Laura Nixon

Cigarettes Become a Dangerous Product: Tobacco in the Rearview Mirror, 1952–1965

Tobacco controls unparalleled success comes partly from advocates broadening the focus of responsibility beyond the smoker to include industry and government. To learn how this might apply to other issues, we examined how early tobacco control events were framed in news, legislative testimony, and internal tobacco industry documents. Early debate about tobacco is stunning for its absence of the personal responsibility rhetoric prominent today, focused instead on the health harms from cigarettes. The accountability of government, rather than the industry or individual smokers, is mentioned often; solutions focused not on whether government had a responsibility to act, but on how to act. Tobacco lessons can guide advocates fighting the food and beverage industry, but must be reinterpreted in current political contexts.

Big Soda's Long Shadow: News Coverage of Local Proposals to Tax Sugar-Sweetened Beverages in Richmond, El Monte and Telluride.

In 2012 and 2013, Richmond and El Monte, CA, and Telluride, CO, became the first communities in the country to vote on citywide sugary drink taxes. In the face of massive spending from the soda industry, all three proposals failed at the ballot box, but the vigorous public debates they inspired provide valuable insights for future policy efforts. We analyzed local and national news coverage of the three proposals and found that pro-tax arguments appeared most frequently in the news. Advocates for the taxes focused primarily on the potential community health benefits the taxes could produce and the health harms caused by sodas. Tax opponents capitalized on the existing political tensions in each community, including racial and ethnic divisions in Richmond, anti-government attitudes in El Monte, and a culture of individualism in Telluride. Pro-tax arguments came mainly from city officials and public health advocates, while anti-tax forces recruited a wide range of people to speak against the tax. The soda industry itself was conspicuously absent from news coverage. Instead, in each community, the industry funded anti-tax coalition groups, whose affiliation with industry was often not acknowledged in the news. Our analysis of this coverage exposes how soda tax opponents used strategies established by the tobacco industry to fight regulation. Despite these defeats, tax advocates can take inspiration from more mature public health campaigns, which indicate that such policies may take many years to gain traction.

Food and Beverage Marketing to Youth

After nearly a decade of concern over the role of food and beverage marketing to youth in the childhood obesity epidemic, American children and adolescents — especially those from communities of color — are still immersed in advertising and marketing environments that primarily promote unhealthy foods and beverages. Despite some positive steps, the evidence shows that the food and beverage industry self-regulation alone is not likely to significantly reduce marketing of unhealthy foods and beverages to youth. A variety of research is needed to monitor industry marketing of unhealthy products to young people, and identify the most promising approaches to improve children’s food marketing environments. The continued presence of unhealthy marketing toward children despite years of industry self-regulation suggests it is time for stronger action by policymakers to protect young people from harmful marketing practices.

Fast-Food Fights: News Coverage of Local Efforts to Improve Food Environments Through Land-Use Regulations, 2000–2013

Zoning and other land-use policies are a promising but controversial strategy to improve community food environments. To understand how these policies are debated, we searched existing databases and the Internet and analyzed news coverage and legal documentation of efforts to restrict fast-food restaurants in 77 US communities in 2001 to 2013. Policies intended to improve community health were most often proposed in urban, racially diverse communities; policies proposed in small towns or majority-White communities aimed to protect community aesthetics or local businesses. Health-focused policies were subject to more criticism than other policies and were generally less successful. Our findings could inform the work of advocates interested in employing land-use policies to improve the food environment in their own communities.

Moving research to practice through partnership: A case study in Asphalt Paving

BACKGROUND Multi-stakeholder partnerships play a critical role in dissemination and implementation in health and safety. To better document and understand construction partnerships that have successfully scaled up effective interventions to protect workers, this case study focused on the collaborative processes of the Asphalt Paving Partnership. In the 1990s, this partnership developed, evaluated, disseminated, and achieved near universal, voluntary adoption of paver engineering controls to reduce exposure to asphalt fumes. METHODS We used in-depth interviews (n = 15) and document review in the case study. RESULTS We describe contextual factors that both facilitated and challenged the formation of the collaboration, central themes and group processes, and research to practice (r2p) outcomes. CONCLUSIONS The Asphalt Paving Partnership offers insight into how multi-stakeholder partnerships in construction can draw upon the strengths of diverse members to improve the dissemination and adoption of health and safety innovations and build a collaborative infrastructure to sustain momentum over time.Background Multi-stakeholder partnerships play a critical role in dissemination and implementation in health and safety. To better document and understand construction partnerships that have successfully scaled up effective interventions to protect workers, this case study focused on the collaborative processes of the Asphalt Paving Partnership. In the 1990s, this partnership developed, evaluated, disseminated, and achieved near universal, voluntary adoption of paver engineering controls to reduce exposure to asphalt fumes. Methods We used in-depth interviews (n = 15) and document review in the case study. Results We describe contextual factors that both facilitated and challenged the formation of the collaboration, central themes and group processes, and research to practice (r2p) outcomes. Conclusions The Asphalt Paving Partnership offers insight into how multi-stakeholder partnerships in construction can draw upon the strengths of diverse members to improve the dissemination and adoption of health and safety innovations and build a collaborative infrastructure to sustain momentum over time. Am. J. Ind. Med. 58:824–837, 2015.

