Identifying implementation gaps and priorities for the Singapore government to improve food environment policies: perspectives from a local expert panel

2020 ◽  
pp. 1-8
Author(s):  
Zoey Tay ◽  
Clare Whitton ◽  
Rob M van Dam ◽  
Kee Seng Chia ◽  
Boyd Swinburn ◽  
...  
Keyword(s):  
Food Environment ◽  
Best Practice ◽  
Expert Panel ◽  
Environment Policy ◽  
Obesity And Diabetes ◽  
Independent Expert ◽  
High Prevalence ◽  
Local Expert ◽  
Eating Out ◽  
Implementation Gaps

Abstract Objective: Singapore, an urbanised, developed nation, with a high reliance on food importation and a high prevalence of eating out is facing rising rates of obesity and diabetes. The objective of the current study was to characterise and evaluate the Singapore government’s policies to improve the food environment and to identify and prioritise concrete actions. Design: The Healthy Food Environment Policy Index tool and process were used. An expert panel rated the Singapore government’s implementation of forty-seven indicators compared with international best practice in 2018. Indicators were prioritised, and specific recommendations were proposed by panel. Setting: Singapore. Participants: Twenty experts primarily from academia. Results: As compared with international benchmarks, the level of implementation of most indicators (thirty-three indicators, 70 %) by the Singapore government was evaluated as being at least moderate. Highly rated indicators included those related to provision of healthier meals at school, supporting the use of healthier ingredients by food vendors and governmental leadership. More policy indicators (6, 26 %) as compared with infrastructure support indicators (2, 8 %) received a ‘very little or no implementation’ rating. After rating, the experts prioritised eleven indicators and proposed thirty-one actions informed by several considerations including those of effectiveness, political acceptability, feasibility and unique characteristics of food retail in Singapore. Conclusions: Supported by documented evidence, an independent expert panel identified areas of strengths and provided specific recommendations to meaningfully improve the Singapore food environment to facilitate healthier eating. Fundamental recommendations including improving nutrition profiling and strengthening monitoring systems have the potential to positively influence environments across policy domains.

scholarly journals Implementing healthy food environment policies in New Zealand: nine years of inaction

2022 ◽  
Vol 20 (1) ◽  
Author(s):  
Sally Mackay ◽  
Sarah Gerritsen ◽  
Fiona Sing ◽  
Stefanie Vandevijvere ◽  
Boyd Swinburn
Keyword(s):  
New Zealand ◽  
Policy Implementation ◽  
Food Environment ◽  
Best Practice ◽  
Good Practice ◽  
Healthy Food ◽  
Government Officials ◽  
Stimulate Action ◽  
National Governments ◽  
Implementation Gaps

Abstract Background The INFORMAS [International Network for Food and Obesity/Non-communicable Diseases (NCDs) Research, Monitoring and Action Support] Healthy Food Environment Policy Index (Food-EPI) was developed to evaluate the degree of implementation of widely recommended food environment policies by national governments against international best practice, and has been applied in New Zealand in 2014, 2017 and 2020. This paper outlines the 2020 Food-EPI process and compares policy implementation and recommendations with the 2014 and 2017 Food-EPI. Methods In March–April 2020, a national panel of over 50 public health experts participated in Food-EPI. Experts rated the extent of implementation of 47 “good practice” policy and infrastructure support indicators compared to international best practice, using an extensive evidence document verified by government officials. Experts then proposed and prioritized concrete actions needed to address the critical implementation gaps identified. Progress on policy implementation and recommendations made over the three Food-EPIs was compared. Results In 2020, 60% of the indicators were rated as having “low” or “very little, if any” implementation compared to international benchmarks: less progress than 2017 (47%) and similar to 2014 (61%). Of the nine priority actions proposed in 2014, there was only noticeable action on one (Health Star Ratings). The majority of actions were therefore proposed again in 2017 and 2020. In 2020 the proposed actions were broader, reflecting the need for multisectoral action to improve the food environment, and the need for a mandatory approach in all policy areas. Conclusions There has been little to no progress in the past three terms of government (9 years) on the implementation of policies and infrastructure support for healthy food environments, with implementation overall regressing between 2017 and 2020. The proposed actions in 2020 have reflected a growing movement to locate nutrition within the wider context of planetary health and with recognition of the social determinants of health and nutrition, resulting in recommendations that will require the involvement of many government entities to overcome the existing policy inertia. The increase in food insecurity due to COVID-19 lockdowns may provide the impetus to stimulate action on food polices.

