There are many reasons for the health inequities that we see around the world today. Public policy and the way society organises its affairs affects the economic, social and physical factors that influence the conditions in which people are born, grow, live, work and age - the social determinants of health. Tackling health inequities is a political issue that requires leadership, political courage, progressive public policy, social struggle and action, and a sound evidence base.
There are many reasons for the health inequities that we see around the world today. Public policy and the way society organises its affairs affects the economic, social and physical factors that influence the conditions in which people are born, grow, live, work and age - the social determinants of health. Tackling health inequities is a political issue that requires leadership, political courage, progressive public policy, social struggle and action, and a sound evidence base.
Scholarship on the commercial determinants of health (CDoH) has sought to understand the multiple ways corporate policies, practices and products affect population health. At the same time, gender is recognised as a key determinant of health and an important axis of health inequalities. To date, there has been limited attention paid to the ways in which the CDoH engage with and impact on gender inequalities and health. This review seeks to address this gap by examining evidence on the practices and strategies of two industries-tobacco and alcohol-and their interaction with gender, with a particular focus on women. We first describe the practices by which these industries engage with women in their marketing and corporate social responsibility activities, reinforcing problematic gender norms and stereotypes that harm women and girls. We then examine how tobacco and alcohol companies contribute to gender inequalities through a range of strategies intended to protect their market freedoms and privileged position in society. By reinforcing gender inequalities at multiple levels, CDoH undermine the health of women and girls and exacerbate global health inequalities. ; While this research received no specific funding, both authors are members of the SPECTRUM Consortium (Shaping Public Health Policies to Reduce Inequalities and Harm) funded by the UK Prevention Research Partnership (MR/S037519/1).
This article argues that health outcomes, specifically nutrition related health outcomes, are socially determined, and can be linked to a wider political economy in which peoples' dietary consumption is structurally determined, evolving from political, economic and social forces. The article examines trade and investment agreements as regulatory vehicles that cultivate poor dietary consumption and inequalities in health outcomes between and within countries. How does this happen? The liberalization of trade and investment, and unfettered influence of powerful economic interests including transnational food and beverage companies has resulted in trade agreements that enable excess availability, affordability and acceptability of highly processed, nutrient poor foods worldwide, ultimately resulting in poor nutrition and consequently oral and other non-communicable diseases. These trade and nutrition policy tensions shine a spotlight on the challenges ahead for global health and development policies, including achievement of the Sustainable Development Goals.
Many of the societal level factors that affect health – the 'social determinants of health (SDH)' – exist outside the health sector, across diverse portfolios of government, and other major institutions including non-governmental organisations (NGOs) and the private sector. This has created growing interest in how to create and implement public policies which will drive better and fairer health outcomes. While designing policies that can improve the SDH is critical, so too is ensuring they are appropriately administered and implemented. In this paper, we draw attention to an important area for future public health consideration – how policies are managed and implemented through complex administrative layers of 'the state.' Implementation gaps have long been a concern of public administration scholarship. To precipitate further work in this area, in this paper, we provide an overview of the scholarly field of public administration and highlight its role in helping to understand better the challenges and opportunities for implementing policies and programs to improve health equity.
Food security is not just a food policy issue. What, when, where and how much people eat is influenced by a complex mix of factors at the societal and individual levels. These influences operate both directly through the food system and indirectly through political, economic, social, and cultural pathways - peoples' dietary behaviours are a response to the broader daily living conditions in which they are born, live, learn, work and age. In this paper we propose that to address food insecurity and diet-related death and disease, policy must tackle the systemic problems that generate poor nutrition in all its forms, and reflect how our food systems are making people sick. This has implications for economic, agriculture, food, social and health policy at the global, regional, national and local levels.
Many of the societal level factors that affect health – the 'social determinants of health (SDH)' – exist outside the health sector, across diverse portfolios of government, and other major institutions including non-governmental organisations (NGOs) and the private sector. This has created growing interest in how to create and implement public policies which will drive better and fairer health outcomes. While designing policies that can improve the SDH is critical, so too is ensuring they are appropriately administered and implemented. In this paper, we draw attention to an important area for future public health consideration – how policies are managed and implemented through complex administrative layers of 'the state.' Implementation gaps have long been a concern of public administration scholarship. To precipitate further work in this area, in this paper, we provide an overview of the scholarly field of public administration and highlight its role in helping to understand better the challenges and opportunities for implementing policies and programs to improve health equity.
Food security is not just a food policy issue. What, when, where and how much people eat is influenced by a complex mix of factors at the societal and individual levels. These influences operate both directly through the food system and indirectly through political, economic, social, and cultural pathways - peoples' dietary behaviours are a response to the broader daily living conditions in which they are born, live, learn, work and age. In this paper we propose that to address food insecurity and diet-related death and disease, policy must tackle the systemic problems that generate poor nutrition in all its forms, and reflect how our food systems are making people sick. This has implications for economic, agriculture, food, social and health policy at the global, regional, national and local levels.
The inter-related nature of food, health and climate change requires a better understanding of the linkages and a greater alignment of policy across these issues to be able to adequately meet the pressing social and health challenges arising from climate change. Food price is one way through which climate change may affect health. The aim of this study of the global and Australian food systems is to provide a whole-of-system analysis of food price vulnerabilities, highlighting the key pressure points across the food system through which climate change could potentially have the greatest impact on consumer food prices and the implications for population health. We outline areas where there are particular vulnerabilities for food systems and food prices arising from climate change, particularly global commodity prices; agricultural productivity; short term supply shocks; and less direct factors such as input costs and government policies. We use Australia as a high-income country case study to consider these issues in more detail. The complex and dynamic nature of pricing mechanisms makes it difficult to predict precisely how prices will be impacted. Should prices rise disproportionately among healthy foodstuffs compared to less healthy foods there may be adverse health outcomes if less expensive and less healthy foods are substituted. Higher prices will also have equity implications with lower socio-economic groups most impacted given these households currently spend proportionately more of their weekly income on food. The ultimate objective of this research is to identify the pathways through the food system via which climate change may affect food prices and ultimately population health, thereby providing evidence for food policy which takes into account environmental and health considerations.
