Empowering People to Make Healthier Choices: A Critical Discourse Analysis of the Tackling Obesity Policy

Brookes, Gavin

doi:10.1177/10497323211027536

Cited by 22 publications

(19 citation statements)

References 51 publications

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“…Previous research has shown that public health policy tends to overemphasize individuals' choices, lifestyle factors, and their own responsibility, in line with neoliberal ideology. 34 This political and economic ideology revolves around individual freedom as the most central value in a society. Well-being is viewed as best achieved by individuals exercising their personal freedom and responsibility over their bodies, health, and lifestyle, by making the "correct" choices when it comes to self-care, food, exercise, and other lifestyle factors.…”

Section: Discussionmentioning

confidence: 99%

Scandinavian Online Cancer Information as Expressions of Governmentality

Aasen

Dahl

Ottesen

et al. 2022

Advances in Nursing Science

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We compared online distributed information provided to patients with cancer in Scandinavian countries through the lens of governmentality. A secondary comparative qualitative analysis was conducted. Discourses in online patient information showed differences in governmentality techniques across the countries: Norway used a paternalist approach, Denmark an educative approach, and Sweden an individualistic approach and expected the patients to make the “right” decisions. Online information for patients with cancer in Denmark and Norway showed high professional and health care system involvement, whereas in Sweden, there was high patient involvement. There was almost no use of the person-centered approach among the online discourses.

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Section: Discussionmentioning

confidence: 99%

Scandinavian Online Cancer Information as Expressions of Governmentality

Aasen

Dahl

Ottesen

et al. 2022

Advances in Nursing Science

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“…England might be said to have a neoliberal political system based on ideals of competition, free markets with minimal state intervention and corporate regulation to promote economic prosperity. [38][39][40][41] Neoliberal systems reject the idea that health is the product of structural forces placed on individuals, diminishing the role of social, economic and commercial influences on health. 42 In this system, governments might be reluctant to use population-level structural interventions to address upstream drivers of ill health.…”

Section: How Political Context Shapes Diabetes Preventionmentioning

confidence: 99%

Explaining the UK’s ‘high-risk’ approach to type 2 diabetes prevention: findings from a qualitative interview study with policy-makers in England

et al. 2023

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ObjectivesWhen seeking to prevent type 2 diabetes, a balance must be struck between individual approaches (focusing on people’s behaviour ‘choices’) and population approaches (focusing on the environment in which those choices are made) to address the socioeconomic complexity of diabetes development. We sought to explore how this balance is negotiated in the accounts of policy-makers developing and enacting diabetes prevention policy.MethodsTwelve semistructured interviews were undertaken with nine UK policy-makers between 2018–2021. We explored their perspectives on disease prevention strategies and what influenced policy decision-making. Interviews were transcribed and analysed thematically using NVIVO. We used Shiffman’s political priority framework to theorise why some diabetes prevention policy approaches gather political support while others do not.ResultsThe distribution of power and funding among relevant actors, and the way they exerted their power determined the dominant approach in diabetes prevention policy. As a result of this distribution, policy-makers framed their accounts of diabetes prevention policies in terms of individual behaviour change, monitoring personal quantitative markers but with limited ability to effect population-level approaches. Such an approach aligns with the current prevailing neoliberal political context, which focuses on individual lifestyle choices to prevent disease rather than on infrastructure measures to improve the environments and contexts within which those choices are made.ConclusionWithin new local and national policy structures, there is an opportunity for collaborative working among the National Health Service, local governments and public health teams to balance the focus on disease prevention, addressing upstream drivers of ill health as well as targeting individuals with the highest risk of diabetes.

