Is it a complex system? Identifying connections and interventions in the system of unhealthy commodity influence on public health

Contribution presented at the 3^rd Calisia Conference on Family Health, Kalisz, Poland, 18-20 June 2023
Unhealthy commodities, such as tobacco, alcohol, sugar-sweetened beverages, and high-fat, salt, and sugar foods, are significant contributors to noncommunicable diseases, resulting in at least 14.5 million annual global deaths. It is imperative to implement interventions that prevent and mitigate the influence of the unhealthy commodity industry (UCI) on public health policies. While the field of public health has seen emerging lite­rature on interventions, current conceptualisations fail to adequately account for the broader systemic complexities surrounding UCI influence, potentially undermining the effectiveness of interventions.
Recognising the potential of systems thinking to understand intervention complexity, this research sought to create a systems map illustrating the intricate web of UCI influence. Subsequently, we identified and explored various interventions to address UCI influence, their interconnections within the broader systems, and the challenges associated with their implementation. To collect data, we conducted online participatory workshops involving stakeholders with expertise in UCIs. The Action Scales Model was employed to assist participants in identifying interventions and facilitating discussions. Thematic analysis was utilised to analyse the data.
Fifty-two individuals participated in twenty-three workshops. They identified twenty-seven diverse, interconnected, and interdependent interventions corresponding to five pathways of influence. These interventions aim to curtail UCI’s ability to: 1) Directly access public sector decision-makers (regulate public official interactions with UCIs; reform political financing; regu­late lobbying; regulate revolving doors; regulate public- private partnerships); 2) Create confusion and doubt about policy decisions (reform science governance and funding; frame and reframe the narrative; expose, raise awareness, and denormalise; monitor UCIs and the public sector actor; provide formal and informal education or training; regulate the media industry and marketing); 3) Prioritise industry growth and profits (challenge neoliberalism and GDP growth; reform investment practices; reform corporate ownership and management; promote fair competition and encourage the production and consumption of healthy alternatives; minimise externalities; reform taxes; and invest in...


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