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How does whole of government action address inequities in obesity? A case study from Australia

机译:整个政府行动如何解决肥胖症的不公平情况?澳大利亚的案例研究

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Abstract Background There are many factors across different sectors that contribute to inequities in obesity levels. This implies the need for action across different government departments and policy domains (hereafter referred to as whole of government multisectoral action). In this study we explored the public policy attention given to inequities in obesity using an Australian case study. Methods Interviews were conducted with 33 stakeholders involved in the development and implementation of the whole of government Healthy Weight Initiative (HWI). A thematic analysis was undertaken to identify ways in which government policy makers and implementers explicitly or implicitly described how actions delivered through the HWI addressed inequities in obesity within the population. Results The analysis revealed that the focus of the HWI was predominantly aimed at the general population, with minimal attention given to addressing the social distribution of obesity. The reasons for this were explained in terms of five themes: (1) rationale for a population wide approach; (2) when to apply an equity lens, (3) issues of government responsibility, (4) philosophically opposing concepts of equity, and (5) tensions across departments as a result of competing concepts of equity. Conclusions It is important to create a shared understanding plus a concern for addressing inequities in public policy, regardless of whether or not a universal population-wide or a targeted approach is being applied. It is also important that policies and programs address the social distribution of obesity while understanding local contexts and needs. In striving to develop policy that brings an explicit focus on health equity, policymakers must consider the sociological, political, economic, and philosophical tensions at play between different policy actors and government departments, and identify how to navigate these without reverting to siloed working.
机译:抽象背景在不同部门有许多因素有助于肥胖水平的不公平。这意味着对不同政府部门和政策域名的行动需要(以下简称整个政府多部门行动)。在这项研究中,我们探讨了使用澳大利亚案例研究的肥胖症中的不公平的公共政策关注。方法采访33名利益攸关方参与了整个政府健康体重倡议(HWI)的发展和实施。对专题分析进行了专题分析,以确定政府政策制定者和实施者明确或隐含地描述如何通过HWI提供的行动如何解决人口中肥胖的不公平。结果分析表明,利军的重点主要针对一般人群,以满足肥胖的社会分布而最小的关注。关于五个主题的原因是解释的:(1)人口广泛的理由; (2)何时申请股票镜头,(3)政府责任的问题,(4)批凿权益概念,(5)各部门的紧张局势导致股权竞争概念。结论创造共同的理解以及对公共政策的不公平承担不管是否正在应用普遍的人群或目标方法,重要的是解决公共政策中的不平等。在理解当地背景和需求的同时,政策和计划也涉及肥胖的社会分布也很重要。在努力制定带来明确关注健康股权的政策时,政策制定者必须考虑在不同政策行动者和政府部门之间发挥作用的社会学,政治,经济和哲学紧张局势,并确定如何在不恢复偏离工作的情况下导航这些问题。

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