably received and perceived by the public.
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Demeshko A, Buckley L, Morphett K, Adams J, Meany R, Cullerton K. Characterising trusted spokespeople in noncommunicable disease prevention: A systematic scoping review. Prev Med Rep 2022; 29:101934. [PMID: 35942296 PMCID: PMC9356185 DOI: 10.1016/j.pmedr.2022.101934] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/20/2022] [Accepted: 07/26/2022] [Indexed: 12/03/2022] Open
Abstract
Noncommunicable diseases (NCD) are an increasing global threat. Utilising public policy to address NCDs can reduce incidence and prevalence. However, NCD-relevant public policy action is minimal in many countries as changing public policy is difficult and multifactorial. Two factors that may influence this process is the message people receive and the messenger delivering it. To date, much health communication research has focused on message content, with limited research on messengers that are trusted by policymakers and the public to communicate NCD matters. We aimed to review the literature to characterise who the public and policymakers consider to be trustworthy and/or credible for NCD messaging, and why this might be the case. Arksey and O'Malley's scoping review methodology guided the review. A systematic search of three databases up to June 2021 combined with hand searching of review reference lists was undertaken. Nineteen articles were included. Data extraction focused on study design, issue being influenced, spokesperson studied, and measures of trust. Results showed health professionals were the most-frequently trusted sources of information. Other spokespeople, such as government sources or religious leaders, were only trustworthy in some contexts, and even distrusted in others. Reasons why spokespeople were trusted included technical expertise, strategic engagement with stakeholders, and reputation. However, we also found the nature of trust and credibility of spokespeople is dependent on the studied population and context. Overall, characteristics of influential messengers were nonspecific. Thus, trusted messengers and their characteristics in NCD-messaging must be better understood to develop and maintain the trust of the public and policymakers.
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Affiliation(s)
- Anastassia Demeshko
- School of Public Health, The University of Queensland, 266 Herston Rd, Herston, QLD 4006, Australia
| | - Lisa Buckley
- School of Public Health, The University of Queensland, 266 Herston Rd, Herston, QLD 4006, Australia
| | - Kylie Morphett
- School of Public Health, The University of Queensland, 266 Herston Rd, Herston, QLD 4006, Australia
| | - Jean Adams
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge CB2 0QQ, United Kingdom
| | - Roger Meany
- Health and Wellbeing Queensland, Ground Floor, 139 Coronation Drive, Milton Green, Milton, QLD 4064, Australia
| | - Katherine Cullerton
- School of Public Health, The University of Queensland, 266 Herston Rd, Herston, QLD 4006, Australia
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Fernández Sánchez-Escalonilla S, Fernández-Escobar C, Royo-Bordonada MÁ. Public Support for the Imposition of a Tax on Sugar-Sweetened Beverages and the Determinants of Such Support in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3758. [PMID: 35409442 PMCID: PMC8998005 DOI: 10.3390/ijerph19073758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/17/2022] [Accepted: 03/20/2022] [Indexed: 02/01/2023]
Abstract
(1) Background: Taxes on sugar-sweetened beverages are an effective public health intervention, but can be difficult to implement in the absence of public support. This is the first study to analyze the Spanish population’s support for a tax on sugar-sweetened beverages. (2) Methods: We conducted a cross-sectional study of a representative sample of the Spanish adult population (n = 1002), using a computer-aided telephone interview with a questionnaire on nutritional policies. The support for the tax was calculated by the percentage of those who agreed plus those who strongly agreed with the measure. The sociodemographic determinants of support for the tax were analyzed using chi-squared test (χ2) and Poisson multiple regression models with robust variance. (3) Results: Of the participants, 66.9% supported a tax on sugar-sweetened beverages. Support for the tax was 9.2% higher (70% vs. 64.1%) when responders were first asked about support for tax relief and subsidies for healthy foods (p = 0.049). Support for the tax was 16% and 35% lower among persons reporting center and right-wing political sympathies (p < 0.01), and 16% lower among regular consumers of sugar-sweetened beverages (p = 0.01). (4) Conclusions: A clear majority of the Spanish population is in favor of imposing a tax on sugar-sweetened beverages. Awareness-raising campaigns and a policy of combining the measure with subsidies or tax cuts on healthy foods could increase the level of support among those currently against the intervention.
