Targeting population nutrition through municipal health and food policy: Implications of New York City’s experiences in regulatory obesity prevention

Obesity remains a major public health challenge across OECD countries and policy-makers globally require successful policy precedents. This paper analyzes New York City’s innovative experiences in regulatory approaches to nutrition. We combined a systematic documentary review and key informant interviews (n = 9) with individuals directly involved in nutrition policy development and decision-making. Thematic analysis was guided by Kingdon’s three-streams-model and the International Obesity Task Force’s evidence-based decision-making framework. Our findings indicate that decisive mayoral leadership spearheaded initial agenda-change and built executive capacity to support evidence-driven policy. Policy-makers in the executive branch recognized the dearth of evidence for concrete policy interventions, and made contributing to the evidence base an explicit goal. Their approach preferred decision-making through executive action and rules passed by the Board of Health that successfully banned trans-fats from food outlets, set institutional food standards, introduced menu labeling requirements for chain restaurants, and improved access to healthy foods for disadvantaged populations. Although the Health Department collaborated with the legislature on legal and programmatic food access measures, there was limited engagement with elected representatives and the community on regulatory obesity prevention. Our analysis suggests that this hurt the administration’s ability to successfully communicate the public health messages motivating these contentious proposals; contributing to unexpected opposition from food access and minority advocates, and fueling charges of executive overreach. Overall, NYC presents a case of expert-driven policy change, underpinned by evidence-based environmental approaches. The city’s experience demonstrates that there is scope to redefine municipal responsibilities for public health and that incremental change and contentious public discussion can impact social norms around nutrition.     

Incentives for cattle producers to adopt an E. Coli vaccine: An application of best–worst scaling

E. coli O157:H7 is an important source of foodborne disease. The E. coli pathogen occurs naturally within the rumen of livestock (including cattle) and does not affect the health of the cattle, however, can be a source of cross-contamination during food processing or environmental contamination of drinking and irrigation water supplies. A vaccine to reduce the risk of cattle shedding E. coli is licensed for use in Canada and the US, however, adoption of the vaccine by cattle producers has been extremely low. Using data from a survey of cow–calf producers in western Canada, the influence of a set of thirteen incentives to encourage adoption of the vaccine is examined using Best–Worst Scaling. Incentives include policy interventions, market/supply chain incentives, production protocol incentives, and producer reputation incentives. Heterogeneity in producer responses to the incentives is evident and is further explored with a Latent Class Cluster analysis. Results suggest that a ‘one size fits all’ policy to encourage adoption of an E. coli vaccine by cattle producers may be challenging.     

Advancing the evidence base for public policies impacting on dietary behaviour,physical activity and sedentary behaviour in Europe: The Policy Evaluation Network promoting a multidisciplinary approach

Non-communicable diseases (NCDs) are the leading cause of global mortality. As the social and economic costs of NCDs have escalated, action is needed to tackle important causes of many NCD’s: low physical activity levels and unhealthy dietary behaviours. As these behaviours are driven by upstream factors, successful policy interventions are required that encourage healthy dietary behaviours, improve physical activity levels and reduce sedentary behaviours of entire populations. However, to date, no systematic research on the implementation and evaluation of policy interventions related to these health behaviours has been conducted across Europe. Consequently, no information on the merit, gaps, worth or utility of cross-European policy interventions is available, and no guidance or recommendations on how to enhance this knowledge across European countries exists. As part of the Joint Programming Initiative “A Healthy Diet for a Healthy Life” (JPI HDHL), 28 research institutes from seven European countries and New Zealand have combined their expertise to form the Policy Evaluation Network (PEN). PEN’s aim is to advance tools to identify, evaluate, implement and benchmark policies designed to directly or indirectly target dietary behaviours, physical activity, and sedentary behaviour in Europe, as well as to understand how these policies increase or decrease health inequalities. Using well-defined evaluation principles and methods, PEN will examine the content, implementation and impact of policies addressing dietary behaviour, physical activity levels and sedentary behaviour across Europe. It will realise the first steps in a bespoke health policy monitoring and surveillance system for Europe, and refine our knowledge of appropriate research designs and methods for the quantification of policy impact. It will contribute to our understanding of how to achieve successful transnational policy implementation and monitoring of these policies in different cultural, demographic or socioeconomic settings. PEN will consider equity and diversity aspects to ensure that policy actions are inclusive and culturally sensitive. Finally, based on three policy cases, PEN will illustrate how best to evaluate the implementation and impact of such policies in order to yield healthy diets and activity patterns that result in healthier lives for all European citizens.     

