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"Risk" and "risk behavior" have become key terms in public health. Largely based on epidemiological categories, risk terminology in public health tends to describe health problems at the individual level. Criticisms of individualized risk discourse include the failure of these concepts of risk to address broader determinants of health. Juxtaposing "expert" and "lay" perceptions of hepatitis C viral infection we discuss the importance of social, political, and economic conditions in shaping perceptions of health and health risks. We use the lived experience of hepatitis C infection as a case study to show how lay epidemiology offers insights into the complex nature of risk and provides evidence for the connections between health problems to their social context. Although accessing and synthesizing lay and expert knowledge require research inputs and theoretical understandings from an array of disciplines and skill sets, collaborative efforts will more effectively investigate the ways in which disease often spreads along the lines of social structure. Multidisciplinary approaches expand traditional epidemiological notions of risk and vulnerability to construct more nuanced descriptions of human behavior and more contextually situated health interventions.

"Risk" and "risk behavior" have become key terms in public health. Largely based on epidemiological categories, risk terminology in public health tends to describe health problems at the individual level. Criticisms of individualized risk discourse include the failure of these concepts of risk to address broader determinants of health. Juxtaposing "expert" and "lay" perceptions of hepatitis C viral infection we discuss the importance of social, political, and economic conditions in shaping perceptions of health and health risks. We use the lived experience of hepatitis C infection as a case study to show how lay epidemiology offers insights into the complex nature of risk and provides evidence for the connections between health problems to their social context. Although accessing and synthesizing lay and expert knowledge require research inputs and theoretical understandings from an array of disciplines and skill sets, collaborative efforts will more effectively investigate the ways in which disease often spreads along the lines of social structure. Multidisciplinary approaches expand traditional epidemiological notions of risk and vulnerability to construct more nuanced descriptions of human behavior and more contextually situated health interventions.

Offers conceptual, methodological and practical insights into understanding and successfully mediating cultural influences to address old and new public health issues including safe water delivery, leprosy, Attention Deficit Hyperactivity Disorder and body image

Indigenous Australians experience profound levels of disadvantage in health, living standards, life expectancy, education and employment, particularly in comparison with non-Indigenous Australians. Very little information is available about the healthy development of Australian Indigenous children; the Longitudinal Study of Indigenous Children (LSIC) is designed to fill this knowledge gap.This dataset provides an opportunity to follow the development of up to 1759 Indigenous children. LSIC conducts annual face-to-face interviews with children (aged 0.5-2 and 3.5-5 years at baseline in 2008) and their caregivers. This represents between 5% and 10% of the total population of Indigenous children in these age groups, including families of varied socioeconomic and cultural backgrounds. Study topics include: the physical, social and emotional well-being of children and their caregivers; language; culture; parenting; and early childhood education.LSIC is a shared resource, formed in partnership with communities; its data are readily accessible through the Australian Government Department of Social Services (see http://dss.gov.au/lsic for data and access arrangements). As one of very few longitudinal studies of Indigenous children, and the only national one, LSIC will enable an understanding of Indigenous children from a wide range of environments and cultures. Findings from LSIC form part of a growing infrastructure from which to understand Indigenous child health.

In 1986, the Ottawa Charter alerted a new generation of health promotion practitioners to the benefits of working with the non-health sectors; including the commercial sector. Since then, the establishment of partnerships with government and non-government bodies has been advanced as a positive way of fostering policies that enhance health and well-being. The food and nutrition field has enthusiastically adopted partnerships between government, non-government and industry. In this article, we focus on the tactics employed by industry bodies to further their cause in a range of fields that are characterized by risk and contestation. We describe the nature of the alliances and interactions between commercial, scientific and government groups whose stated aim is to improve Australia's diet. Our analysis shows that these partnerships have been guided less by the ethos of the Ottawa Charter and more by the interests of the various parties: namely the food industry's need for credibility in making health claims, the financial imperatives of professional bodies and scientists whose public funding is inadequate, and government endorsement of public-private partnerships as the preferred mechanism for service delivery. The symbiotic relationship that is emerging between segments of the food industry and the nutrition professions raises questions about the independence of the dietary advice being given to consumers. We conclude by arguing for a research programme to investigate the consequences of intersectoral partnerships on the nutritional status of the population.

Indigenous Australians experience profound levels of disadvantage in health, living standards, life expectancy, education and employment, particularly in comparison with non-Indigenous Australians. Very little information is available about the healthy development of Australian Indigenous children; the Longitudinal Study of Indigenous Children (LSIC) is designed to fill this knowledge gap.This dataset provides an opportunity to follow the development of up to 1759 Indigenous children. LSIC conducts annual face-to-face interviews with children (aged 0.5-2 and 3.5-5 years at baseline in 2008) and their caregivers. This represents between 5% and 10% of the total population of Indigenous children in these age groups, including families of varied socioeconomic and cultural backgrounds. Study topics include: the physical, social and emotional well-being of children and their caregivers; language; culture; parenting; and early childhood education.LSIC is a shared resource, formed in partnership with communities; its data are readily accessible through the Australian Government Department of Social Services (see http://dss.gov.au/lsic for data and access arrangements). As one of very few longitudinal studies of Indigenous children, and the only national one, LSIC will enable an understanding of Indigenous children from a wide range of environments and cultures. Findings from LSIC form part of a growing infrastructure from which to understand Indigenous child health.