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Affiliation(s)
| | - Carlos Fernández-Escobar
- Public Health and Epidemiology Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, 28871 Alcalá de Henares, Spain;
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Al-Alawy K, Gaafar R, Moonesar IA, Muhsineh S. The nexus of Sugar-Sweetened Beverages: Insights on demographics, enablers and barriers. PUBLIC HEALTH IN PRACTICE 2021; 2:100189. [PMID: 36101613 PMCID: PMC9461627 DOI: 10.1016/j.puhip.2021.100189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/31/2021] [Accepted: 09/06/2021] [Indexed: 11/29/2022] Open
Abstract
Objectives The study objectives were to a) explore the association between household income and nationality and Sugar-Sweetened Beverage (SSB) enablers and barriers, and b) inform public health policy and health promotion. Study design A Cross-sectional Study in the UAE. Methods Nationally representative population survey was used to capture demographic and SSB behaviour data. Results We recruited 7500 participants into the study and received 1290 responses (17.2% participation rate). We report statistically significant associations between household income, nationality, and enablers and barriers. In some instances, similar enablers and barriers were reported by household income and nationality. Conclusions There are several associations between household income, nationality and SSB enablers, and barriers. These associations should be considered for future public health policy and health promotion decision-making to reduce SSB consumption. In addition, further research is needed to explore how other demographic factors (modifying variables) are associated with SSB enablers and barriers. They are statistically significant associations between household income, nationality and SSB enablers, and barriers; For SSB enablers, participants agreed that SSB is readily available when they go out, and the label and packaging does not suggest SSB is harmful to health. Participants had neutral viewpoints on SSB affordability and availability at home, ease of access through mobile platforms and lack of healthier alternatives suggesting more work is needed to sway participants to disagree or strongly disagree on these aspects; For SSB barriers, participants agreed that they worry about their health if they drink SSB, know about SSB that prevents them from drinking SSB, and were happy with the sugar-free alternatives. There were several areas where participants expressed a neutral viewpoint, e.g. there are no good deals/promotions to buy SSB, SSB is not available when they go out, they do not like the taste of SSB, SSB makes them sick, the label and packaging of SSB tells them it is harmful to their health, and they always have cheaper or free alternatives suggesting more work needed to sway participants to agree or strongly agre; and Household income and nationality can influence SSB enablers and barriers in different ways, and in some instances, presents a nexus.
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Ng SW, Colchero MA, White M. How should we evaluate sweetened beverage tax policies? A review of worldwide experience. BMC Public Health 2021; 21:1941. [PMID: 34702248 PMCID: PMC8546197 DOI: 10.1186/s12889-021-11984-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 10/12/2021] [Indexed: 02/02/2023] Open
Abstract
Over 45 jurisdictions globally have implemented sweetened beverage taxes. Researchers and policymakers need to assess whether and how these taxes change beverage demand and supply, their intended and unanticipated health, economic and equity impacts. Lessons from such evaluations can maximise the policies' success and impact on non-communicable disease prevention globally. We discuss key theoretical, design and methodological considerations to help policymakers, funders and researchers commission and conduct rigorous evaluations of these policies and related disease prevention efforts. We encourage involving the perspectives of various stakeholders on what evaluations are needed given the specific context, what data and methods are appropriate, readily available or can be collected within time and budget constraints. A logic model /conceptual system map of anticipated implications across sectors and scales should help identify optimal study design, analytical techniques and measures. These models should be updated when synthesising findings across diverse methods and integrating findings across subpopulations using similar methods.
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Affiliation(s)
- Shu Wen Ng
- Carolina Population Center, University of North Carolina at Chapel Hill, CB #8120, 137 East Franklin Street, Chapel Hill, NC, 27516, USA.
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, CB#7461, UNC-Chapel Hill, Chapel Hill, NC, 27599-7461, USA.
| | - M Arantxa Colchero
- Center for Health Systems Research, Instituto Nacional de Salud Pública, Universidad No 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, CP, 62100, Cuernavaca, Morelos, Mexico
| | - Martin White
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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Adams J, Pell D, Penney TL, Hammond D, Vanderlee L, White M. Public acceptability of the UK Soft Drinks Industry Levy: repeat cross-sectional analysis of the International Food Policy Study (2017-2019). BMJ Open 2021; 11:e051677. [PMID: 34561262 PMCID: PMC8475144 DOI: 10.1136/bmjopen-2021-051677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 08/19/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To determine whether public acceptability, in terms of both support for and perceived effectiveness of, the UK Soft Drinks Industry Levy (SDIL) changed between 4 months prior to, and 8 and 20 months after, implementation. DESIGN Repeat cross-sectional online survey. SETTING The UK. PARTICIPANTS UK respondents to the International Food Policy Study aged 18-64 years who provided information on all variables of interest in November-December 2017 (4 months prior to SDIL implementation), 2018 (8 months after) or 2019 (20 months after; n=10 284). OUTCOME MEASURES Self-reported support for, and perceived effectiveness of, the SDIL. RESULTS The adjusted logistic regression model predicted that 70% (95% CI: 68% to 72%) of participants supported the SDIL in 2017, 68% (95% CI: 67% to 70%) in 2018 and 68% (95% CI: 66% to 70%) in 2019. There was no evidence of a difference in support in 2018 vs 2017 (OR: 0.93; 95% CI: 0.81 to 1.05); or in 2019 vs 2017 (OR: 0.90; 95% CI: 0.78 to 1.03). The adjusted logistic regression model predicted that 72% (95% CI: 70% to 74%) of participants perceived the SDIL to be effective in 2017, 67% (95% CI: 65% to 69%) in 2018 and 67% (95% CI: 64% to 69%) in 2019. There was evidence that perceived effectiveness decreased a small amount in 2018 vs 2017 (OR: 0.78; 95% CI: 0.69 to 0.88). The difference in 2019 vs 2017 was similar. CONCLUSIONS We found high support for the SDIL among UK adults and this did not change between 4 months before implementation and 8 or 20 months after. While perceived effectiveness remained high, there was evidence that this decreased slightly after implementation in 2018, but no further in 2019. Greater understanding of influences on public acceptability of effective structural public health interventions is required.
