Fostering the Catalyst Role of Government in Advancing Healthy Food Environments

Document Type : Perspective


1 School of Physical & Occupational Therapy, McGill University, Montréal, QC, Canada

2 McGill Centre for the Convergence for Health and Economics, McGill University, Montréal, QC, Canada

3 Institut national de sante publique, Québec, QC, Canada

4 Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA

5 Pan American Health Organisation, Washington, DC, USA

6 McGill University, Montréal, QC, Canada


Effective approaches to non-communicable disease (NCD) prevention require intersectoral action targeting health and engaging government, industry, and society. There is an ongoing vigorous exploration of the most effective and appropriate role of government in intersectoral partnerships. This debate is particularly pronounced with regards to the role of government in controlling unhealthy foods and promoting healthy food environments. Given that food environments are a key determinant of health, and the commercial sector is a key player in shaping such environments (eg, restaurants, grocery stores), the relationship between government and the commercial sector is of primary relevance. The principal controversy at the heart of this relationship pertains to the potential influence of commercial enterprises on public institutions. We propose that a clear distinction between the regulatory and catalyst roles of government is necessary when considering the nature of the relationship between government and the commercial food sector. We introduce a typology of three catalyst roles for government to foster healthy food environments with the commercial sector and suggest that a richer understanding of the contrasting roles of government is needed when considering approaches NCD prevention via healthy food environments.


