A recent announcement that VicHealth will run a citizen’s jury to look at solutions to obesity was not met with support from all in the health setting. Criticisms include questions around the influence of the final report. In this post Jerril Rechter, CEO of Vic Health explains that with rising rates of overweight and obesity, it’s time for a new, de-politicised approach to tackling the issue and demonstrates how she believes the citizen’s jury approach can help.
Jerril Rechter writes:
Obesity is a major, complex health issue facing Victoria and Australia.
With nearly two thirds of Australian adults and a quarter of children aged two to 17 either overweight or obese, the total financial cost of obesity in Australia is estimated to be $8.3 billion a year. These figures are projected to rise [i], so now is the time for comprehensive and sustained action on obesity.
The majority of people know that to prevent obesity, they need to eat well and move more. But knowing what they should do isn’t translating to what people are actually doing. If we’re really going to tackle Victoria’s growing obesity problem and reverse trends, we’re going to need to try something ‘different’. It’s time to drive change in a way that hasn’t been done before and to create sustained behaviour change.
To this aim, VicHealth is bringing 100 people together for Victoria’s first Citizens’ Jury on Obesity. These 100 jurors will explore what seems on the surface to be a simple question – how do we get people to eat better? This exciting initiative is part of our vision for more Victorians to live healthier and happier lives.
This is the first time an event of this scale has taken place on this issue in Australia. It’s designed to bring everyday Victorians – not the experts we traditionally refer to – into a discussion and debate around solutions to make healthy eating easier.
Sound policy development responds to the needs and the issues of the people they will impact most. We must ensure we find ways that those concerns are heard and understood and that policy outcomes are owned and supported by the community.
A citizens’ jury de-politicises societal issues and the policy development process. It can bring a trusted and less partisan voice to a process. We trust our community to make serious decisions as part of our justice system, so it makes sense to trust the same community when it comes to making decisions about issues that affect us, such as our health. The evidence is there showing the effectiveness of citizens’ juries and we believe a well-designed Citizens’ Jury on Obesity will help shift public attitudes and create momentum for action on overweight and obesity in Victoria.
The idea of a Citizens’ Jury isn’t new. Various forms of citizens’ juries have been undertaken in Australia and internationally on issues ranging from electoral reform in Canada, employee leave and benefits in the United Kingdom, local budgets and spending in South America to budget planning in the City of Melbourne.
A recent systematic review by Street et al (2014) on the use of citizens’ juries in health policy decision-making found 37 papers describing 66 citizens’ juries. Henderson et al (2013) evaluated the use of citizens’ juries in food policy, finding them to be an effective means of gaining insight into public views of policy and the circumstances under which the public will consider food regulation. Blacksher (2013) has undertaken research which found promising evidence in the capacity for participatory and deliberative practices to advance health equity and justice. There is also experience from Brazil and Finland. VicHealth’s Citizens’ Jury on Obesity in Victoria will be informing a series of deliberative forums on obesity in the UK.
The 100 members of Victoria’s Citizens’ Jury on Obesity will be randomly selected and representative of the Victorian population as a whole. Rigorous recruiting methodology will be used with the goal of getting representation from as many possible communities, professions, lifestyle groups and demographics as possible.
Over a six-week period, the jurors will meet online and read, discuss and interrogate a broad range of perspectives and issues related to how Victorians can eat better. They will focus specifically on food and the way we eat, recognising the large role it plays in society and the range of influences few of us are aware of when it comes to food choices such as social setting, colour and context. This process will allow them to identify further information they need, apparent gaps, and request specific expertise. They’ll also be provided with an evidence base on obesity which we’ve developed, along with the World Health Organization Collaborating Centre for Obesity Prevention at Deakin University and the Behavioural Insights Team in the United Kingdom as well as submissions from numerous stakeholders including the public, food manufacturers and producers, retailers, public health advocates and all levels of government. The jurors will then meet face-to-face over two days in Melbourne on 17 and 18 October to determine what government, industry and community need to do to help Victorians eat better.
The jury will present a series of ‘asks’ and potential solutions to obesity to a steering group formed by VicHealth. The group includes representatives from the Australian Medical Association Victoria, Australian Beverages Council, Australian Food & Grocery Council, CHOICE, City of Melbourne, Coles, Centre for Physical Activity and Nutrition Research at Deakin University, Foodbank Victoria, Obesity Policy Coalition, Tennis Australia, and the Victorian Government Department of Premier and Cabinet.
It will be the role of the steering group to provide responses and recommendations regarding each ‘ask’ the jury makes in a public report aimed at key decision-makers in government and industry.
This is an exciting time for change in Victoria and for Australia more broadly. Obesity and its health impacts are seriously contributing to the burden of disease in Australia; it’s time for us to tackle them with a new, innovative and people-led approach.
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To inform the Citizens’ Jury, our partner, newDemocracy Foundation, is inviting interested parties to make a submission to the Jury, focusing on what they think needs to be done to help us eat better. This process is deliberately designed to be transparent, fair and accessible. Submissions might come from the public, food manufacturers and producers, retailers, public health advocates and all levels of government. For more information on VicHealth’s Citizens’ Jury, see http://citizensjury.vichealth.vic.gov.au
The Behavioural Insights Team is a social purpose company led by chief executive Dr David Halpern. It started life within the British Government as the world’s first government institution dedicated to the application of behavioural sciences.
[i] No Time to Weight. Obesity: A National Epidemic and its Impact on Australia, Obesity Australia, 2014
I suspect that when people are depressed they eat more – to keep up the blood sugar levels – and eat heavier foods to reduce the emotional pain in the solar plexus.
If so, fixing depression must be a key to weight reduction
It is probably not quite correct to say that this process will de-politicise the issue, as studies have shown that the approaches that people are willing to support or not support to address public health problems are directly related to their political views, particularly their views about the role of government vs the individual. This is therefore deeply political.