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Affiliation(s)
- Jean Adams
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - David Pell
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Midlands Region, NHS RightCare, Newcastle upon Tyne, UK
| | - Tarra L Penney
- School of Global Health, York University Faculty of Health, Toronto, Ontario, Canada
| | - David Hammond
- School of Public Health, University of Waterloo, Waterloo, Ontario, Canada
| | - Lana Vanderlee
- School of Nutrition, Laval University, Quebec, Quebec, Canada
| | - Martin White
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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Do sugar taxes work? FOOD SCIENCE AND TECHNOLOGY 2021. [DOI: 10.1002/fsat.3503_6.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Yau A, Singh-Lalli H, Forde H, Keeble M, White M, Adams J. Newspaper coverage of food insecurity in UK, 2016-2019: a multi-method analysis. BMC Public Health 2021; 21:1201. [PMID: 34238270 PMCID: PMC8268386 DOI: 10.1186/s12889-021-11214-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 05/13/2021] [Indexed: 11/10/2022] Open
Abstract
Background Food insecurity is a growing concern in the UK. Newspaper coverage can reflect and shape public and political views. We examined how frequently food insecurity was reported on in UK newspapers, how the problem and its drivers were described, and which solutions were proposed. Methods Using Factiva, we searched for news articles that were substantively about food insecurity and published in national UK newspapers between 01 January 2016 and 11 June 2019. We examined whether the number of articles differed over the study period, and conducted a thematic analysis to theoretical saturation using a random sample of articles. Results Overall, 436 articles met our inclusion criteria and 132 (30%) were analysed thematically. Reporting was more prevalent in the summer, with mentions of ‘holiday hunger’ among children, and leading up to Christmas, when charity was encouraged. Articles often contained views from advocacy groups and charities, who appeared to play an important role in maintaining news interest in food insecurity. From the thematic analysis, we developed themes related to the problems (‘definitions of food insecurity’ and ‘consequences of food insecurity for individuals’), drivers (‘insufficient income as an immediate driver’ and ‘government versus individual responsibility’), and solutions (‘charitable food aid’ and ‘calls for government action’). The problem of food insecurity was often defined by food bank use or hunger, but other definitions and a range of consequences for individuals were acknowledged. Articles identified government as a driver of food insecurity, especially in relation to the roll-out of Universal Credit. Few articles proposed individual failings as a driver of food insecurity. The reported existing solutions predominantly focused on food banking and redistributing ‘food waste’. The public, charities, and individuals experiencing food insecurity were generally portrayed as supportive of government action to tackle food insecurity. However, contention within government regarding the extent of food insecurity, governmental responsibility and potential solutions was reported. Conclusions Food insecurity was a topic of significant interest within UK newspapers. Newspapers were used to call for government action and advocate for structural, income-based solutions. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11214-9.
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Affiliation(s)
- Amy Yau
- Centre for Diet & Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK. .,Present address: Population Health Innovation Lab, Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, UK.
| | - Hardeep Singh-Lalli
- Centre for Diet & Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Hannah Forde
- Centre for Diet & Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Matthew Keeble
- Centre for Diet & Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Martin White
- Centre for Diet & Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Jean Adams
- Centre for Diet & Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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Cobiac LJ, Scarborough P. Modelling future trajectories of obesity and body mass index in England. PLoS One 2021; 16:e0252072. [PMID: 34077469 PMCID: PMC8172072 DOI: 10.1371/journal.pone.0252072] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/10/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Obesity is a leading risk for poor health outcomes in England. We examined best- and worst-case scenarios for the future trajectory of the obesity epidemic. METHODS Taking the last 27 years of Health Survey for England data, we determined both position and shape of the adult body mass index (BMI) distribution and projected these parameters 20 years forward in time. For the best-case scenario, we fitted linear models, allowing for a quadratic relationship between the outcome variable and time, to reflect a potential reversal in upwards trends. For the worst-case scenario, we fitted non-linear models that applied an exponential function to reflect a potential flattening of trends over time. Best-fitting models were identified using Monte Carlo cross-validation on 1991-2014 data, and predictions of population prevalence across five BMI categories were then validated using 2015-17 data. RESULTS Both linear and non-linear models showed a close fit to observed data (mean absolute error <2%). In the best-case scenario, the proportion of the population at increased risk (BMI≥25kg/m2) is predicted to fall from 66% in 2017 to 53% (95% confidence interval: 41% to 64%) in 2035. In the worst-case scenario, this proportion is likely to remain relatively stable overall- 64% (37% to 90%) in 2035 -but with an increasing proportion of the population at highest risk (BMI≥35kg/m2). CONCLUSIONS While obesity prediction depends on chosen modelling methods, even under optimistic assumptions it is likely that the majority of the English population will still be at increased risk of disease due to their weight until at least 2035, without greater allocation of resources to effective interventions.
