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Susannah Tooze

PhD student

Healthy Places, Healthy Planet, Health Inequalities

University of Cambridge

Susannah.tooze@mrc-epid.cam.ac.uk

Project title

Framing of ‘obesity’ and its impact on UK health policy. 

Supervisors

Dr Benjamin Hawkins, University of Cambridge. Professor Martin White, University of Cambridge. Dr Cecile Knai, LSHTM. Professor Karen Lock, LSHTM.

Research interests

Obesity, food environments, food policy, health inequalities, upstream determinants of health, planetary health, systems thinking, implementation science, framing analysis, commercial determinants of health.

Project summary

The ‘framing’ of health issues by policy actors (policymakers, interested stakeholders and the public) is a key factor in deciding which issues get identified as problems worthy of government intervention, what the problem is perceived to be and what are legitimate policy solutions. The importance of framing is recognised by commercial actors in health harming industries, such as alcohol, tobacco, gambling and processed foods, which invest significant resources in attempts to influence policy debates in ways that serve their commercial interests at the expense of public health.  

Consequently, it is important for public health researchers, policymakers and advocates to understand the ways in which health policy debates are framed, by whom, and the consequences for policy outcomes. Revealing the effects of policy framing could help public health actors to reframe debates and advocate for effective, evidence-informed alternatives.  

This mixed-methods study will involve undertaking a framing analysis of obesity policies in England with a comparative perspective (over time, with devolved administrations and/ or with related policy areas such as alcohol) informed by critical discourse theory. This will help us to understand how framings are developed and implemented, the attribution of responsibility for obesity and the proposed solutions to address this evident in policy discourses. The proposed methods are well-established in social and public policy research and their application to public health research is growing.  

Data sources will include: relevant policy documents (e.g. parliamentary debates and legislation); public consultations and responses to emerging policy proposals (such as the Childhood Obesity Plan); intervention in these debates by policy stakeholders across public, voluntary and commercial sectors; and the coverage of these in the media. The PhD is of immediate policy relevance as it will seek to identify the extent to which different actors’ framings (e.g. the food industry, medical professionals or researchers) are reflected in policy.  

This project addresses a need for further research identified by Theis and White (Milbank Quarterly, 2021) in a current SPHR PhD studentship, and builds on and updates the only other recent review of policy framing on obesity in England (Ulijaszek and McLennan 2016). It will extend our understanding of a key public health challenge and address barriers to more effective evidence-informed policymaking. The findings will be of critical relevance to policymakers at both local and national levels in the UK and globally.  

Susannah's Q&A

  • What has been your career journey so far?

    I qualified as a registered nurse in 2005 from the University of Birmingham. My clinical speciality was Emergency Nursing and I spent ten years working in a variety of Accident and Emergency Departments in Surrey, London and The Midlands. I also spent four years working as a nursing officer onboard passenger cruise ships. I subsequently studied a Master of Public Health (MPH) degree at the University of Birmingham and I hold a Postgraduate Certificate in Education. I have been working as a Nurse Academic since 2017 and I am currently a Senior Lecturer in Nursing at the University of Exeter.

  • Why did you choose to do a PhD in public health research?

    I have a long-held interest in public health that was initially stimulated by an aspiration to empower people and communities to make healthier decisions, having observed first-hand, in my role as a registered nurse, the perceived effect of lifestyle choices on health and wellbeing. Postgraduate study and my work as a nurse academic enabled my thinking to evolve. I have come to recognise that people exist within complex systems and that a vital component of enhancing health and wellbeing lies with interventions that address ‘upstream’ socioeconomic and structural factors. My aspiration is to contribute towards a body of evidence that will underpin strategies and interventions to tackle the pervasive issue of dietary-related ill health.

  • What is your research focused on?

    My research is focused on developing a better understanding of the way in which different stakeholders within the food system frame problems such as ‘obesity’ and ‘dietary-related ill health’.

  • Why is it important?

    The ‘framing’ of health issues, by policymakers, commercial interests and the public, is a key factor in deciding which issues get identified as problems worthy of government intervention, what the problems are perceived to be and the legitimacy of proposed policy solutions.

  • What do you like about being a part of the NIHR School for Public Health Research?

    I’m absolutely delighted to have been awarded this studentship because the NIHR School of Public Health Research offers such a comprehensive and wide-ranging suite of support, training and resources. Being part of the School has widened my network considerably and I have already had the opportunity to talk to lots of interesting people at all career stages. I feel part of a community of practice, which will be invaluable for both practical and psychosocial support. It is also reassuring to know that there is an extra layer of formal independent support in place, to complement that offered by my host institution. The School offers a multitude of training opportunities and resources, as well as the chance to develop my skills as a researcher outside of my immediate PhD work. I’m also really excited to have the opportunity to undertake a placement to further enhance my knowledge and skills.

  • What skills have you learnt and/or are hoping to learn as part of your PhD?

    I look forward to working collaboratively with a wide range of people and to building an extended network of colleagues. I hope to develop expert knowledge in my field and to have the opportunity to explore different research methodologies. I am keen to further my knowledge and practical experience of public involvement and engagement. I plan to try out a variety of knowledge exchange activities with a view to maximising the impact of my research.

  • What do you hope to do after completing your PhD?

    I am committed to establishing an impactful career in public health research that enables me to make a meaningful contribution to society. I have found it a privilege to work in academia because I have met so many interesting people from so many different disciplines. I have also found that I have had a plethora of interesting and exciting opportunities for career advancement, so I look forward to what the future holds.

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