Who says what about sugar-sweetened beverage tax? Stakeholders' framing of evidence: a newspaper analysis

Abstract

BackgroundIn politically contested health debates, such as sugar-sweetened beverage (SSB) taxation, stakeholders seek to present evidence and arguments for or against specific policy initiatives, based on their interests. The news media have a crucial role in shaping public opinion and the political climate by selectively choosing which issues to focus on. This study examined how stakeholders' positions and evidence on SSB taxation were represented in the media with a view to informing future public health advocacy strategies. MethodsWe conducted a structured search of the Nexis database to identify all newspaper articles relating to SSB taxation published in 11 national UK newspapers between April 1, 2015, and Nov 30, 2016. Newspaper articles were excluded if they did not specifically cite stakeholder arguments for or against SSB taxation. The final sample contained 491 articles. Two reviewers double coded a 25% random sample of articles to develop and test a coding frame, before systematically coding the content of the remaining articles. Qualitative content data were entered into NVivo (version 11) and the constant comparative approach was used to identify emergent patterns and themes with particular emphasis on differences across the data. FindingsA wide range of stakeholders (n=287) presented evidence and arguments for or against SSB taxation (1924). Stakeholder positions were largely reflected by their vested political interests. Industry stakeholders were more likely to draw upon market justice frames in opposition to taxation, asserting that they were already taking voluntary action and such measures would be anti-competitive. Public health advocates and campaigners however were more likely to draw upon social justice frames in support of SSB taxation as one of a package of policy-level measures needed to change behaviour with regard to sugar consumption. InterpretationA complex, poorly-understood, interdependency exists between the framing of evidence in public policy debates, media representations of this evidence, and the influencing strategies used by stakeholders. These insights into stakeholders' framing of evidence could inform wider debates about the media strategies of global producers and marketers of unhealthy commodities manoeuvring to directly lobby the public, and help public health advocates develop more effective media advocacy strategies. FundingSupported by the UK Medical Research Council as part of the Understandings and Uses of Public Health Research programme (MC_U130085862, MC_UU_12017/6) and the Informing Healthy Public Policy programme (MC_UU_12017/15) and by the Chief Scientist Office of the Scottish Government Health Directorates (SPHSU15). The funders had no role in the commissioning of the study, writing of the abstract, or decision to submit it for publication.