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Affiliation(s)
- Linda J. Cobiac
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- * E-mail:
| | - Peter Scarborough
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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Pell D, Mytton O, Penney TL, Briggs A, Cummins S, Penn-Jones C, Rayner M, Rutter H, Scarborough P, Sharp SJ, Smith RD, White M, Adams J. Changes in soft drinks purchased by British households associated with the UK soft drinks industry levy: controlled interrupted time series analysis. BMJ 2021; 372:n254. [PMID: 33692200 PMCID: PMC7944367 DOI: 10.1136/bmj.n254] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/15/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine changes in household purchases of drinks and confectionery one year after implementation of the UK soft drinks industry levy (SDIL). DESIGN Controlled interrupted time series analysis. PARTICIPANTS Members of a panel of households reporting their purchasing on a weekly basis to a market research company (average weekly number of participants n=22 183), March 2014 to March 2019. INTERVENTION A two tiered tax levied on manufacturers of soft drinks, announced in March 2016 and implemented in April 2018. Drinks with ≥8 g sugar/100 mL (high tier) are taxed at £0.24/L and drinks with ≥5 to <8 g sugar/100 mL (low tier) are taxed at £0.18/L. Drinks with <5 g sugar/100 mL (no levy) are not taxed. MAIN OUTCOME MEASURES Absolute and relative differences in the volume of, and amount of sugar in, soft drinks categories, all soft drinks combined, alcohol, and confectionery purchased per household per week one year after implementation of the SDIL compared with trends before the announcement of the SDIL. RESULTS In March 2019, compared with the counterfactual estimated from pre-announcement trends, purchased volume of drinks in the high levy tier decreased by 155 mL (95% confidence interval 240.5 to 69.5 mL) per household per week, equivalent to 44.3% (95% confidence interval 59.9% to 28.7%), and sugar purchased in these drinks decreased by 18.0 g (95% confidence interval 32.3 to 3.6 g), or 45.9% (68.8% to 22.9%). Purchases of low tier drinks decreased by 177.3 mL (225.3 to 129.3 mL) per household per week, or 85.9% (95.1% to 76.7%), with a 12.5 g (15.4 to 9.5 g) reduction in sugar in these drinks, equivalent to 86.2% (94.2% to 78.1%). Despite no overall change in volume of no levy drinks purchased, there was an increase in sugar purchased of 15.3 g (12.6 to 17.9 g) per household per week, equivalent to 166.4% (94.2% to 238.5%). When all soft drinks were combined, the volume of drinks purchased did not change, but sugar decreased by 29.5 g (55.8 to 3.1 g), or 9.8% (17.9% to 1.8%). Purchases of confectionery and alcoholic drinks did not change. CONCLUSIONS Compared with trends before the SDIL was announced, one year after implementation, the volume of soft drinks purchased did not change. The amount of sugar in those drinks was 30 g, or 10%, lower per household per week-equivalent to one 250 mL serving of a low tier drink per person per week. The SDIL might benefit public health without harming industry. TRIAL REGISTRATION ISRCTN18042742.
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Affiliation(s)
- David Pell
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge CB2 0QQ, UK
| | - Oliver Mytton
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge CB2 0QQ, UK
| | - Tarra L Penney
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge CB2 0QQ, UK
- Faculty of Health, School of Kinesiology and Health Science, Toronto, Canada
| | - Adam Briggs
- Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Warwick Medical School, University of Warwick, Division of Health Sciences, Coventry, UK
| | - Steven Cummins
- Population Health Innovation Lab, Department of Public Health, Environment and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Catrin Penn-Jones
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge CB2 0QQ, UK
| | - Mike Rayner
- Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- National Institute of Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Headington, Oxford, UK
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Peter Scarborough
- Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- National Institute of Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Headington, Oxford, UK
| | - Stephen J Sharp
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge CB2 0QQ, UK
| | - Richard D Smith
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Martin White
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge CB2 0QQ, UK
| | - Jean Adams
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge CB2 0QQ, UK
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Essman M, Stoltze FM, Carpentier FD, Swart EC, Taillie LS. Examining the news media reaction to a national sugary beverage tax in South Africa: a quantitative content analysis. BMC Public Health 2021; 21:454. [PMID: 33676468 PMCID: PMC7937301 DOI: 10.1186/s12889-021-10460-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 02/17/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND South Africa was the first sub-Saharan African country to implement a sugar-sweetened beverage (SSB) tax called the Health Promotion Levy (HPL) in April 2018. Given news media can increase public awareness and sway opinions, this study analyzed how the media represented the HPL, including expressions of support or challenge, topics associated with the levy, and stakeholder views of the HPL. METHODS We performed a quantitative content analysis of online South African news articles related to the HPL published between January 1, 2017 and June 30, 2019. We coded the presence or absence of mentions related to health and economic effects of the HPL and HPL support or opposition. Prevalence of these mentions, overall and by source (industry, government, academics, other), were analyzed with Pearson χ2 and post-hoc Fisher exact tests. RESULTS Across all articles, 81% mentioned health, and 65% mentioned economics topics. 