STORRE Community: This community contains the ePrints and eTheses produced by the School's staff and students.
http://hdl.handle.net/1893/2672
This community contains the ePrints and eTheses produced by the School's staff and students.2024-03-29T11:48:38ZBuilding a Systems Map: Applying Systems Thinking to Unhealthy Commodity Industry Influence on Public Health Policy
http://hdl.handle.net/1893/35900
Title: Building a Systems Map: Applying Systems Thinking to Unhealthy Commodity Industry Influence on Public Health Policy
Author(s): Bertscher, Adam; Nobles, James; Gilmore, Anna; Bondy, Krista; Van Den Akker, Amber; Dance, Sarah; Bloomfield, Michael J; Zatonski, Mateusz
Abstract: Background Unhealthy commodity industries (UCIs) engage in political practices to influence public health policy, which poses barriers to protecting and promoting public health. Such influence exhibits characteristics of a complex system. Systems thinking would therefore appear to be a useful lens through which to study this phenomenon, potentially deepening our understanding of how UCI influence are interconnected with one another through their underlying political, economic and social structures. As such this study developed a qualitative systems map to depict the complex pathways through which UCIs influence public health policy and how they are interconnected with underlying structures. Methods Online participatory systems mapping workshops were conducted between November 2021 and February 2022. As a starting point for the workshops, a preliminary systems map was developed based on recent research. Twenty-three online workshops were conducted with 52 geographically diverse stakeholders representing academia, civil society, public office and global governance organisations. Analysis of workshop data in NVivo and feedback from participants resulted in a final systems map. Results The preliminary systems map consisted of 40 elements across six interdependent themes. The final systems map consisted of 64 elements across five interdependent themes, representing key pathways through which UCIs impact health policymaking: 1) direct access to public sector decision-makers; 2) creation of confusion and doubt about policy decisions; 3) corporate prioritisation of commercial profits and growth; 4) industry leveraging the legal and dispute settlement processes; and 5) industry leveraging policymaking, norms, rules, and processes. Conclusion UCI influence on public health policy is highly complex, involves interlinked practices, and is not reducible to a single point within the system. Instead, pathways to UCI influence emerge from the complex interactions between disparate national and global political, economic and social structures. These pathways provide numerous avenues for UCIs to influence public health policy, which poses challenges to formulating a singular intervention or limited set of interventions capable of effectively countering such influence. Using participatory methods, we made transparent the interconnections that could help identify interventions future work.2024-03-13T00:00:00ZDispositional and situational attributions for why the rich live longer than the poor
http://hdl.handle.net/1893/35875
Title: Dispositional and situational attributions for why the rich live longer than the poor
Author(s): Bridger, Emma K.; Tufte‐Hewett, Angela; Comerford, David A.
Abstract: Despite considerable focus on predictors of attitudes towards economic inequality, there is less psychological research into attitudes towards other unequal outcomes between the rich and poor, including differences in health and life expectancy. Two studies examine whether causal attributions for these socioeconomic health inequalities predict attitudes towards them. A cross-sectional study of 332 UK and US respondents showed that most respondents indicate a preference for some degree of income inequality but no life expectancy inequality between the richest and poorest in society. These preferences for equal life expectancy for the rich and poor were significantly less likely for respondents who viewed health inequalities to be caused by dispositional factors (e.g., self-control, ability or effort). In a second pre-registered cross-sectional study (n = 602), dispositional attributions negatively predicted self-reported concern about health inequality, whilst endorsing situational attributions (e.g., discrimination and prejudice, wages) was positively associated with concerns on this issue. Moreover, situational attributions positively predicted support for six policy proposals for reducing health inequality, while dispositional attributions were associated with increased support for some of these interventions and decreased support for others. Despite very distinct distribution preferences for income and life expectancy outcomes, causal attributions continue to predict attitudes towards health inequality and associated policy interventions.2023-06-01T00:00:00ZComplex Interventions for a Complex System? Using Systems Thinking to Explore Ways to Address Unhealthy Commodity Industry Influence on Public Health Policy
