International Journal of Health Policy and Management最新文献

Taxonomies are essential tools for structuring evidence in public health, particularly in rapidly evolving fields like the Commercial Determinants of Health (CDoH). Ulucanlar et al addressed an important gap by proposing taxonomies to systematically document and classify corporate political activity (CPA) across unhealthy commodity industries. In this commentary we reflect on the broader relevance of these frameworks for CDoH research and discuss their real-world applicability through a case study of the Portuguese alcohol industry. Drawing from our empirical findings, we highlight both the practical strengths and challenges we encountered, and propose an additional use: employing CPA taxonomies as communication tools to translate complex corporate strategies into accessible narratives for broader public health audiences. Finally, we identify opportunities for refinement, including developing complementary quantitative metrics and the integration of CPA surveillance into routine public health systems.

Green practices have become the responsibility of healthcare system in the current warming planet. The article by Soares and colleagues reviews the literature on circular economy implementation in the European Union (EU) and its application in healthcare system. In this commentary, we complement the findings by discussing ways to build a greener healthcare system and introducing life cycle assessment (LCA), a method to quantify the environmental impacts of products and services in healthcare. LCA is useful to compare the environmental impacts of different clinical products and pathways. Within the healthcare system, avoiding overdiagnosis and overprescribing, improving building energy efficiency, and fleet electrification are important green practices. In addition, we cannot ignore the differences in regional energy system when comparing the carbon footprint of different healthcare systems.

Energy policies have a major impact on the health and well-being of the population. However, Australia's energy policies rarely consider health and well-being in their policies. In Australia and in many other countries, energy policies, while developed by governments, are heavily influenced by commercial entities within the fossil fuel industry. This means that Australia's energy policy does not reflect what climate science tells us is necessary for a safe climate. Australia's environmental laws are insufficient to protect both nature and the environment. Environment and climate advocates have been urging the Australian government to strengthen these laws while industry, particularly the mining industry have been pushing to weaken them. This clearly demonstrates the strong intersection between commercial and political determinants of health.

The World Health Organization's (WHO's) non-communicable disease (NCD) Best Buys provides a comprehensive package of technically sound policy advice in response to the growing global burden of NCDs. However, despite these policy mechanisms being touted as beneficial to countries' health and economic bottom lines, uptake has remained slow and globally disparate. Loffreda and colleagues' analysis draws attention to the importance of political economy forces in shaping governments' responses to NCDs and, in particular, their uptake of the NCD Best Buys. In building on this work, we examine the history and instances of contemporary application of the NCD Best Buys to consider the limitations of these technocratically framed policy recommendations. In doing so, we highlight the risks present in focusing on the technical - while negating the contextually nuanced political - dimension of policy adoption. We thus advocate for greater political engagement in policy design and implementation as well as a revitalised "double-loop" approach to NCD policy learning, where policy and system feedback is not solely used to reify policy advice but rather interrogate the assumptions underpinning such.

McKee et al make a powerful plea for placing trust-building at the core of public health initiatives. I endorse that call and propose one general principle along with four practical guidelines for building trust between the public and the authorities. The general principle is that trust is rooted in shared identity and that, therefore, the task of building trust is rooted in building a sense of shared identity both amongst the public and between the public and authorities. The four guidelines are (1) trust the people!; (2) recognise and respect difference; (3) engage with the public; and (4) understanding and support trump blame and punishment. Details and justifications for each of these guidelines is provided in Supplementary file 1.

In this commentary I aim to contribute to Ronald Labonté's recent editorial "Can a Well-Being Economy Save Us?" on the role of well-being economies in providing for everyone's needs within the limits of our planet. In particular, I add a couple of lessons from the COVID-19 pandemic that can provide the required inspiration to plot a path beyond capitalism - one that is based on hope that change is possible, one where our understanding of well-being is detached from economic growth, one where demand and excess are challenged and one where we go beyond the market to meet our needs.

Even in situations where there exists robust evidence on what works and what needs to change to tackle deep-seated and persistent public health challenges, the lack of sustained progress across polities globally remains a cause for concern. Adopting a political economy perspective to better understand why the adoption and implementation of policies to tackle non-communicable diseases (NCDs) continues to be deficient, Loffreda and colleagues' systematic review of facilitating and inhibiting factors sheds valuable light on the subject. The adoption of a political economy approach is long overdue since it gets to the nub of identifying enablers and barriers to change and how to tackle the latter while strengthening the former. However, whether such an approach will be welcomed by policy-makers or be rejected merits further exploration if research is going to stand any chance of being heeded and acted upon.

Background: There is increasing recognition of the role governments play in addressing the health and environmental sustainability challenges within current food systems. This study seeks to understand food system policies designed and/or implemented by selected national and local governments in Africa, and the barriers and facilitators faced when designing or implementing policies to create healthy and environmentally sustainable food systems.

Methods: From an evidence-based list of proposed policies with double- or triple-duty potential to achieve healthy and environmentally sustainable food systems, a policy mapping was performed in five African countries (Benin, Côte d'Ivoire, Senegal, Togo, and Uganda) and one city in each of these countries (Ouidah, Bouaké, Saint-Louis, Sokodé, and Mbale). Semi-structured interviews were then conducted with policy stakeholders. The interview data were analysed in NVivo 14 using the thematic framework analysis approach, informed by the Health Policy Triangle (HPT).

Results: The mapping showed that African countries have designed and implemented policies that simultaneously address food insecurity and climate change, mainly through food production policies. Within food environments, countries are focussing on interventions to prevent obesity, mainly food provision or food pricing policies. However, many policy gaps remain. Several technical and political barriers were commonly experienced when designing and implementing food system policies, regardless of the jurisdiction, context or region, such as insufficient financial resources, lack of political will, limited data, and inadequate monitoring and enforcement mechanisms. The major facilitators perceived were supportive public opinion and awareness, international agreements, sound agenda-setting, multi-sector and multi-stakeholder consultations and partnerships, availability of both financial resources and data, and solid political will.

Conclusion: This article gives an overview of policies designed and implemented to achieve sustainable food systems, highlighting a strong focus through agriculture on undernutrition and climate change objectives. It also identifies their potential legislative, financial, and practical barriers and facilitators.

In their study on which we provide commentary, the authors applied a qualitative systems dynamics methodology to explore how transnational corporate power has led to policy inertia in the prevention of diet-related non-communicable disease (RD-NCD) in South Africa. This commentary explores the potential of systems thinking and causal loop diagrams to deepen understandings of - and responses to - the commercial determinants of health (CDOH). We reflect on the application of causal loop diagrams in policy processes and provide reflections that proposed strategies for change will need to take into account recent shifts in global discourse, funding streams and the balance of global power.