54% of articles expressed support, 26% opposition, and 20% a balanced view of the HPL. All sources except industry expressed majority support for the HPL. Health reasons were the most common justifications for support, and economic harms were the most common justifications for opposition. Statements that sugar intake is not related to obesity, the HPL will not reduce SSB intake, and the HPL will cause industry or economic harm were all disproportionately high in industry sources (92, 80, and 81% vs 25% prevalence in total sample) (p < 0.001). Statements that sugar intake is related to obesity and non-communicable diseases were disproportionately high in both government (46 and 54% vs 31% prevalence in total sample) (p < 0.001) and academics (33 and 38% vs 25% prevalence in total sample) (p < 0.05). Statements that the HPL will improve health and the HPL will reduce health care costs were disproportionately high in government (47% vs 31% prevalence in total sample) (p < 0.001) and academics (44% vs 25% prevalence in total sample) (p < 0.05), respectively. CONCLUSIONS Industry expressed no support for the HPL, whereas academics, government, and other sources mainly expressed support. Future studies would be improved by linking news media exposure to SSB intake data to better understand the effects news media may have on individual behavior change.
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Affiliation(s)
- Michael Essman
- Gillings School of Global Public Health, Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Fernanda Mediano Stoltze
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Elizabeth C Swart
- Faculty of Community and Health Sciences, University of the Western Cape, Robert Sobukwe Rd, Bellville, Cape Town, South Africa
| | - Lindsey Smith Taillie
- Gillings School of Global Public Health, Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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THEIS DOLLYR, WHITE MARTIN. Is Obesity Policy in England Fit for Purpose? Analysis of Government Strategies and Policies, 1992-2020. Milbank Q 2021; 99:126-170. [PMID: 33464689 PMCID: PMC7984668 DOI: 10.1111/1468-0009.12498] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Policy Points This analysis finds that government obesity policies in England have largely been proposed in a way that does not readily lead to implementation; that governments rarely commission evaluations of previous government strategies or learn from policy failures; that governments have tended to adopt less interventionist policy approaches; and that policies largely make high demands on individual agency, meaning they rely on individuals to make behavior changes rather than shaping external influences and are thus less likely to be effective or equitable. These findings may help explain why after 30 years of proposed government obesity policies, obesity prevalence and health inequities still have not been successfully reduced. If policymakers address the issues identified in this analysis, population obesity could be tackled more successfully, which has added urgency given the COVID-19 pandemic. CONTEXT In England, the majority of adults, and more than a quarter of children aged 2 to 15 years live with obesity or excess weight. From 1992 to 2020, even though the government published 14 obesity strategies in England, the prevalence of obesity has not been reduced. We aimed to determine whether such government strategies and policies have been fit for purpose regarding their strategic focus, nature, basis in theory and evidence, and implementation viability. METHOD We undertook a mixed-methods study, involving a document review and analysis of government strategies either wholly or partially dedicated to tackling obesity in England. We developed a theory-based analytical framework, using content analysis and applied thematic analysis (ATA) to code all policies. Our interpretation drew on quantitative findings and thematic analysis. FINDINGS We identified and analyzed 14 government strategies published from 1992 to 2020 containing 689 wide-ranging policies. Policies were largely proposed in a way that would be unlikely to lead to implementation; the majority were not interventionist and made high demands on individual agency, meaning that they relied on individuals to make behavior changes rather than shaping external influences, and are thus less likely to be effective or to reduce health inequalities. CONCLUSIONS The government obesity strategies' failure to reduce the prevalence of obesity in England for almost 30 years may be due to weaknesses in the policies' design, leading to a lack of effectiveness, but they may also be due to failures of implementation and evaluation. These failures appear to have led to insufficient or no policy learning and governments proposing similar or identical policies repeatedly over many years. Governments should learn from their earlier policy failures. They should prioritize policies that make minimal demands on individuals and have the potential for population-wide reach so as to maximize their potential for equitable impacts. Policies should be proposed in ways that readily lead to implementation and evaluation.