Main Subjects

Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA. 2012;307(5):491-497. doi:10.1001/jama.2012.39
Moodie R, Stuckler D, Monteiro C, et al. Profits and pandemics: prevention of harmful effects of tobacco, alcohol, and ultra-processed food and drink industries. Lancet. 2013;381(9867):670-679. doi:10.1016/s0140-6736(12)62089-3
Chaloupka FJ, Yurekli A, Fong GT. Tobacco taxes as a tobacco control strategy. Tob Control. 2012;21(2):172-180. doi:10.1136/tobaccocontrol-2011-050417
Widome R, Samet JM, Hiatt RA, et al. Science, prudence, and politics: the case of smoke-free indoor spaces. Ann Epidemiol. 2010;20(6):428-435. doi:10.1016/j.annepidem.2010.03.004
Swinburn B, Kraak V, Rutter H, et al. Strengthening of accountability systems to create healthy food environments and reduce global obesity. Lancet. 2015;385(9986):2534-2545. doi:10.1016/s0140-6736(14)61747-5
Backholer K, Sarink D, Beauchamp A, et al. The impact of a tax on sugar-sweetened beverages according to socio-economic position: a systematic review of the evidence. Public Health Nutr. 2016;19(17):3070-3084. doi:10.1017/s136898001600104x
Le Bodo Y, Paquette MC, De Wals P. Sugar-Sweetened Beverage Taxation Logics and Ethical Concerns. Taxing Soda for Public Health: A Canadian Perspective. Cham: Springer International Publishing; 2016:75-82.
Dube L, Pingali P, Webb P. Paths of convergence for agriculture, health, and wealth. Proc Natl Acad Sci U S A. 2012;109(31):12294-12301. doi:10.1073/pnas.0912951109
Dube L, Addy NA, Blouin C, Drager N. From policy coherence to 21st century convergence: a whole-of-society paradigm of human and economic development. Ann N Y Acad Sci. 2014;1331:201-215. doi:10.1111/nyas.12511
UN. Political declaration of the high-level meeting of the General Assembly on the prevention and control of non-communicable diseases. New York, NY: United Nations; 2011.
Nilsson M, Griggs D, Visbeck M. Policy: Map the interactions between Sustainable Development Goals. Nature. 2016;534(7607):320-322. doi:10.1038/534320a
Magnusson RS, Patterson D. The role of law and governance reform in the global response to non-communicable diseases. Global Health. 2014;10:44. doi:10.1186/1744-8603-10-44
Stuckler D, Nestle M. Big food, food systems, and global health. PLoS Med. 2012;9(6):e1001242. doi:10.1371/journal.pmed.1001242
Saloojee Y, Dagli E. Tobacco industry tactics for resisting public policy on health. Bull World Health Organ. 2000;78(7):902-910.  
Brownell KD, Warner KE. The perils of ignoring history: Big Tobacco played dirty and millions died. How similar is Big Food? Milbank Q. 2009;87(1):259-294. doi:10.1111/j.1468-0009.2009.00555.x
Monteiro CA, Levy RB, Claro RM, de Castro IR, Cannon G. Increasing consumption of ultra-processed foods and likely impact on human health: evidence from Brazil. Public Health Nutr. 2011;14(1):5-13. doi:10.1017/s1368980010003241
Moubarac J-C, Batal M, Martins APB, et al. Time Trends Changes in the Consumption of Ultra-Processed Products During the 20th Century in Canada. Can J Diabetes. 2013;37:S245. doi:10.1016/j.jcjd.2013.03.168
Silva V, Turci SRB, Oliveira APN, Richter AP. Can the risk in public-private partnerships be classified? Cad Saude Publica. 2017;33Suppl 3(Suppl 3):e00086316. doi:10.1590/0102-311x00086316
Dube L, Labban A, Moubarac JC, Heslop G, Ma Y, Paquet C. A nutrition/health mindset on commercial Big Data and drivers of food demand in modern and traditional systems. Ann N Y Acad Sci. 2014;1331:278-295. doi:10.1111/nyas.12595
Martinez S. Local Food Systems; Concepts, Impacts, and Issues. DIANE Publishing; 2010:87.
Vedung E. Policy instruments: typologies and theories. In: Carrots, Sticks, and Sermons: Policy Instruments and Their Evaluation. UK: Transaction Publishers; 1998:21-58.
Hood C, Margetts H. The Tools of Government in the Digital Age. Palgrave Macmillan; 2007:233.
Jordan A, Wurzel RKW, Zito A. The Rise of ‘New’ Policy Instruments in Comparative Perspective: Has Governance Eclipsed Government? Polit Stud. 2005;53(3):477-496. doi:10.1111/j.1467-9248.2005.00540.x
Gostin LO. Public health law in a new century: part I: law as a tool to advance the community's health. JAMA. 2000;283(21):2837-2841.
Mello MM, Studdert DM, Brennan TA. Obesity--the new frontier of public health law. N Engl J Med. 2006;354(24):2601-2610. doi:10.1056/NEJMhpr060227
WHO. WHO Study Group on Tobacco Product Regulation: Report on the Scientific Basis of Tobacco Product Regulation: Third Report of a WHO Study Group. Geneva: World Health Organization; 2009:955.
