An introduction to public health advocacy: reflections on theory and practice

An introduction to public health advocacy: reflections on theory and practice

Hannah Brinsden and Tim Lang

The purpose of this briefing paper is to encourage debate among academics and civil society about the role of advocacy in food, what it is and how to use it more effectively for the public interest. The paper’s particular focus is on advocacy in nutrition and health, but it makes points of wider relevance to advocates of improved environmental, consumer and social justice features of the food system. It focuses on organisational advocacy, carried out by civil society organisations such as NGOs, public health associations and academia.

The paper takes as its starting point the widespread diet-related ill health we face today, and the need for strong public health advocacy to champion changes to the food system that favour the public good. It highlights the complexity for advocacy posed by multi-level governance, and the government’s continual sharing of power of policy making in the food system, typically in favour of the market interest. The paper describes some of the academic theory that underpins civil society campaigns and efforts to influence change, while also alerting food and nutrition advocates to the challenges, complexities and gaps in knowledge they may face. It calls for a process of discussion across academic disciplines and civil society about food, nutrition and the advocacy that is needed for change.

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1 Comment

  1. Michael Throngton says:

    It is a paradox.
    * Public health measures are for the benefit of the public
    * Public health measures should therefore be funded from the public purse, or implemented through laws and regulation
    * This means that politicians have to make the final say on which laws are passed, and how tax-payers’ money is spent
    * But politicians care desperately about getting re-elected, and often demand “public health actions” that are not evidence-based because there is a demand for them; or resist public health measures that are evidence-based, but which will upset lobby groups or donors to their party
    * Therefore, politicians may resist or obstruct the implementation of evidence-based policy
    * Many public health professionals are employed in the public sector. Most are now employees of Public Health England – a civil service body; or local governments
    * Such employers are under strong pressure to support ministers. Indeed, they seem to be compelled to find justifications for governmental/ministerial initiatives (such as NHS Health Checks, port screening for viral haemorrhagic disease, fracking)
    * Such employers also suppress evidence or argument from their employees that disagrees with ministerial opinion – e.g. blocking publication of a report on the possible benefits of a sugar tax, and an evaluation of port health screening
    * In consequence there is a public health evidence paradox, where the evidence is heavily biased by the government
    * Similar effects apply with corporations’ attempts to suppress or rubbish evidence that threatens them
    * This process – or part of it – is sometimes referred to as “agnotology”

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