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Affiliation(s)
- DOLLY R.Z. THEIS
- Centre for Diet and Activity Research and MRC Epidemiology UnitUniversity of Cambridge
| | - MARTIN WHITE
- Centre for Diet and Activity Research and MRC Epidemiology UnitUniversity of Cambridge
- Bennett Institute for Public PolicyUniversity of Cambridge
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McGill E, Er V, Penney T, Egan M, White M, Meier P, Whitehead M, Lock K, Anderson de Cuevas R, Smith R, Savona N, Rutter H, Marks D, de Vocht F, Cummins S, Popay J, Petticrew M. Evaluation of public health interventions from a complex systems perspective: A research methods review. Soc Sci Med 2021; 272:113697. [PMID: 33508655 DOI: 10.1016/j.socscimed.2021.113697] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/27/2020] [Accepted: 01/07/2021] [Indexed: 02/09/2023]
Abstract
INTRODUCTION Applying a complex systems perspective to public health evaluation may increase the relevance and strength of evidence to improve health and reduce health inequalities. In this review of methods, we aimed to: (i) classify and describe different complex systems methods in evaluation applied to public health; and (ii) examine the kinds of evaluative evidence generated by these different methods. METHODS We adapted critical review methods to identify evaluations of public health interventions that used systems methods. We conducted expert consultation, searched electronic databases (Scopus, MEDLINE, Web of Science), and followed citations of relevant systematic reviews. Evaluations were included if they self-identified as using systems- or complexity-informed methods and if they evaluated existing or hypothetical public health interventions. Case studies were selected to illustrate different types of complex systems evaluation. FINDINGS Seventy-four unique studies met our inclusion criteria. A framework was developed to map the included studies onto different stages of the evaluation process, which parallels the planning, delivery, assessment, and further delivery phases of the interventions they seek to inform; these stages include: 1) theorising; 2) prediction (simulation); 3) process evaluation; 4) impact evaluation; and 5) further prediction (simulation). Within this framework, we broadly categorised methodological approaches as mapping, modelling, network analysis and 'system framing' (the application of a complex systems perspective to a range of study designs). Studies frequently applied more than one type of systems method. CONCLUSIONS A range of complex systems methods can be utilised, adapted, or combined to produce different types of evaluative evidence. Further methodological innovation in systems evaluation may generate stronger evidence to improve health and reduce health inequalities in our complex world.
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Affiliation(s)
- Elizabeth McGill
- Department of Health Services, Research and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom.
| | - Vanessa Er
- Department of Health Services, Research and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Tarra Penney
- MRC Epidemiology Unit, Centre for Diet and Activity Research (CEDAR) and University of Cambridge, Cambridge, United Kingdom
| | - Matt Egan
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London; United Kingdom
| | - Martin White
- MRC Epidemiology Unit, Centre for Diet and Activity Research (CEDAR) and University of Cambridge, Cambridge, United Kingdom
| | - Petra Meier
- Public Health, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, United Kingdom
| | - Margaret Whitehead
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
| | - Karen Lock
- University of Exeter Medical School, Exeter, United Kingdom
| | | | - Richard Smith
- University of Exeter Medical School, Exeter, United Kingdom
| | - Natalie Savona
- Department of Health Services, Research and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Harry Rutter
- Department of Social & Policy Sciences, University of Bath, Bath, United Kingdom
| | - Dalya Marks
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London; United Kingdom
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Steven Cummins
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London; United Kingdom
| | - Jennie Popay
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| | - Mark Petticrew
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London; United Kingdom
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Public acceptance of obesity prevention policies in the UK. J Cancer Policy 2021; 27:100256. [DOI: 10.1016/j.jcpo.2020.100256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/15/2020] [Accepted: 10/18/2020] [Indexed: 11/15/2022]
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25
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Vanderlee L, White CM, Kirkpatrick SI, Rynard VL, Jáuregui A, Adams J, Sacks G, Hammond D. Nonalcoholic and Alcoholic Beverage Intakes by Adults across 5 Upper-Middle- and High-Income Countries. J Nutr 2021; 151:140-151. [PMID: 33245111 PMCID: PMC7779239 DOI: 10.1093/jn/nxaa324] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 08/19/2020] [Accepted: 10/01/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Despite considerable public health interest in sugary drink consumption, there has been little comparison of intake across countries. OBJECTIVES This study aimed to compare the consumption frequency and amounts of commonly consumed beverages among adults in 5 upper-middle- and high-income countries, and examine differences in consumption between population subgroups. METHODS Adults aged 18-65 y completed online surveys in December 2017 in Australia (n = 3264), Canada (n = 2745), Mexico (n = 3152), the United Kingdom (n = 3221), and the USA (n = 4015) as part of the International Food Policy Study. The frequency of consuming beverages from 22 categories in the past 7 d was estimated using the Beverage Frequency Questionnaire. Regression models were used to examine differences in the likelihood of any consumption and in the amounts consumed of sugar-sweetened beverages (SSBs), sugary drinks (SSBs and 100% juice), diet, and alcoholic beverages between countries and across sociodemographic subgroups. RESULTS The prevalence of reported SSB consumption in the past 7 d ranged from 47% (United Kingdom) to 81% (Mexico), and that of sugary drinks ranged from 62% (United Kingdom) to 87% (Mexico). Rates of consumption of diet drinks ranged from 26% (Mexico) to 37% (United Kingdom), whereas alcoholic drink consumption rates ranged from 45% (USA) to 52% (Canada). Respondents in Mexico were more likely to consume SSBs and sugary drinks, and in greater amounts, than those in other countries. Respondents in the United Kingdom were more likely to consume diet drinks than those in Australia, Canada, and Mexico, and greater amounts of diet drinks were consumed in the United Kingdom and the USA. Across countries, younger respondents and males were more likely to consume greater amounts of SSBs and sugary drinks. CONCLUSIONS Most adult respondents across all countries consumed SSBs and sugary drinks, with greater consumption in Mexico and the USA. Consumption varied greatly across countries, but patterns of association among subpopulations were relatively similar.
