Barriers and Enablers for Healthy Food Systems and Environments: The Role of Local Governments

Abstract

Purpose of review Food systems at all levels are experiencing various states of dysfunction and crisis, and in turn their governance contributes to other intensifying crises, such as climate change, biodiversity loss and the rapid expansion of dietary-related non-communicable diseases. In many jurisdictions governments at local, state and national levels are taking action to tackle some of the key challenges confronting food systems through a range of regulatory, legislative and fiscal measures. This article comprises a narrative review summarising recent relevant literature with a focus on the intersection between corporate power and public health. The review sought to identify some of the principal barriers for the design and support of healthy food systems and environments, as well as key reforms that can be adopted to address these barriers, with a focus on the role of local governments. Recent findingsThe review found that, where permitted to do so by authorising legislative and regulatory frameworks, and where political and executive leadership prioritises healthy and sustainable food systems, local governments have demonstrated the capacity to exercise legislative and regulatory powers, such as planning powers to constrain the expansion of the fast food industry. In doing so, they have been able to advance broader goals of public health and wellbeing, as well as support the strengthening and expansion of healthy and sustainable food systems. Summary Whilst local governments in various jurisdictions have demonstrated the capacity to take effective action to advance public health and environmental goals, such interventions take place in the context of a food system dominated by the corporate determinants of health. Accordingly, their wider health-promoting impact will remain limited in the absence of substantive reform at all levels of government.

Megatrends in Africa: Implications for food in urban high-density areas with special focus on Nairobi and Cape Town

“…It is generally recognized that changes in food demand are driven by factors such as increased incomes driving a shift away from starchy staples, increasing importance of consumption away from home and innovations around convenience food but also changing gender roles based on increasing women's participation in wage employment (FAO, 2017). In many cases, the poorest consumers will turn to heavily marketed convenience fast food -particularly unhealthy, highly processed items (Cockx et al, 2019;Hossain and Scott-Villiers, 2017;Rose et al, 2022) or will continue to rely on public distribution programs that are focused on delivering calories instead of nutrition.…”

Taking Action Locally to Strive for Healthy Food Systems and Environments

“…influencing wages, the availability of social programs, or even healthcare coverage) [9]. At a more upstream level, the embeddedness of neoliberal values and the predominance of 'individual rights and freedoms' and 'consumer choice' discourses have been identified as exacerbating the impact of food systems on the socioeconomic, environmental, and health domains [1,10] in that they remove accountability from the food corporations. The term 'corporate agnogenesis' was coined by Fooks et al (2019) and depicts the use of a range of tactics to purposely introduce uncertainties in the policy-making processes regarding the harmful impacts of different commodities such as food through selective presentation and communication of evidence [11].…”

“…Examples of such tactics include confounding referencing and misleading summaries, misuse of raw data, and cherry-picking and selective quotations. Through the review of case studies like the introduction of a sugar tax in South Africa [11] or the discourses around the determinants of obesity [12], Rose et al (2022) show how these strategies amplify an already existing emphasis on the individual responsibility regarding health-related issues. Individuals are urged to eat healthier and to make more sustainable choices, which contrasts with a rather lax liability of food companies who are free to apply voluntary nutritional targets and regulation systems to their products.…”

“…For example, several reviews have identified an association between the concentration of unhealthy food outlets (described as food swamps) and the consumption of unhealthy food and rates of obesity [13,14], while food deserts and areas where residents cannot meet the majority of their daily living and work requirements have been evidenced to be detrimental to health [15,16]. Through case examples from Melbourne, Los Angeles, and several cities in England, Rose et al (2022) show how the previously described strategies have been used by Big Food corporations, harming public health. Possible steps by local governments to counteract these barriers include the restriction of new openings, the establishment of a minimum distance of fast food outlets from schools and children's facilities, the enforcement of tax subsidies for the implementation of healthy food stores, or the establishment of planning rules such as the 20-minute neigh-bourhoods where all facilities should be within walking or biking distance for residents.…”

“…2) and has been posited to have the virtue of uncovering some of the most critical structural impediments to optimal public health which the socio-ecological model tends to oversee: those related to corporate power. The article by Rose et al (2022) comprises a narrative review of the relation of corporate power to public health and looks at practical implementations by local governments in Australia, the US, and the UK. In doing so, the authors seek to identify some of the main barriers for the design and support of healthy food systems and environments, as well as key reforms that could be adopted to overcome these barriers.…”