In 1986, the Ottawa Charter alerted a new generation of health promotion practitioners to the benefits of working with the non-health sectors; including the commercial sector. Since then, the establishment of partnerships with government and non-government bodies has been advanced as a positive way of fostering policies that enhance health and well-being. The food and nutrition field has enthusiastically adopted partnerships between government, non-government and industry. In this article, we focus on the tactics employed by industry bodies to further their cause in a range of fields that are characterized by risk and contestation. We describe the nature of the alliances and interactions between commercial, scientific and government groups whose stated aim is to improve Australia's diet. Our analysis shows that these partnerships have been guided less by the ethos of the Ottawa Charter and more by the interests of the various parties: namely the food industry's need for credibility in making health claims, the financial imperatives of professional bodies and scientists whose public funding is inadequate, and government endorsement of public-private partnerships as the preferred mechanism for service delivery. The symbiotic relationship that is emerging between segments of the food industry and the nutrition professions raises questions about the independence of the dietary advice being given to consumers. We conclude by arguing for a research programme to investigate the consequences of intersectoral partnerships on the nutritional status of the population.

As obesity continues to rise in the US, Canada, Australia and various European countries, this volume offers a perspective that classifies obesity as a social phenomenon as well as a public health problem. The authors argue obesity is a condition of modernisation and present in-depth supporting data.

Background: It is assumed that people who inject drugs (PWID) care little about their health. This emerges from social and moral perceptions of PWID and is framed by research that focuses on their morbidity and mortality. Drawing on the narratives of Australian women who inject drugs, we examined the salience of health for our participants and the contexts that structure their descriptions of health and wellbeing. Methods: We conducted qualitative interviews with 83 women who inject drugs and live with hepatitis C virus (HCV) to explore their experiences of health and health care seeking. Findings: Although the interviews focused on HCV, women discussed their health within broader contexts of drug dependence, unstable housing, unemployment, financial strain, other health issues and relationships. Concern about HCV was less pronounced than concerns about other health problems and socio-economic circumstances. Broadening the focus of health beyond drug use alone, women's narratives strongly suggest that PWID can and do care about their health. Conclusions: Whilst research and policy often focus on health problems and barriers to health amongst PWID, the women in our sample maintained positive health beliefs and behaviours. Much like other members of society, their health priorities are contextualised by cultural, economic and political factors. This suggests that health interventions aimed at women who inject drugs could build upon the salience of a range of health priorities as well as integrating these with structural interventions designed to improve housing and economic status.

Issue addressed: Debate on obesity spans complex health and social issues drawing on varying representations of fat bodies. This paper seeks to determine whether the recent public health focus on social inequalities is reflected in broader policy debate on obesity. Methods: We reviewed public submissions to the 2008 Australian House Standing Committee on Health and Ageing inquiry into obesity. Using a qualitative framing approach we categorised the 95 submissions, analysing a sample of 20 of them, thereby, elucidating attitudes to obesity held by a range of interested stakeholders. Results: Two primary frames and one lesser frame were identified. While it was common for contributors to situate obesity as a problem of individuals, it was equally common for contributors to draw on environmental level arguments where obesity is located in structural forces outside of the individual. The range of attributing factors reflects disagreement as to the causes of obesity, although adherents to both the individual and environmental frames called for more government regulation and financial support. Only two submissions directed policy reform to issues of inequality. Conclusions: Empirically, this study represents a novel investigation of the role of public health ethics in obesity debate and policy. Politically, we highlight the relative lack of explicit attention given to inequality in the debate, even though social inequalities are demonstrably relevant.

Issue addressed: Debate on obesity spans complex health and social issues drawing on varying representations of fat bodies. This paper seeks to determine whether the recent public health focus on social inequalities is reflected in broader policy debate on obesity. Methods: We reviewed public submissions to the 2008 Australian House Standing Committee on Health and Ageing inquiry into obesity. Using a qualitative framing approach we categorised the 95 submissions, analysing a sample of 20 of them, thereby, elucidating attitudes to obesity held by a range of interested stakeholders. Results: Two primary frames and one lesser frame were identified. While it was common for contributors to situate obesity as a problem of individuals, it was equally common for contributors to draw on environmental level arguments where obesity is located in structural forces outside of the individual. The range of attributing factors reflects disagreement as to the causes of obesity, although adherents to both the individual and environmental frames called for more government regulation and financial support. Only two submissions directed policy reform to issues of inequality. Conclusions: Empirically, this study represents a novel investigation of the role of public health ethics in obesity debate and policy. Politically, we highlight the relative lack of explicit attention given to inequality in the debate, even though social inequalities are demonstrably relevant.