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Affiliation(s)
- Lana Vanderlee
- NUTRISS Centre, School of Nutrition, Laval University, Québec, Québec, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Christine M White
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Sharon I Kirkpatrick
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Vicki L Rynard
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Alejandra Jáuregui
- Centre for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Jean Adams
- Centre for Diet & Activity Research, Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Gary Sacks
- Global Obesity Centre, Deakin University, Geelong, Victoria, Australia
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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Cullerton K, Baker P, Adsett E, Lee A. What do the Australian public think of regulatory nutrition policies? A scoping review. Obes Rev 2021; 22:e13106. [PMID: 32748480 DOI: 10.1111/obr.13106] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/19/2020] [Accepted: 06/28/2020] [Indexed: 12/31/2022]
Abstract
Effective government policies are crucial to creating healthy food environments. However, changing public policy is a slow and challenging process involving many competing factors. One cited factor is public opinion towards a proposed policy. This study aimed to systematically explore public opinion on regulatory nutrition policy issues in Australia from 2009 to 2019, to determine whether low levels of public opinion corresponded with the low levels of regulatory policy action in this country. We found that there was varying levels of public support in Australia for public health nutrition action. Regulatory- and legislative-based policies generally had moderate to high levels of support except for food and drink taxes, which had low to moderate support. Despite high levels of public support for certain policy initiatives, national public health nutrition policy in Australia has not evolved consistently with the level of public support nor the evidence base over the past decade indicating other more important factors at play in policymaking.
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Affiliation(s)
- Katherine Cullerton
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Phillip Baker
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
| | - Eloise Adsett
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Amanda Lee
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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Gillison F, Grey E, Griffin T. Parents' Perceptions and Responses to the UK Soft Drinks Industry Levy. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:626-631. [PMID: 31919006 DOI: 10.1016/j.jneb.2019.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 11/07/2019] [Accepted: 11/08/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To record parents' awareness of the UK soft drinks industry levy (SDIL) and explore associations between negative psychological reactance to the levy and motivation and intentions to change consumption and purchasing. METHODS A cross-sectional online survey with UK-based parents of children aged 5-11 years (n = 237). Regression analyses were used to test associations between psychosocial responses to the levy and behavioral intentions to change family consumption and purchasing. RESULTS A total of 92% of responding parents were aware of the SDIL. Of the responding parents, 57% supported its aims, but 29% felt it threatened their freedom of choice. A total of 41% expressed intention to change shopping habits or restrict their child's intake as a result. Reactance and motivation were poorer in low-income families, and intentions to change were positively predicted by motivation. CONCLUSIONS AND IMPLICATIONS This snapshot suggests that the UK SDIL is largely supported by parents and associated with intentions to change their children's intake.
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Affiliation(s)
- Fiona Gillison
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, United Kingdom.
| | - Elisabeth Grey
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, United Kingdom
| | - Tania Griffin
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, United Kingdom
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Law C, Cornelsen L, Adams J, Pell D, Rutter H, White M, Smith R. The impact of UK soft drinks industry levy on manufacturers' domestic turnover. ECONOMICS AND HUMAN BIOLOGY 2020; 37:100866. [PMID: 32224445 PMCID: PMC7615081 DOI: 10.1016/j.ehb.2020.100866] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 02/10/2020] [Accepted: 02/19/2020] [Indexed: 06/10/2023]
Abstract
In March 2016, the UK government announced the Soft Drinks Industry Levy (SDIL) which came into effect in April 2018. In common with the reaction to sugar-sweetened beverage (SSB) taxes in other countries, the SDIL announcement was met with strong industry opposition, with claims that it would harm their profits. The SDIL was designed to incentivise reformulation of SSBs by providing a 2-year delay between the announcement and the enforcement of the levy, and adopting a two-tiered rate based on the sugar content of the drinks. Using interrupted time series analysis, this paper examines how the domestic turnover of UK soft drinks manufacturers changed after the announcement and the implementation of the SDIL. Our results show some evidence of a short-term negative impact of the SDIL announcement on the domestic turnover of the UK soft drinks manufacturers. This effect, however, did not continue post-implementation. These findings suggest that manufacturers were, to a large extent, able to mitigate the effects of levy before it came into effect.
