Taking on the Commercial Determinants of Health at the level of actors, practices and systems

The use of private regulatory measures to create healthy food retail environments: a scoping review

OBJECTIVE

Different forms of public and private regulation have been used to improve the healthiness of food retail environments. The aim of this scoping review was to systematically examine the types of private regulatory measures used to create healthy food retail environments, the reporting of the processes of implementation, monitoring, review and enforcement and the barriers to and enablers of these.

DESIGN

Scoping review using the Johanna Briggs Institute guidelines. Ovid MEDLINE, PsycINFO, Embase, CINAHL Plus, Business Source Complete and Scopus databases were searched in October 2020 and again in September 2023 using terms for 'food retail', 'regulation' and 'nutrition'. Regulatory measure type was described by domain and mechanism. Deductive thematic analysis was used to identify reported barriers and enablers to effective regulatory governance processes using a public health law framework.

SETTING

Food retail.

PARTICIPANTS

Food retail settings using private regulatory measures to create healthier food retail environments.

RESULTS

In total, 17 694 articles were screened and thirty-five included for review from six countries, with all articles published since 2011. Articles reporting on twenty-six unique private regulatory measures cited a mix of voluntary (n 16), mandatory (n 6) measures, both (n 2) or did not disclose (n 2). Articles frequently reported on implementation (34/35), with less reporting on the other regulatory governance processes of monitoring (15/35), review (6/35) and enforcement (2/35).

CONCLUSIONS

We recommend more attention be paid to reporting on the monitoring, review and enforcement processes used in private regulation to promote further progress in improving the healthiness of food retail environments.

What Are Healthy Societies? A Thematic Analysis of Relevant Conceptual Frameworks

BACKGROUND

While support for the idea of fostering healthy societies is longstanding, there is a gap in the literature on what they are, how to beget them, and how experience might inform future efforts. This paper explores developments since Alma Ata (1978) to understand how a range of related concepts and fields inform approaches to healthy societies and to develop a model to help conceptualize future research and policy initiatives.

METHODS

Drawing on 68 purposively selected documents, including political declarations, commission and agency reports, peer-reviewed papers and guidance notes, we undertook qualitative thematic analysis. Three independent researchers compiled and categorised themes describing the domains of a potential healthy societies approach.

RESULTS

The literature provides numerous frameworks. Some of these frameworks promote alternative endpoints to development, eschewing short-term economic growth in favour of health, equity, well-being and sustainability. They also identify values, such as gender equality, collaboration, human rights and empowerment that provide the pathways to, or underpin, such endpoints. We categorize the literature into four "components": people; places; products; and planet. People refers to social positions, interactions and networks creating well-being. Places are physical environments-built and natural-and the interests and policies shaping them. Products are commodities and commercial practices impacting population health. Planet places human health in the context of the 'Anthropocene.' These components interact in complex ways across global, regional, country and community levels as outlined in our heuristic.

CONCLUSION

The literature offers little critical reflection on why greater progress has not been made, or on the need to organise and resist the prevailing systems which perpetuate ill-health.

Protecting, promoting and supporting breastfeeding in all policies: reframing the narrative

Recent research highlights the importance of breastfeeding to health across the lifecourse, yet inadequate investment to facilitate breastfeeding according to World Health Organization recommendations threatens to undermine breastfeeding's protective effects. Western media narratives often fail to convey the significance of breastfeeding, and such narratives can hinder efforts to direct sufficient resources to scaling up effective systems and generating policy change. Delayed action disproportionately harms poor and marginalized communities. The urgency of making these investments in an era of rapidly intensifying climate change and other crises is clear. Reframing the narrative is needed to better appreciate the significance of breastfeeding as well as to recognize and address extensive efforts of undermine it. Evidence-based scientific, health professional and media discussions are necessary to recognize breastfeeding as foundational to food and health security and to enact change so that protecting, promoting and supporting breastfeeding is integrated across all policies.