International Journal of Health Policy and Management

International Journal of Health Policy and Management

Building a Systems Map: Applying Systems Thinking to Unhealthy Commodity Industry Influence on Public Health Policy

Document Type : Original Article

Authors
Adam Bertscher 1
James Nobles 2
Anna B. Gilmore 3
Krista Bondy 4
Amber van den Akker 3
Sarah Dance 5
Michael Bloomfield 1
Mateusz Zatoński 3
1 Department of Social and Policy Sciences, Faculty of Humanities & Social Sciences, University of Bath, Bath, UK
2 Centre of Active Lifestyles, Leeds Beckett University, Leeds, UK
3 Department for Health, Faculty of Humanities & Social Sciences, University of Bath, Bath, UK
4 School of Management, Marketing, Business & Society, University of Bath, Bath, UK
5 Department of Psychology, Faculty of Humanities & Social Sciences, University of Bath, Bath, UK
10.34172/ijhpm.2024.7872
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 (CS), public office, and global governance organisations (CGO). 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 policy-making: (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 policy-making, 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 in future work.
Keywords
Systems Mapping
Complex Adaptive Systems
Participatory Research
Unhealthy Commodities
Commercial Determinants of Health
Non-communicable Diseases 
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International Journal of Health Policy and Management
Volume 13, Issue 1
2024
Pages 1-17

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  • Received Date 08 December 2022
  • Revised Date 24 October 2023
  • Accepted Date 12 March 2024
  • First Published Date 13 March 2024
  • Published Date 01 December 2024