Big Data and the transformation of food and beverage marketing: undermining efforts to reduce obesity?

ABSTRACT The confluence of new ways to quickly gather, analyze, and use large volumes of information – so-called ‘Big Data’ – coupled with the widespread adoption of digital devices, has transformed marketing, including food marketing. However, the effects on health of the marriage between Big Data and digital food marketing are largely un-researched and unknown. In the midst of ongoing global concern about obesity, there is a need for public health scholars to be informed of the nature and extent of Big Data’s impact on marketing in order to create new research agendas, methods, and evidence-based approaches that will be effective in today’s highly dynamic digital marketplace. In this paper, we identify six key features of this new Big Data food marketing system, explore how they depart from traditional forms of advertising, marketing, and retail operations, and offer suggestions for research strategies and public health interventions. While there is some evidence to suggest that data analytics and digital technologies could be harnessed to help address obesity and chronic disease, we argue that without intervention current trends will continue, and these techniques will be used primarily to promote junk food, sugar-sweetened beverages, and other unhealthy products, thus increasing health disparities, and worsening health outcomes.

The Woodhull Study Revisited: Nurses’ Representation in Health News Media 20 Years Later

Abstract Purpose To determine if nurses are represented in health news stories more frequently today than 20 years ago when Sigma Theta Tau International Nursing Honorary Society published The Woodhull Study on Nursing and the Media, which found that nurses were cited as sources in only 4% of the stories. Design Content analysis of health news stories for the month of September 2017 in the same publications used in the original Woodhull study. Methods Searches with Nexis and Webhose identified 2,243 articles related to health care published by the news outlets in September 2017. A random sample of 537 of these articles was obtained: 258 from seven newspapers, 127 from three weekly newsmagazines, and 152 from three health industry publications. After removing irrelevant articles or those with only passing references to health, 365 articles were reviewed and coded, using the original studys coding schema. Findings Nurses were identified as the source of only 2% of quotes in the articles and were never sourced in stories on health policy. When quoted, nurses mainly commented on the profession itself. Nurses or the nursing profession were mentioned in 13% of the articles. Nurses were identified in 4% of photographs or other images that accompanied the articles. Conclusions Nurses remain invisible in health news media, despite their increasing levels of education, unique roles, and expertise. Clinical Relevance Nurses’ clinical expertise is accompanied by unique perspectives on health, illness, and health care; but the public is not benefiting from the wisdom and insight that nurses can provide in health news stories.

The shift in framing of food and beverage product reformulation in the United States from 1980 to 2015

Abstract Food and beverage product reformulation is a public health nutrition policy of recent prominence; it is a so-called ‘win-win’ policy, as unlike other nutrition policies, it has the potential to also benefit the food and beverage industry. However, reformulation has also been criticized as being driven by industry interests. In order to inform future policy debates about reformulation, we sought to investigate how and why reformulation became a public health initiative by conducting a framing analysis on 278 US newspaper articles from 1980 to 2015. Frames are aspects of text emphasizing a particular definition of a problem or solution, and they help shape policy discourses and the public policy agenda. Three primary frames of reformulation were identified: business, health, and political. Having multiple frames enables reformulation to assume different meanings in different contexts, which helps to explain how it has garnered broad support from multiple sectors. The political frame of reformulation, however, only grew in importance after 2001, to describe reformulations occurring in response to public health policy initiatives aimed at obesity and noncommunicable diseases. The increasing use of a political frame, and the events described in the articles, suggests that voluntary reformulation followed a growing threat of policy change and litigation facing the industry, a finding that provides important context to debates about voluntary reformulation initiatives. Future reformulation initiatives will need to reconcile and negotiate the varying frames and aims of reformulation in order to ensure they are a success from the public health perspective.

Dorfman et al. Respond

Kraak et al. offer a model of corporate accountability that, if adopted by agencies such as the Federal Trade Commission and others, would be of great service to public health. Their framework takes our conceptualizations of responsibility to the next level. The object of historical investigation is to apply an understanding of the past to look forward. Looking back to the pre-1964 Surgeon General’s report era, we were reminded of a time when Americans were not timid about the need for government intervention in the face of health harms. The irony is that in those circumstances it would have been easier to advance the type of robust corporate accountability rubric that Kraak et al. propose, yet the need for such actions would have been less apparent. By contrast, the need is evident now, but given the vilification of government and ascendancy of corporate power that the authors acknowledge, that need will be difficult to answer.