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Affiliation(s)
- Cherry Law
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, United Kingdom.
| | - Laura Cornelsen
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, United Kingdom
| | - Jean Adams
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, United Kingdom
| | - David Pell
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, United Kingdom
| | - Harry Rutter
- Department of Social & Policy Sciences, University of Bath, United Kingdom
| | - Martin White
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, United Kingdom
| | - Richard Smith
- College of Medicine & Health, University of Exeter, United Kingdom
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The Relationship between Self-Reported Exposure to Sugar-Sweetened Beverage Promotions and Intake: Cross-Sectional Analysis of the 2017 International Food Policy Study. Nutrients 2019; 11:nu11123047. [PMID: 31847203 PMCID: PMC6950183 DOI: 10.3390/nu11123047] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 11/28/2019] [Accepted: 12/09/2019] [Indexed: 12/18/2022] Open
Abstract
Sugar-sweetened beverage (SSB) consumption is independently associated with several non-communicable diseases, so policymakers are increasingly implementing measures, such as marketing regulation, to reduce intake. To help understand how such measures work, this study examined the association between SSB consumption and self-reported exposure to SSB promotions, both overall and by type of promotion, and whether these relationships vary between the UK, USA, Canada, Mexico, and Australia. Cross-sectional analysis of the online 2017 International Food Policy Study was performed (n = 15,515). Participants were grouped into 5265 (34%) non-, 5117 (33%) low-, and 5133 (33%) high-SSB consumers. Multinomial logistic regression models examined whether SSB consumption varied by exposure to total SSB promotion and by type: traditional, digital, recreational environment, and functional environment. Multiplicative interactions were included to investigate international variations. An additional unit of total self-reported SSB promotion exposure increased the likelihood of participants being low SSB consumers (relative risk ratio (RRR) = 1.08, 95% confidence interval (CI) = 1.06–1.10) and high SSB consumers (RRR = 1.13, 95% CI = 1.11–1.16). Only exposure to traditional and digital promotion increased the likelihood of participants being SSB consumers, though this may be explained by degree of exposure, which was not measured in this study. Some evidence illustrated international variation in these relationships.
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Royo-Bordonada MÁ, Fernández-Escobar C, Simón L, Sanz-Barbero B, Padilla J. Impact of an excise tax on the consumption of sugar-sweetened beverages in young people living in poorer neighbourhoods of Catalonia, Spain: a difference in differences study. BMC Public Health 2019; 19:1553. [PMID: 31752787 PMCID: PMC6873539 DOI: 10.1186/s12889-019-7908-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 11/07/2019] [Indexed: 02/02/2023] Open
Abstract
Background Sugar-sweetened beverage consumption is contributing to the obesity epidemic. On 28 March 2017, Catalonia enacted a law levying an excise tax on sugar-sweetened beverages for public health reasons. The purpose of this study is to assess the impact of the tax on the consumption of sugar-sweetened beverages in Catalonia (Spain). Methods Before-and-after study to assess changes in the prevalence of consumption of sugar-sweetened beverages among 1929 persons aged 12 to 40 years residing in low-income neighbourhoods of Barcelona (intervention) and Madrid (control). Beverage consumption frequency was ascertained via a validated questionnaire administered during the month prior to the tax’s introduction (May 2017) and again at 1 year after it had come into force. The effect of the tax was obtained using Poisson regression models with robust variance weighted using propensity scores. Results While the prevalence of regular consumers of taxed beverages fell by 39% in Barcelona as compared to Madrid, the prevalence of consumers of untaxed beverages remained stable. The main reason cited by more than two-thirds of those surveyed for reducing their consumption of sugar-sweetened beverages was the increase in price, followed by a heightened awareness of their health effects. Conclusions The introduction of the Catalonian excise tax on sugar-sweetened beverages was followed by a reduction in the prevalence of regular consumers of taxed beverages.
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Affiliation(s)
| | - Carlos Fernández-Escobar
- National School of Public Health, Institute of Health Carlos III, Sinesio Delgado, 8, 28029, Madrid, Spain
| | - Lorena Simón
- National Center of Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - Belen Sanz-Barbero
- National School of Public Health, Institute of Health Carlos III, Sinesio Delgado, 8, 28029, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Javier Padilla
- Primary Care Health Center Isabel II, Madrid, Parla, Spain
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Marteau TM, White M, Rutter H, Petticrew M, Mytton OT, McGowan JG, Aldridge RW. Increasing healthy life expectancy equitably in England by 5 years by 2035: could it be achieved? Lancet 2019; 393:2571-2573. [PMID: 31258113 DOI: 10.1016/s0140-6736(19)31510-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 06/11/2019] [Indexed: 11/23/2022]
Affiliation(s)
- Theresa M Marteau
- Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 0SR, UK.
| | - Martin White
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Mark Petticrew
- Department of Social and Environmental Research, London School of Hygiene & Tropical Medicine, London UK
| | - Oliver T Mytton
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - James G McGowan
- Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 0SR, UK
| | - Robert W Aldridge
- Institute of Health Informatics, University College London, London, UK
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