The decision by Australia's High Court to uphold the constitutionality of the country's ground-breaking tobacco plain packaging laws has been heralded as a victory for national sovereignty over vested interests. However, the ability of governments worldwide to introduce and implement public health policies and laws is increasingly threatened by trade and investment treaties that privilege investors over governments and provide avenues for international corporations to challenge democratically enacted public health policies in different countries.
The inter-related nature of food, health and climate change requires a better understanding of the linkages and a greater alignment of policy across these issues to be able to adequately meet the pressing social and health challenges arising from climate change. Food price is one way through which climate change may affect health. The aim of this study of the global and Australian food systems is to provide a whole-of-system analysis of food price vulnerabilities, highlighting the key pressure points across the food system through which climate change could potentially have the greatest impact on consumer food prices and the implications for population health. We outline areas where there are particular vulnerabilities for food systems and food prices arising from climate change, particularly global commodity prices; agricultural productivity; short term supply shocks; and less direct factors such as input costs and government policies. We use Australia as a high-income country case study to consider these issues in more detail. The complex and dynamic nature of pricing mechanisms makes it difficult to predict precisely how prices will be impacted. Should prices rise disproportionately among healthy foodstuffs compared to less healthy foods there may be adverse health outcomes if less expensive and less healthy foods are substituted. Higher prices will also have equity implications with lower socio-economic groups most impacted given these households currently spend proportionately more of their weekly income on food. The ultimate objective of this research is to identify the pathways through the food system via which climate change may affect food prices and ultimately population health, thereby providing evidence for food policy which takes into account environmental and health considerations.
The decision by Australia's High Court to uphold the constitutionality of the country's ground-breaking tobacco plain packaging laws has been heralded as a victory for national sovereignty over vested interests. However, the ability of governments worldwide to introduce and implement public health policies and laws is increasingly threatened by trade and investment treaties that privilege investors over governments and provide avenues for international corporations to challenge democratically enacted public health policies in different countries.
The aim of this research is to identify how well Australian food policy adopts a public health approach and integrates considerations of climate change. In addition, the barriers and opportunities for Australian food policy to achieve a coherent public health and climate change foci will be identified. The specific objectives are to: identify the paradigms and values that exist in the policy community relating to food policy, public health and climate change; map and critically examine the existing policies in each domain (food, health, climate change); describe the actors, processes, power and governance structures that currently exist across the policy domains; develop strategies with which to address the: process and power barriers for developing and implementing Australian food policy; identify opportunities for creating Australian food policy with a coherent public health and climate change approach. This research is timely given the Australian Federal government's current food policy focus with the release of the: draft Australian Dietary Guidelines (NHMRC 2011), National Food Plan Issues paper (DAFF 2011), Food and Health Dialogue (DoHA 2011) and Australia and Food Security in a Changing World (PMSEIC 2010). In addition, it is necessary due to the Australian Federal government's release of the draft Proposed Basin Plan (MDBA 2011) and Carbon Credits (Carbon Farming Initiative) Bill 2011(ComLaw). This poster will provide a summary of the interim literature review's findings, in particular: an assessment of the paradigms and values that exist in the policy community relating to food policy, public health and climate change. ; Australian Postgraduate Awards
Abstract Human-induced climate change will affect the lives of most populations in the next decade and beyond. It will have greatest, and generally earliest, impact on the poorest and most disadvantaged populations on the planet. Changes in climatic conditions and increases in weather variability affect human wellbeing, safety, health and survival in many ways. Some impacts are direct-acting and immediate, such as impaired food yields and storm surges. Other health effects are less immediate and typically occur via more complex causal pathways that involve a range of underlying social conditions and sectors such as water and sanitation, agriculture and urban planning. Climate change adaptation is receiving much attention given the inevitability of climate change and its effects, particularly in developing contexts, where the effects of climate change will be experienced most strongly and the response mechanisms are weakest. Financial support towards adaptation activities from various actors including the World Bank, the European Union and the United Nations is increasing substantially. With this new global impetus and funding for adaptation action come challenges such as the importance of developing adaptation activities on a sound understanding of baseline community needs and vulnerabilities, and how these may alter with changes in climate. The global health community is paying heed to the strengthening focus on adaptation, albeit in a slow and unstructured manner. The aim of this paper is to provide an overview of adaptation and its relevance to global health, and highlight the opportunities to improve health and reduce health inequities via the new and additional funding that is available for climate change adaptation activities.
Effectively addressing the health risks of climate change necessitates an active crosssectoral approach because health risks arise predominantly via sectors such as water, agriculture and energy. Much has been written on climate change and its impact on health, but little attention has focused on the realpolitik of how to progress the development and implementation of health-relevant strategies and policies to reduce this impact. The objective of this paper is to propose three solutions to address current deficiencies: i) strengthening the capacity and understanding of health officials in relation to climate change and health; ii) improving cross-sectoral partnerships with sectors relevant to climate change and health, and iii) identifying organisations influential in the development of climate change mitigation and adaptation strategies and policies, with a view to better target advocacy efforts. Practical examples of each solution are provided. In conclusion, as a steward of public health, the health sector must take the initiative to encourage a cross-sectoral approach that includes capacity development, coupled with an understanding of influential organisations. If this is done effectively, health, social and economic development goals can be reached more efficiently.