Operational model for planning the harvest and distribution of perishable agricultural products

This paper presents an operational model that generates short term planning decisions for the fresh produce industry. In particular, the application developed helps the grower to maximize his revenues by making production and distribution decisions during the harvest season. The main motivation for this model comes from the fact that the profitability of producers is highly dependent on the handling of short term planning in the harvest season. Some of the factors affecting profitability include the management of labor costs, the preservation of the value of perishable crops, and the use transportation modes that provide the best trade-off between time (quality of products) and cost. These issues are interrelated, and their judicious management is fundamental for attaining good financial results. The results of the proposed planning model indicate that significant savings can be obtained by managing the trade-off of the freshness at the delivery of the product with the added labor and transportation cost at the grower's side. Moreover the results also show that dynamic, information based, management practices might be preferred over traditional practices based in fixed labor allocation and distribution practices.     

Health information and consumer learning in the bottled water market

This paper examines the impact of health information in different media outlets on bottled water consumption through consumer learning. We develop a random coefficient discrete choice model with Bayesian learning process to capture consumers’ learning of health information and changes in their beverage choices over time. Consumers are assumed to have initial prior beliefs about the health effect of different beverages and to update their beliefs using health information received from different media types. Empirical results show that consumers’ perceived quality of bottled water kept increasing during our sample period, and this learning process accounted for 24.44% of the industry’s revenue, which is about 4.8 billion dollars per year. Comparing the effectiveness of different media outlets, we find that the sales impact of traditional media (TV and radio) is greater than online sources. Our findings highlight the contribution of health information to the bottled water industry and provide policy makers with a new direction to reduce high-calorie food consumption and improve public health.     

A ‘Common Food Policy’ for Europe: How governance reforms can spark a shift to healthy diets and sustainable food systems

More than half of adults in the European Union (EU) are now either overweight or obese (53%). Non-communicable diseases (NCDs), many of which are diet-related, account for 70% of mortality in Europe and a growing share of healthcare costs. While eating habits have an important role to play in NCD prevention, consumption patterns across the EU are diverging significantly from recommended diets. There is growing consensus on the solution: a series of coordinated and wide-ranging policy interventions to build healthy ‘food environments’.This article argues that EU governance structures remain ill-adapted to the systemic nature of this and other challenges in food systems (e.g. climate change, biodiversity loss, food poverty): conflicting objectives and missed synergies are identified between different policy areas (agriculture, trade, health, environment, etc.) and between different levels of governance (EU, national, local). An integrated food policy framework – a ‘Common Food Policy’ – is therefore required to meet the EU’s public health and sustainability objectives. It identifies four distinct aspects of the governance shift required to promote healthy diets and build sustainable food systems in Europe: (i) coherence across policy areas; (ii) coherence across governance levels; (iii) governance for transition; and (iv) food democracy. Blueprints for a Common Food Policy are already emerging, and are ripe for consideration, development, and implementation by the European institutions.     

Conditions influencing the adoption of a soda tax for public health: Analysis of the French case (2005–2012)

Although over 40 jurisdictions have adopted a tax on sugar-sweetened beverages (SSBs) for public health worldwide, it is still debated in many places. Policy processes can influence the prospect of an SSB tax, its design and its public health benefits. To get an insight into such processes, we undertook a case study of the soda tax enacted in France on the 1^st of January 2012. Newspaper articles (2003–2013) and institutional documents (2007–2012) were identified using keywords and search engines. Qualitative data extraction and analyses were performed on a thematic and chronological basis, with guidance from Kingdon’s multiple streams theory (MST). Triangulation was enhanced by using complementary sources. This study shows that in August 2011, the French government surprisingly announced a €3.58 cent/L excise tax on SSBs, excluding juices with no added sugars and non-calorically sweetened beverages (NCSBs). As part of a large budgetary plan, the proposal aimed to reduce SSB consumption and raise revenue that was earmarked for health care. Several conditions contributed to opening a policy window: The announcement occurred in the context of severe budgetary deficits; soda tax scenarios had already been discussed at a high level; and the bill was supported by convinced political leaders. Subsequently, the tax successfully passed through the legislative process due to a series of unexpected events, but its public health rationale and design were weakened. The first event was the disorganised reaction by the food industry, despite their sharp opposition to the tax. The next event was the support of the soda tax that came from a majority of Deputies, provided that the revenues would serve another purpose: relieving wage costs in the farming sector. Finally, policy entrepreneurs favoured a compromise to make the tax politically acceptable and legally viable: The tax rate doubled, the scope was extended to NCSBs and revenues were split between health care and agriculture. This study sheds light on influence factors that could be taken into account by public health actors willing to influence soda tax policy processes.     

