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

Abstract

Background: 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. Methods: 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. Results: 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. Conclusion: 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).

Shifting the social determinants of food insecurity during the COVID-19 pandemic: the Australian experience

“…Our previous research supports the notion that government rhetoric is not equity-oriented with respect to addressing population diets in high-income countries (Zorbas et al, 2021 ). We found that equity was only a surface-level consideration in national nutrition policy strategies, with actions focused on changing individual-level behaviours rather than structural drivers of diet-related health inequities (Chung et al, 2021 ; Zorbas et al, 2021 ).…”

“…Greater London Authority, 2019 ; Saunders et al, 2017 ). Nonetheless, our previous research has shown that national governments do not have the tools or adequate commitment to achieve these public health imperatives (Chung et al, 2021 ; Zorbas et al, 2020a , 2021 ). Equity-oriented policy progress is likely to continue to be hindered by the inadequate representations of the voices and values of those experiencing social and economic exclusion in policy processes, research and advocacy efforts (Browne et al, 2019 ; Centre for Public Impact - A BCG Foundation, 2020 ).…”

The Effect of Food Vouchers and an Educational Intervention on Promoting Healthy Eating in Vulnerable Families: A Pilot Study

“…The consumption of a diet with a high intake of energy-dense and low nutrient-dense foods is a major risk factor for weight gain, obesity, and associated metabolic and cardiovascular diseases morbidity and mortality [1]. Families with greater socioeconomic disadvantages, such as lower income, lower educational level, or living in socioeconomically disadvantaged neighborhoods, are more likely to have overweight and poorer health outcomes compared to families with less disadvantage [2, 3]. As such, the price and affordability of food are key determinants in the choice of products included in the shopping basket, with people of lower socioeconomic status being the most sensitive to food prices [4].…”

Is the cost‐effectiveness of an early‐childhood sleep intervention to prevent obesity affected by socioeconomic position?

“…Considering that this inequality can likely be attributed to differences in social circumstances and opportunities, not biological inevitability, it should be regarded as an inequity. Improving such health inequities is frequently considered a responsibility of government health policy and funding [4]; however, obesity policies in the UK [5] and Australia [6] have been criticized for failing to address inequities.…”