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“…Environments are physical sites where systems of power (racism, sexism, capitalism and inequality) are exchanged from society to the individual/families (53,59). Environmental policies improve the social/individual interface to compensate for inequality, they can exhibit significant cost savings in the mid-to-long term (13), and they can eventually change the norm (60).…”

Section: Environmentsmentioning

confidence: 99%

“…Implementation deficit is the phenomenon whereby the intent of a government is expressed in their policies, however actions to that end are not carried out (71). Lifestyle drift is a phenomenon whereby there is a shifting from interventions aimed at determinants onto individual/family behavior using language such as "empowerment" and "choice" (59). Neoliberal modes of governance inherently reconfigure the responsibility for health and well-being at the feet of the individual (59), which extends to parents in the case of young children.…”

Section: Systems Approachesmentioning

confidence: 99%

“…Lifestyle drift is a phenomenon whereby there is a shifting from interventions aimed at determinants onto individual/family behavior using language such as "empowerment" and "choice" (59). Neoliberal modes of governance inherently reconfigure the responsibility for health and well-being at the feet of the individual (59), which extends to parents in the case of young children. This is not to dismiss the utility of interventions aimed at individual/family lifestyle behaviors (6,72,73) or in ECEC settings (52), rather it is to highlight the need to also address wider determinants concurrently (13,70,74).…”

Section: Systems Approachesmentioning

confidence: 99%

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Australian State and Territory Eclectic Approaches to Obesity Prevention in the Early Years: Policy Mapping and Perspectives of Senior Health Officials

Esdaile

Gillespie

Baur

et al. 2022

Front. Public Health

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BackgroundThe international increase in the prevalence of childhood obesity has hastened in recent decades. This rise has coincided with the emergence of comorbidities in childhood—such as type II diabetes, non-alcoholic fatty liver disease, metabolic syndrome, sleep apnoea and hypertension—formerly only described in adulthood. This phenomenon suggests global social and economic trends are impacting on health supportive environments. Obesity prevention is complex and necessitates both long-term and systems approaches. Such an approach considers the determinants of health and how they interrelate to one another. Investment in the early years (from conception to about 5 years of age) is a key life stage to prevent obesity and establish lifelong healthy habits relating to nutrition, physical activity, sedentary behavior and sleep. In Australia, obesity prevention efforts are spread across national and state/territory health departments. It is not known from the literature how, with limited national oversight, state and territory health departments approach obesity prevention in the early years.MethodsWe conducted a qualitative study including policy mapping and interviews with senior officials from each Australian state/territory health department. A series of questions were developed from the literature to guide the policy mapping, drawing on the World Health Organisation Ending Childhood Obesity Report, and adapted to the state/territory context. The policy mapping was iterative. Prior to the interviews initial policy mapping was undertaken. During the interviews, these policies were discussed, and participants were asked to supply any additional policies of relevance to obesity prevention. The semi-structured interviews explored the approaches to obesity prevention taken in each jurisdiction and the barriers and enablers faced for policy implementation. Thematic analysis was used to analyse the data, using NVivo software.ResultsState and territory approaches to obesity prevention are eclectic and while there are numerous similarities between jurisdictions, no two states are the same. The diversity of approaches between jurisdictions is influenced by the policy culture and unique social, geographic, and funding contexts in each jurisdiction. No Australian state/territory had policies against all the guiding questions. However, there are opportunities for sharing and collaborating within and between Australian jurisdictions to establish what works, where, and for whom, across Australia's complex policy landscape.ConclusionsEven within a single country, obesity prevention policy needs to be adaptable to local contexts. Opportunities for jurisdictions within and between countries to share, learn, and adapt their experiences should be supported and sustained funding provided.

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Empowering People to Make Healthier Choices: A Critical Discourse Analysis of the Tackling Obesity Policy

Cited by 22 publications

References 51 publications

Scandinavian Online Cancer Information as Expressions of Governmentality

Scandinavian Online Cancer Information as Expressions of Governmentality

Explaining the UK’s ‘high-risk’ approach to type 2 diabetes prevention: findings from a qualitative interview study with policy-makers in England

Australian State and Territory Eclectic Approaches to Obesity Prevention in the Early Years: Policy Mapping and Perspectives of Senior Health Officials

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