Leveraging open innovation to improve society: past achievements and future trajectories

Open innovation (OI) is an approach which describes a purposive attempt to draw together knowledge from different contributors to develop and exploit innovation. It has become clear that OI directly benefits organisations' economic performance and resilience, but researchers, practitioners, and policy makers became also convinced that OI might be the way forward to tackle the world’s most pressing societal challenges, representing unresolved Grand Challenges, which can only be weathered by diverse sets of collaborative partners that join forces. Although anecdotal evidence points at how OI practices can be employed to achieve societal impact not only in private firms but also in public organisations, very little understanding exists ‐beyond anecdotal‐ to link OI to societal impact. This special issue has the ambition to start the discussion and establish a framework as the stepping stone to tackle this complex research gap.     

Economic analysis of spillover effects of an integrated pest management (IPM) strategy for suppression of mango fruit fly in Kenya

The International Centre of Insect Physiology and Ecology (icipe) recently developed and disseminated an integrated pest management (IPM) strategy to suppress the invasive oriental fruit fly species Bactrocera dorsalis in mango-growing communities in Africa. While the economic benefits of the strategy in mango production have been established, the cross-commodity benefits have not been assessed, despite evidence of the target fruit fly species’ effect on a wide range of cultivated host crops. Using propensity score matching, we analysed data on 371 households obtained from a survey of an icipe project in Kenya and sought to determine whether applying an IPM strategy for fruit fly had a spillover effect on gross margins. We focused on four alternative cultivated hosts of B. dorsalis, namely avocado, pawpaw, citrus and banana. We found positive and significant cross-commodity spillover effects in respect of employing the IPM strategy for fruit fly targeting pawpaw and citrus, suggesting a wide scope for IPM investment in Kenya and other fruit-producing regions in sub-Saharan Africa.     

Food and health research in Europe: Structures,gaps and futures

BackgroundFood and health research is concerned with production, marketing, choice, regulation and policy for food as it affects health, and the mechanisms and control of diet-related diseases, nutrition and obesity. It covers positive and negative impacts of food on health, as well as issues related to under and over consumption of food. The European Union-funded study FAHRE (Food and Health Research in Europe) has described structures and identified gaps and needs for food and health research across Europe.MethodsFAHRE was conducted by a consortium of partners in 7 European countries, including private and public research organisations, university-based researchers and civil society organisations. National advisers in 32 European countries made reports on the structures of food and health research, and nine experts made reports on food and health research themes. At the end of this phase, a stakeholder conference was held to review and discuss the findings, and from this a Strategic Document was developed and distributed electronically for wider consultation at national level. This report presents the findings of the Strategic Document.ResultsFAHRE proposed that future research using public funding should address the global issue of unhealthy eating, including obesity, which causes preventable disability and disease, reduced working life and increased healthcare costs. FAHRE suggests a move of the focus of research from healthy food to healthy eating, and to overcome the existing separation between food research and health research through a shift of research towards food for health.EU member states have widely differing national systems for research management, and information is poorly standardised for comparisons. There are many research programmes in both food and health, usually managed by ministries of science, but rarely in collaboration with ministries of health. Industry mainly contributes ‘near product’ research: few industry small and medium enterprises are engaged with food and health research, nor are civil society organisations. EU food and health research has been focused within the agriculture research theme, and not sufficiently linked to health research.FAHRE recommends coordination of food and health research through an EU-level Coordinating Agency, with budget and representation from the three EU directorates Agriculture, Health and Research, the member states, and wider stakeholders including civil society and industry. There should be corresponding ‘food and health research agencies’ in the member states bringing together national policy-makers and stakeholders, and directing research funding. Food safety agencies may provide a model for this joint approach. Further proposals include strengthening social and policy research, accessing Structural Funds for research programmes, and more strategic approaches to determining research programmes and funding.ConclusionFood and health research in Europe should move from ‘healthy food’, which concentrates on food as a product, to research for ‘healthy eating’ which is concerned with appropriate intake and reducing disease. Coordination of research on this theme, at European level, and between member states, could deliver major economic and social returns.     