http://hdl.handle.net/1893/35873
Title: Complex Interventions for a Complex System? Using Systems Thinking to Explore Ways to Address Unhealthy Commodity Industry Influence on Public Health Policy
Author(s): Bertscher, Adam; Matthes, Britta; Nobles, James; Gilmore, Anna; Bondy, Krista; Van Den Akker, Amber; Dance, Sarah; Bloomfield, Michael J; Zatonski, Mateusz
Abstract: Background Interventions are needed to prevent and mitigate unhealthy commodity industry (UCI) influence on public health policy. Whilst literature on interventions is emerging, current conceptualisations remain incomplete as they lack considerations of the wider systemic complexities surrounding UCI influence, which may limit intervention effectiveness. This study applies systems thinking as a theoretical lens to help identify and explore how possible interventions relate to one another in the systems in which they are embedded. Related challenges to addressing UCI influence on policy, and actions to support interventions, were also explored. Methods Online participatory workshops were conducted with stakeholders with expertise in UCIs. A systems map, depicting five pathways to UCI influence, and the Action Scales Model were used to help participants identify interventions and guide discussions. Codebook thematic analysis was used to analyse the data. Results Fifty-two stakeholders participated in 23 workshops. Participants identified 27 diverse, interconnected and interdependent interventions corresponding to the systems map’s pathways that reduce the ability of UCIs to influence policy, e.g., reform policy financing; regulate public-private partnerships; reform science governance and funding; frame and reframe the narrative, challenge neoliberalism and GDP growth; leverage human rights; change practices on multistakeholder governance; and reform policy consultation and deliberation processes. Participants also identified four potential key challenges to interventions (i.e., difficult to implement or achieve; partially formulated; exploited or misused; requires tailoring for context), and four key actions to help support intervention delivery (i.e., coordinate and cooperate with stakeholders; invest in civil society; create a social movement; nurture leadership). Conclusion A systems thinking lens revealed the theoretical interdependence between disparate and heterogenous interventions. This suggests that to be effective, interventions need to align, work collectively, and be applied to different parts of the system synchronously. Importantly, these interventions need to be supported by intermediary actions to be achieved. Urgent action is now required to strengthen healthy alliances and implement interventions.2024-02-27T00:00:00ZPerceived health inequalities: are the UK and US public aware of occupation-related health inequality, and do they wish to see it reduced?
http://hdl.handle.net/1893/35872
Title: Perceived health inequalities: are the UK and US public aware of occupation-related health inequality, and do they wish to see it reduced?
Author(s): Bridger, Emma K.; Tufte-Hewett, Angela; Comerford, David A.
Abstract: Background One underexamined factor in the study of lay views of socioeconomic health inequalities is occupation-related health. Examining health by occupational social class has a long history in the UK but has been comparatively overlooked in US public health literatures, where the relationship between health and work has attended more to hazard exposure. Methods Representative samples of the UK and US indicated the perceived and ideal lifespan of people working in “higher managerial/professional” and “routine” occupations. We examine perceptions of inequality and desires for equality across occupation groups as a function of country and key socio-demographic variables. Results 67.8% of UK and 53.7% of US participants identified that professionals live longer than routine workers. Multivariate models indicated that US participants were markedly less likely to be aware of occupation-related inequalities after controlling for age, gender, and education. Awareness was negatively related to age (in the US) and recent voting behaviours (both samples). Desiring equal life expectancy was less likely in the US sample, and less likely across both samples among older participants and those with lower levels of education. Conclusion Employing a novel approach to measuring perceived and ideal life expectancy inequality, this is the first study to examine perceptions of lifespan inequality by occupational groups. It reports widespread understanding of the occupation-related gradient in lifespan and a desire that these inequalities be eliminated in the UK, but considerably less awareness and desire for equality in the US. Greater tolerance for social status inequalities in the US than other similar countries appear to also extend to differences in life expectancy.2023-11-24T00:00:00Z