A Critical Analysis of Representations of Inequalities in Childhood Obesity in Australian Health Policy Documents.

Alexandra Chung,Anna Peeters,Christina Zorbas,Jennifer Browne,Kathryn Backholer

doi:10.34172/ijhpm.2021.82

Alexandra Chung, Anna Peeters + Show 3 more

Open Access

https://doi.org/10.34172/ijhpm.2021.82

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Abstract

In Australia, childhood obesity follows a socioeconomic gradient whereby children with lower socioeconomic position are disproportionately burdened. To reduce these inequalities in childhood obesity requires a multi-component policy-driven response. Action to address health issues is underpinned by the ways in which they are represented as 'problems' in public policy. This study critically examines representations of inequalities in childhood obesity within Australian health policy documents published between 2000-2019. Australia's federal, state and territory government health department websites were searched for health policy documents including healthy weight, obesity, healthy eating, food and nutrition strategies; child and youth health strategies; and broader health and wellbeing, prevention and health promotion policies that proposed objectives or strategies for childhood obesity prevention. Thematic analysis of eligible documents was guided by a theoretical framework informed by problematization theory, ecological systems theory, and theoretical principles for equity in health policy. Eighteen policy documents were eligible for inclusion. The dominant representation of inequalities in childhood obesity was one of individual responsibility. The social determinants of inequalities in childhood obesity were acknowledged, yet policy actions predominantly focused on individual determinants. Equity was positioned as a principle of policy documents but was seldom mentioned in policy actions. Current representations of inequalities in childhood obesity in Australian health policy documents do not adequately address the underlying causes of health inequities. In order to reduce inequalities in childhood obesity future policies will need greater focus on health equity and the social determinants of health (SDoH).

Highlights

The dominant representation of inequalities in childhood obesity in Australian health policy documents was one of individual responsibility with policy actions predominantly focused on individual determinants of health behaviour
This study presents the first critical analysis of how inequalities in childhood obesity are represented in Australian health policy
Our analysis examined the representations of inequalities in childhood obesity across a sample of 18 Australian health policy documents proposing action to prevent childhood overweight and obesity

Summary

Introduction

Children with obesity have increased risk of adverse physical and psychological health, with excess weight gain and associated health consequences likely to persist into adolescence and adulthood.[1,2,3,4] In Australia and other highincome countries, childhood obesity is socioeconomically patterned whereby children who live in socioeconomically disadvantaged neighbourhoods or whose parents have low income or education are more likely to experience obesity compared to children with a relatively higher socioeconomic position.[5,6] In a number of countries including Australia, socioeconomic inequalities in childhood obesity are widening.[7,8]The determinants of childhood obesity are complex, acting across multiple contexts and in multiple settings.[9]. Health equity can be described as the notion that everyone should have a fair opportunity to attain their full health potential.[15]

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