Next Generation Access (NGA) supply side interventions—An international comparison

Over the last years, technical and economic developments towards the deployment of Next Generation (Access) Networks have triggered discussions under which circumstances investments into physical infrastructure are economically viable. In many countries the discussion has arisen regarding conditions under which private investment will/will not be undertaken and whether or not in such cases public policy measures should support deployment. This could come in different ways—from incentivizing private investments to deploying new “state-owned” networks. Public policy can have an impact for example by intervening into a competitive market. The paper tries to provide answers as to “why” such interventions and supply side policies are undertaken (thereby referring to the central role that broadband infrastructures have for the economy) and “how” such interventions take place, for example an analysis of the public policy interventions to drive Next Generation Access Network deployment. The article thereby derives policy patterns that have occurred in different regions of the world.     

Research priority setting in food and health domain: European stakeholder beliefs about legitimacy criteria and processes

Dietary factors are the most important risk factors affecting health and well-being of population in every Member State of the European Region. Finding sustainable solutions to the food and health challenges is one of the key issues that today’s society urgently needs to address. Research prioritisation thus has an essential role in directing public resources to addressing these challenges. However, the processes of prioritisation among the food and health funders are rarely subject to scrutiny and the calls for democratizing science continue, as a means of enhancing both input legitimacy (with its focus on the processes of decision-making) and output legitimacy (the utility and impact of such decisions). The current study examines what conceptualisations of legitimacy (input and output) are held by the European stakeholders of the food and health research and innovation (R&I) process such as business organisations, non-governmental organisations (NGOs) and public sector organisations. We analyse stakeholder views from a series of European Awareness Scenario Workshops across nine EU countries (N = 295). The content and thematic analysis of the outputs identified six criteria determining conceptualisations of legitimacy: Influence; Representation; Procedural issues; Epistemic focus; Strategic vision; and Impact. The statistical analysis of the coded data highlighted stakeholder differences with business sector organisations being significantly less concerned about influence and representation than either NGO or public sector organisations. The results indicate that input legitimacy is of major concern to civil society and public sector actors. They reflect the wider debate about the way in which food and health R&I should be funded and policy decisions conducted, suggesting a need for better delineation of stakeholder roles and power differentials in this process. The findings are discussed with reference to the current discussions about Responsible Research and Innovation.     

Functional food,uncertainty and consumers’ choices: A lab experiment with enriched yoghurts for lowering cholesterol

A lab experiment was conducted in France to evaluate the impact of health information on consumers’ choices for functional food. Successive messages revealing benefits and uncertainties of consuming yoghurts with added plant sterols for reducing cholesterol were delivered. Results show a significant and positive influence of the message linked to the cholesterol reduction on willingness to pay, even for participants without cholesterol. However participants expressed little interest in information about potential risks and scientific uncertainties, since their impacts on willingness to pay are not always statistically significant. An econometric estimation shows a significant link between the change in willingness to pay and the perception by participants regarding the scientific validity linked to the sterols.     

Product recalls,corporate social responsibility,and firm value: Evidence from the Chinese food industry

Product recalls frequently occur in the Chinese food industry, which is closely linked to public health and social security and attracts significant attention from the government, media, and public. We manually collect food recalls from listed firms in China from 2008 to 2016 and use an event study methodology to investigate the economic consequences of product recalls. First, we find that product recalls result in significantly negative abnormal returns for listed firms. Second, the level of corporate social responsibility (CSR) mitigates the negative effect of food recalls on the wealth of shareholders. Our results are robust to different specifications and measures. This study provides timely evidence and important policy implications for the ongoing food safety crisis in China. The government should release appropriate policies to improve firms’ product quality and activities on CSR in the food industry, which in turn helps the firms obtain benefits.     

