Food and Nutrition Public Policy in Australia: A diversity of views amongst stakeholders

Abstract

Advancing food and nutrition public policy in Australia is essential to halt the increasing prevalence of obesity and associated non-communicable diseases. Developing policy in this space however, is often contentious due to the entrenched views of stakeholders from a variety of interest groups. The aim of this research was to explore where the views of stakeholders are convergent and divergent on the issue, analyse the strategies used by stakeholders to influence the development of public policy, and ultimately, make recommendations to optimise the development of food and nutrition public policies.Structured interviews were undertaken with a purposeful sample of 76 stakeholders who were categorised into the following interest groups: government, public health sector, consumer groups, food and beverage industry, and academia. Interviewees were asked about their views on 1) food and nutrition public policy; 2) a variety of policy principles e.g. collaboration and transparency; and, 3) strategies to influence policy e.g. advocacy. Following transcription, the interviews were analysed using a combination of computational linguistics analysis, content analysis, descriptive and inferential statistics, and thematic analysis.The findings demonstrate a variety of concepts where the views of stakeholders are divergent and convergent. Stakeholders from government described the nature of public policy as fragmented and emphasised the difficulties associated with prevention being a low political priority. Academia emphasised the need to generate and translate the evidence base that informs the development of policy, although this is not at odds with moving forward with initiatives in the absence of a strong evidence-base. Stakeholders from consumer groups spoke of the provision of transparent information to enable personal choice, a view that was in line with the food and beverage industry. Consumer groups also saw value in improving food literacy, while industry took issue with the lack of evidence surrounding the outcomes of some initiatives – such as front-of-pack labelling. Those stakeholders from the public health sector viewed the government’s lack of priority for prevention as a concern, and the need for integration across government portfolios and the community.Despite the divergence among stakeholders, there were several convergent views. Primarily, it is essential that Australia develop a National Nutrition Policy that can guide the implementation of subsequent policies, including the Health Star Rating. The importance of the Healthy Food Partnership in facilitating the integration of stakeholders was also discussed. Several difficulties in achieving these collaborative efforts were outlined, including 1) the presence of conflicts of interest, not only from industry, but also government and academia; 2) the imbalance of power among stakeholders where industry is seen to be more effective in influencing the direction of public policy; and, 3) the distrust that is present among all stakeholders, but particularly between industry and public health.This study also sheds light on the strategies that stakeholders use to depict their views and influence the development of food and nutrition public policy. These strategies were categorised into ‘framing the debate’, ‘building partnerships’, and ‘advocacy’. Stakeholders from all interest groups agreed that obesity is: 1) a moderately severe to very severe problem; 2) both a personal responsibility and a social responsibility; and 3) described as complex and a challenge. There was divergence between the interest groups regarding the causes of obesity, yet overall seen a result of overconsumption. The policy instruments that stakeholders prioritised in addressing obesity were direct regulation and education, with education and advertising identified as the specific issues to target.In terms of building partnerships as a strategy to influence policy, stakeholders agreed that relationships were very important to extremely important. Although the current level of collaboration was seen as poor to satisfactory, stakeholders saw the improvement of collaboration as slightly likely to quite likely. Enablers to collaboration included mechanisms for engagement, leadership and balanced representation, while barriers were the distrust among stakeholders, dogma and unwillingness.Advocacy was seen to be being very influential in the development of food and nutrition public policy with coalition and network building, relationship building with decision makers, and briefings and presentations, being the most used. The most influential advocacy activities were lobbying, policy proposal development, and coalition and network building, with both the most used and influential activities differing at the interest group level. Characteristics of effective advocacy included those that were collaborative, enduring, authentic, adaptable, and considered, while ineffective advocacy was characterised as being impractical, impromptu, rigid, short-sighted and uninformed.Overall, these findings highlight the views of stakeholders and the inherent challenge in balancing, combining, and representing these views in policy. Although there is still a need to further investigate the impact these views have on the outcomes of public policy decisions, as it stands, this research contributes to a deeper understanding of stakeholders. Furthermore, these findings provide a roadmap of recommendations to move forward in order to ultimately, optimise food and nutrition public policy and public health outcomes.