New tool assesses policy impacts on obesity inequalities
A new paper published in the Bulletin of the World Health Organization introduces a policy assessment tool designed to evaluate the effects of obesity prevention policies on health inequalities.
Developed by Tim Lobstein and Mojca Gabrijelčič, the tool offers policymakers a systematic way to predict whether interventions will reduce or widen disparities in obesity prevalence.
Health disparities in obesity are a persistent global issue, with higher rates often observed in disadvantaged populations. While many obesity prevention policies aim to improve public health, their unintended effects on inequalities are not always well understood. This new tool fills a critical gap, allowing policymakers to evaluate the equity implications of their initiatives in advance.
A systematic framework for equity
The policy assessment tool was developed as part of the European Union's Joint Action Best-ReMaP (2020–2023), which focused on best practices in food reformulation, marketing restrictions, and public food procurement. The framework uses a structured four-step approach to assess how policies might affect health equity:
- Pre-existing risk: Evaluates disparities in exposure to obesity risks, such as marketing of unhealthy foods or access to nutritious options.
- Reach and accessibility: Measures whether policies can reach all population groups, especially the most vulnerable.
- Response to policy: Considers whether individuals or groups have the resources, skills, and capacity to benefit from the intervention.
- Sustainability of impact: Examines the potential for long-term equitable benefits, accounting for barriers and threats to implementation.
This approach allows policymakers to assess potential equity impacts quickly and systematically, making it a valuable tool for planning and decision-making.
READ THE STUDY
Examples of policy assessment
The study demonstrates the tool’s application using three common obesity prevention policies:
Restricting marketing to children
Evidence suggests this can reduce disparities in obesity rates, as children from lower socioeconomic backgrounds are often more exposed to unhealthy food marketing.
Food reformulation
Reformulating foods to reduce sugar, salt, and fat content can benefit the entire population. However, access to these reformulated products must be equitable to avoid widening gaps.
Public food procurement
Policies promoting healthier food in schools and public institutions can reduce disparities but require robust implementation to ensure reach across all socio-economic groups.
Implications for policymakers
The findings emphasise the importance of integrating equity considerations into the planning and implementation of public health policies. Interventions that rely on individual agency, such as calorie labelling or educational campaigns, often favour those who already have the resources and knowledge to act, potentially widening disparities. Structural interventions, such as regulatory changes or subsidies for healthy foods, are more likely to reduce inequalities.
Looking ahead
The authors urge policymakers to adopt the tool as a preparatory step for assessing the equity impacts of obesity policies. They also call for stronger evidence on the socio-economic effects of interventions, particularly in low- and middle-income countries where data gaps remain significant.
This innovative tool represents a critical step forward in ensuring that obesity prevention policies contribute to health equity rather than exacerbating existing disparities.
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