Take your partners: Public private interplay in Australian and New Zealand plans for next generation broadband

Within a few days of each other in early 2009, the national governments of Australia and New Zealand announced separate plans to invest heavily in advanced broadband networks. Taxpayers in each country will contribute at least half the estimated cost of fibre-to-the-premises networks reaching the overwhelming majority of households and businesses within 8–10 years. These complex and controversial forms of ‘public private interplay’ demonstrate three trends: a shift away from the liberalization and privatization policy consensus of the last two decades; shared convictions about the anticipated size of fast broadband’s economic and social benefits, and about the need for wholesale-only fixed line network operation to maximize those benefits; and the unlikely impact of the global financial and economic crisis in stimulating investment in particular infrastructures seen as critical to the national economies that emerge from it. This article discusses industry structures and regulation in Australia and New Zealand, their long history of public investment in telecommunications and the recent popularity of public private partnerships (PPPs) with Australian state governments. It outlines the ambitious broadband plans and surveys their prospects. Like so many other policy actions following the global economic crisis, these are distinctively national responses to internationally shared challenges.     

The evolution of the telecommunications policy agenda: Forty years of articles in Telecommunications Policy

This paper investigates the evolution of the telecommunications policy agenda by means of text mining forty years –from 1976 to 2016– of papers in the journal Telecommunications Policy. Text mining techniques help identify the key topics, the dominant combinations of concepts and the main areas of research within this multidisciplinary –technical, economic, social, policy– discipline. In addition they depict an evolution of the policy agenda more nuanced than the conventional public service, pre-competition and post-liberalisation stages typical of telecommunications. Also, in combination with bibliometric information, the results display the relationships between areas of research and methodologies, countries and authors’ background, all together providing a deeper understanding of the past, present and future avenues for research in telecommunications policy.     

Nutritional functional classification study of Panama

Despite significant progress, wide-spread malnutrition persists in Panama. This article describes a study which found that over half the malnutrition in the country is clustered in functional groups economically connected to the agricultural sector and which indicates that food availability is a serious problem for 25% of the population. Food intake deficits were equally prevalent among the urban and rural populations. Dietary composition was not seen as the principal problem; rather malnutrition problems are linked to low wages and poor access to public services. A nutrition policy for Panama must be centred first on employment and income generation, and then on extending and maintaining public health and nutrition services, particularly for the extremely poor in the central provinces. Food policy per se would not seem a priority area for public intervention.     

The politics of success in the fight against malnutrition in Peru

The dramatic reduction in children’s chronic malnutrition in Peru observed in recent years has defied the patterns of stunting reduction worldwide. After nearly a decade of stalled progress, the government reported a reduction in stunting rates of nearly 10 points, from 29.8% in 2005 to 18.1% in 2011. The specialized literature has acknowledged the critical role that immediate (e.g. increasing breastfeeding promotion) and underlying (e.g. investments to improve household food security) interventions have played in reducing stunting (Black et al., 2013), as well as the contributing role of enabling factors related to economic performance. This paper offers an alternative explanation to success by looking at the shift in the government’s nutrition strategy after 2006 with the formation of the Child Malnutrition Initiative (CMI), a civil society working platform, and the adoption of a national poverty reduction strategy prioritizing nutrition interventions (known as CRECER) and conditional cash transfers (JUNTOS). The paper uses veto players theory to explain how these changes effectively contributed to policy change by reducing the effective number of nutrition stakeholders involved and facilitating policy agreements around a common policy platform and established goals. The Peruvian case also highlights the importance of the government’s public commitment to reduce chronic malnutrition in children under five by 5 percent in 5 years (“5 by 5 by 5”) and the accompanying role, advocacy and monitoring from civil society organizations.The paper looks at the success of implementing the nutrition strategy in three dimensions. Horizontally, it looks at the coordination between government and non-government agencies to converge around a common policy discourse;vertically, it looks at the implementation of the nutrition strategy across national, regional and municipal governments;and financially, it looks at the coordinated and conditional allocation of nutrition funding and how this created greater incentives for horizontal and vertical coordination. The paper draws some theoretical and policy implications for improving the effective and accountable delivery of nutrition interventions in Peru and other countries outside Latin America.     

The Labor‐Market Impact of San Francisco's Employer‐Benefit Mandate

We evaluate a San Francisco policy requiring employers to provide health benefits or contribute to a public‐option health plan to better understand the incidence of employer mandates through their effects on wages, employment, and prices. We develop an individual case study approach combining border discontinuity in policies and permutation‐type inference using other metropolitan areas. Findings indicate that employment patterns did not change appreciably following the policy, and there is little evidence of significant negative earnings in highly impacted sectors. However, approximately half of the incidence of the mandate in the restaurant sector fell on consumers via surcharges.