Background: It is assumed that people who inject drugs (PWID) care little about their health. This emerges from social and moral perceptions of PWID and is framed by research that focuses on their morbidity and mortality. Drawing on the narratives of Australian women who inject drugs, we examined the salience of health for our participants and the contexts that structure their descriptions of health and wellbeing. Methods: We conducted qualitative interviews with 83 women who inject drugs and live with hepatitis C virus (HCV) to explore their experiences of health and health care seeking. Findings: Although the interviews focused on HCV, women discussed their health within broader contexts of drug dependence, unstable housing, unemployment, financial strain, other health issues and relationships. Concern about HCV was less pronounced than concerns about other health problems and socio-economic circumstances. Broadening the focus of health beyond drug use alone, women's narratives strongly suggest that PWID can and do care about their health. Conclusions: Whilst research and policy often focus on health problems and barriers to health amongst PWID, the women in our sample maintained positive health beliefs and behaviours. Much like other members of society, their health priorities are contextualised by cultural, economic and political factors. This suggests that health interventions aimed at women who inject drugs could build upon the salience of a range of health priorities as well as integrating these with structural interventions designed to improve housing and economic status.

In Australia, life without the automobile is no longer imaginable. Further, reliance on cars has done much to restructure the social practices & lifestyles of Australians, including their dietary habits. Based on fieldwork in rural New South Wales & the urban centers of Canberra & Sydney, this chapter considers discourses & practices that constitute Australia's fast & slow food car-centered diets. Jakle & Sculle (1997) argued that "fast food, mass produced, was a response to fast cars, mass produced." At first the car simply transported the diners to restaurants, but with the advent of drive-thru windows at McDonald's & other fast food chain outlets, the car, equipped with cup holders, became the dining room. The Slow Food movement has gained a lesser popularity in Australia, primarily in the form of farmers' markets. The authors visited the Good Living Growers' Market in Sydney. Producers drive long distances & fight heavy traffic to bring their wares to the market & then pay high prices for stalls, as do shoppers for parking places, though public transport is available. Then there is intermediate-pace food -- slow-food cuisine delivered, by car or van, to customers' homes or businesses. Thus, different types of foods & special-use vehicles appear to be rapidly co-evolving commodities in Australia. References. J. Stanton

BACKGROUND: Recent studies show corporate political activity (CPA) can have detrimental impacts on health policy processes. The Control of Marketing Promotion of Infant and Young Child Food Act B.E. 2560 (the Act) was implemented in Thailand in 2017, but there have been no studies documenting CPA during its policy processes. Furthermore, the effects of CPA on the Act and how non-industry stakeholders dealt with the CPA have not been explored. This study aimed to analyze the CPA of baby food companies in Thailand, its effects on the Act, and how policymakers have responded to CPA around the Act. METHODS: This qualitative study applied an established framework developed by Mialon and colleagues to collect and systematically analyze publicly available information from seven baby food companies with the highest percentage market share in Thailand. In-depth interviews were also used to explore how people involved in the policy process of the Act experienced the CPA of baby food companies, the consequent effects on the Act, and how they responded to the CPA. RESULTS: During development of the Act, baby food companies used two main strategies, 'information and messaging' and 'constituency building'. We found the companies met policymakers, and they employed evidence or provided information that was favorable to companies. Also, they established relationships with policymakers, health organizations, communities and media. The effects of CPA were that the scope of products controlled by the Act was reduced, and CPA led relevant people to misunderstand and have concerns about the Act. Officials and others countered the influence of CPA by raising awareness and building understanding among involved people, as well as avoiding contact with companies informally. CONCLUSIONS: CPA consists of a variety of practices that resulted in a weakened Act in Thailand. Government officials and other non-industry stakeholders employed strategies to counteract this influence. This study suggests the Department of Health, and other ...

Transnational food retailers expanded to middle-income countries over recent decades responding to supply (liberalized foreign investment) and demand (rising incomes, urbanization, female workforce participation, and time poverty). Control in new markets diffuses along three axes: socio-economic (rich to poor), geographic (urban to rural), and product category (processed foods to fresh foods). We used a mixed method approach to study the progression of modern retail in Thailand on these three axes and consumer preferences for food retailing. In Thailand modern retail controls half the food sales but traditional fresh markets remain important. Quantitative questionnaires administered to members of a large national cohort study revealed around half of respondents were primarily traditional shoppers and half either utilized modern and traditional formats equally or primarily shopped at supermarkets. Fresh foods were mainly purchased at traditional retail formats and dry packaged foods at supermarkets. Qualitative interviews found price and quality of produce and availability of culturally important products to be significant reasons for continued support of fresh markets. Our results show socio-economic and geographic diffusion is already advanced with most respondents having access to and utilizing modern retail. Control of the fresh food sector by transnationals faces barriers in Thailand and may remain elusive. The short to mid-term outcome may be a bifurcated food system with modern and traditional retail each retaining market share, but fresh markets longer term survival may require government assistance as supermarkets become more established. Fresh markets supply affordable, healthy foods, and livelihoods for poorer Thais and are repositories of Thai food culture and social networks. If they survive they will confer cultural, social, economic, and health benefits.