Hawkes C. Regulating and litigating in the public interest: regulating food marketing to young people worldwide: trends and policy drivers. Am J Public Health. 2007;97(11):1962-1973. doi:10.2105/ajph.2006.101162
Magnusson R, Reeve B. 'Steering' Private Regulation? A New Strategy for Reducing Population Salt Intake in Australia. Syd Law Rev. 2014;36(2):255-289.
Mello MM, Pomeranz J, Moran P. The interplay of public health law and industry self-regulation: the case of sugar-sweetened beverage sales in schools. Am J Public Health. 2008;98(4):595-604. doi:10.2105/ajph.2006.107680
Sharma LL, Teret SP, Brownell KD. The food industry and self-regulation: standards to promote success and to avoid public health failures. Am J Public Health. 2010;100(2):240-246. doi:10.2105/ajph.2009.160960
Bexell M. Global Governance, Legitimacy and (De)Legitimation. Globalizations. 2014;11(3):289-299. doi:10.1080/14747731.2014.919744
Carpenter D, Moss DA. Preventing Regulatory Capture: Special Interest Influence and How to Limit it. Cambridge: Cambridge University Press; 2013.
World Health Organization. WHO’s engagement with non-State actors. Discussion paper for the informal consultation with Member States and non-State actors, 17-18 October 2013. Geneva: WHO; 2013.
Chaib F. WHO sets the record straight on work with the food and beverage industry. J Home Econ Inst Aust. 2012;19(3):34.
Tschirley D, Reardon T, Dolislager M, Snyder J. The Rise of a Middle Class in East and Southern Africa: Implications for Food System Transformation. J Int Dev. 2015;27(5):628-646. doi:10.1002/jid.3107
Ostrom E. Beyond markets and states: polycentric governance of complex economic systems. Am Econ Rev. 2010;100(3):641-672. doi:10.1257/aer.100.3.641
Hill PS. Understanding global health governance as a complex adaptive system. Glob Public Health. 2011;6(6):593-605. doi:10.1080/17441691003762108
Stoker G. Governance as theory: five propositions. Int Soc Sci J. 1998;50(155):17-28. doi:10.1111/1468-2451.00106
Hood C. Intellectual Obsolescence and Intellectual Makeovers: Reflections on the Tools of Government after Two Decades. Governance. 2007;20(1):127-144. doi:10.1111/j.1468-0491.2007.00347.x
Jarvenpaa SL, Staples DS. The use of collaborative electronic media for information sharing: an exploratory study of determinants. ‎J Strateg Inf Syst. 2000;9(2):129-154. doi:10.1016/S0963-8687(00)00042-1
Bodor JN, Rose D, Farley TA, Swalm C, Scott SK. Neighbourhood fruit and vegetable availability and consumption: the role of small food stores in an urban environment. Public Health Nutr. 2008;11(4):413-420. doi:10.1017/s1368980007000493
Schermel A, Emrich TE, Arcand J, Wong CL, L'Abbe MR. Nutrition marketing on processed food packages in Canada: 2010 Food Label Information Program. Appl Physiol Nutr Metab. 2013;38(6):666-672. doi:10.1139/apnm-2012-0386
Borys JM, Le Bodo Y, Jebb SA, et al. EPODE approach for childhood obesity prevention: methods, progress and international development. Obes Rev. 2012;13(4):299-315. doi:10.1111/j.1467-789X.2011.00950.x
Burt RS. Social Contagion and Innovation: Cohesion versus Structural Equivalence. Am J Sociol. 1987;92(6):1287-1335.
Borgatti SP, Obstfeld D, Davis J. Brokerage as a Process: Decoupling Third Party Action from Social Network Structure. In: Brass DJ, Labianca G, Mehra A, Halgin DS, Borgatti SP, eds. Contemporary Perspectives on Organizational Social Networks. Emerald Group Publishing Limited; 2014:135-159. Research in the Sociology of Organizations; vol. 40.
Small ML. Unanticipated Gains: Origins of Network Inequality in Everyday Life. Oxford University Press; 2009:309.
Stovel K, Shaw L. Brokerage. Annu Rev Sociol. 2012;38(1):139-158. doi:10.1146/annurev-soc-081309-150054
Cummins S, Flint E, Matthews SA. New neighborhood grocery store increased awareness of food access but did not alter dietary habits or obesity. Health Aff (Millwood). 2014;33(2):283-291. doi:10.1377/hlthaff.2013.0512
Dubowitz T, Ghosh-Dastidar M, Cohen DA, et al. Diet and perceptions change with supermarket introduction in a food desert, but not because of supermarket use. Health Aff (Millwood). 2015;34(11):1858-1868. doi:10.1377/hlthaff.2015.0667
Abbott KW, Genschel P, Snidal D, Zangl B. Two logics of indirect governance: Delegation and orchestration. Br J Polit Sci. 2016;46(4):719-729. doi:10.1017/S0007123414000593
Addy NA, Poirier A, Blouin C, Drager N, Dube L. Whole-of-society approach for public health policymaking: a case study of polycentric governance from Quebec, Canada. Ann N Y Acad Sci. 2014;1331:216-229. doi:10.1111/nyas.12503