1 October 2018 – 31 December 2021
In England today, it is not easy for people to enjoy a healthy diet. Four out of the five top risk factors for healthy years of life lost to death, disability and disease are linked to diet. Globally, the prevalence of overweight and obesity has almost tripled since 1975, making it one of today’s most pressing public health challenges. The UK has the highest prevalence of obesity in Western Europe starting in childhood.
Since 1991, the UK government has recognised the need to address this through ‘healthier’ policies and introduced several major strategies. I analysed all government obesity policies in England and found that 14 strategies containing 689 policies have been proposed over the last three decades, but the prevalence and related inequalities have not been successfully or consistently reduced. Not only were the largest proportion of policies not likely to be effective or equitable, but they were also proposed in a way that was unlikely to lead to them being implemented. This may explain why government tends to propose the same policy ideas again and again, and why there appears to be little to no policy learning. However, things have been improving in recent strategies with more population level policies proposed that are more likely to be effective and equitable, and more leading to implementation, monitoring and evaluation.
In an attempt to ensure effective and evidence-based policies are introduced, many public health professionals and academics have been actively attempting to influence the policy process for decades. However, these efforts have largely been criticised for failing to understand empirically the complex processes within policymaking; for focusing too narrowly on the epistemic assumption that increasing scientific evidence and knowledge will automatically improve policy; and for failing to be informed by empirically-derived policy theories from social and political science.
To help address this, the second part of my PhD has focused on generating high-quality, empirical evidence on the obesity policymaking process. I used an in-depth, single case study and a causal process tracing method to examine what influenced the UK Government’s Childhood Obesity Plan, including the key individuals, organisations, ideologies and values, and evidence and information. I have also examined the particular role of policy entrepreneurs, who are considered exceptionally effective influencers in the policy process.
I have benefited from the insights and advise from a scientific and policy advisory group, as well as academics, lay people and other experts who I have met with over the last three years. I conducted 31 elite interviews with senior policymakers, advisors and other key people involved in the policy process. I intend to keep communicating my work at research conferences and other relevant events, through the media and through meetings with policymakers and researchers.