Geof Rayner

Overcoming policy cacophony on obesity: an ecological public health framework for policymakers

This paper was commissioned by the Foresight programme of the Office of Science and Innovation, Department of Trade and Industry

Ecological public health: the 21st century's big idea? An essay by Tim Lang and Geof Rayner.

Public health thinking requires an overhaul. Tim Lang and Geof Rayner outline five models and traditions, and argue that ecological public health—which integrates the material, biological, social, and cultural aspects of public health—is the way forward for the 21st century

Obesity: a growing issue for European policy?

In Europe, concerns about obesity have been stimulated by trends in several member states, raising challenges for multilevel governance. This paper gives a picture of obesity in Europe, pointing to variations between and within countries. It discusses the various explanations of generalized weight gain, and the policy levers that might tackle it, the paper also maps current policy responses. Policy considerations raised include financial burdens, health-care management, social inequalities, cultural issues, welfare support, and farm and food industry drivers. The paper proposes that obesity is unlikely to be reduced unless it receives both multi-level and multi-field analysis and intervention. In this context, action in Europe is hampered by a fragmented institutional architecture at all levels of governance. It also raises serious questions about the unequal relations between the state, the market and civil society within Europe. The paper concludes with a suggestion that obesity warrants improved European linkages across discrete areas of policy.

Is nudge an effective public health strategy to tackle obesity? Yes

Adam Oliver (doi:10.1136/bmj.d2168) maintains that nudges may help people to make healthier choices, but Geof Rayner and Tim Lang worry that government proposals are little more than publicly endorsed marketing

Conventional and ecological public health

This paper suggests that current models of public health are no longer sufficient as a means for understanding the health challenges of the anthropogenic age, and argues for an alternative based upon an ecological model. The roots of this perspective originated within the Victorian era, although it found only limited expression at that time. Ecological thinking in public health has only been revived relatively recently. Derived from an analysis of obesity, this paper proposes the development of an approach to ecological public health based on four dimensions of existence: the material, the physiological, the social and the cultural-cognitive. The implications for public policy are considered.

Sustainable Food Systems in Europe: Policies, Realities and Futures

ABSTRACT This article reviews the food sustainability challenges facing the 27-nation member European Union (EU). It describes the evolution of sustainable development policy in Europe against the background of the EUs evolution and diverse membership, with particular reference to agriculture and food. It argues that while sustainability challenges in agriculture have received considerable policy attention, those facing the powerful manufacturing and retail segments of the food industry have barely been addressed. Given the scale and complexity of issues encompassing the food industry and its environmental, social, economic, and health effects, public health analysis and policy auditing should be “rethought” on the basis of an ecological public health perspective.

Corporate responsibility in public health.

The government’s invitation to the food industry to fund social marketing on obesity is risky

Does celebrity involvement in public health campaigns deliver long term benefit? No

Simon Chapman (doi:10.1136/bmj.e6364) thinks that the extra publicity that celebrities provide can help promote public health, but Geof Rayner is worried about the insidious influences of celebrity

Why are we fat? Discussions on the socioeconomic dimensions and responses to obesity

This paper draws together contributions to a scientific table discussion on obesity at the European Science Open Forum 2008 which took place in Barcelona, Spain. Socioeconomic dimensions of global obesity, including those factors promoting it, those surrounding the social perceptions of obesity and those related to integral public health solutions, are discussed. It argues that although scientific accounts of obesity point to large-scale changes in dietary and physical environments, media representations of obesity, which context public policy, pre-eminently follow individualistic models of explanation. While the debate at the forum brought together a diversity of views, all the contributors agreed that this was a global issue requiring an equally global response. Furthermore, an integrated ecological model of obesity proposes that to be effective, policy will need to address not only human health but also planetary health, and that therefore, public health and environmental policies coincide.