scholarly journals An assessment of implementation gaps and priority recommendations on food environment policies: the Healthy Food Environment Policy Index (Food-EPI) in Japan

2021 ◽  
pp. 1-36
Author(s):  
Miwa Yamaguchi ◽  
Marika Nomura ◽  
Yusuke Arai ◽  
Stefanie Vandevijvere ◽  
Boyd Swinburn ◽  
...  
Keyword(s):  
Best Practices ◽  
Food Environment ◽  
Food Composition ◽  
Food Prices ◽  
Healthy Food ◽  
Japanese Government ◽  
Alcoholic Beverages ◽  
Food Environments ◽  
Environment Policy ◽  
Implementation Gaps

Abstract Objective: This study aimed to evaluate policies and actions for food environments by the Japanese Government using the Healthy Food Environment Policy Index (Food-EPI). Design: Public health experts rated the extent of implementation of food environment-related the Policy and the Infrastructure-support components, compared to international best practices. Subsequently, the experts proposed and prioritized future actions to address implementation gaps in an online workshop. Setting: Japan Participants: A total of 66 experts rated policy implementation by the Japanese Government, and 23 participated in the workshop on future actions. Results: The implementations of regulations on unhealthy foods and non-alcoholic beverages were rated low in the domains of Food composition, Food labelling, Food promotion, Food prices, and Food retail in the Policy component. The implementations of several domains in the Infrastructure-support component were, overall, rated at a higher level, specifically for monitoring and intelligence systems. Based on the rating, reducing health inequalities by supporting people, both economically and physically, was the highest priority for future actions in both components. Conclusions: This study found that Japan has a robust system for long-term monitoring of population health but lacks regulations on unhealthy foods and non-alcoholic beverages compared to international best practices. This study confirmed the importance of continuous accumulation of evidence through national monitoring systems. Developing comprehensive regulations to restrict food marketing, sales, and accessibility of unhealthy foods and non-alcoholic beverages are needed to improve the health of food environments in Japan.

scholarly journals Evaluating food-related policies in Germany using the Food Environment Policy Index (Food-EPI)

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Geffert ◽  
P von Philipsborn ◽  
J M Stratil ◽  
E A Rehfuess
Keyword(s):  
Food Environment ◽  
Food Systems ◽  
Best Practice ◽  
Online Survey ◽  
Food Environments ◽  
Expert Group ◽  
Sustainable Food ◽  
Environment Policy ◽  
Depth Analysis ◽  
German Food

Abstract Background Germany has seen as rising burden of diet-related adverse health outcomes. Policies for improving food environments and related infrastructure are essential to reduce this burden. A growing awareness of the interlinkages between sustainability and nutrition underlines the need for healthy, sustainable food environments. Therefore, we applied the Food Environment Policy Index (Food-EPI) with an additional domain on sustainability to monitor German food policies and to formulate actions for improvement. Methods For the evidence analysis information on food environment and infrastructure was collected from various sources. Results were validated with an expert group consisting of representatives of government agencies, non-governmental organizations and academia. The level of implementation, compared to international best practice examples, was ranked by the expert group through an online survey. A one-day workshop was conducted to identify actions to fill the gaps identified in the online ranking and to prioritize these actions in terms of importance and achievability. Results The application of the Food-EPI to German policies and interventions shows a nuanced picture of strengths and weaknesses of the German food environment and infrastructure. Some domains such as monitoring and surveillance are in line with international best practice, however other domains show considerable room for improvement. The recommended actions to improve the shortcomings of the German food environment includes a list with priority actions. Conclusions The results from the Food-EPI provides an in-depth analysis of German food environment policies and infrastructure, as well as a list of prioritized actions to improve it. Key message Integrating a sustainability domain into the Food-EPI offers opportunities to identify priority actions for the creation of healthy, sustainable food systems.

scholarly journals The healthy food environment policy index: findings of an expert panel in New Zealand

2015 ◽  
Vol 93 (5) ◽  
pp. 294-302 ◽  
Author(s):  
Stefanie Vandevijvere ◽  
Clare Dominick ◽  
Anandita Devi ◽  
Boyd Swinburn ◽  
Keyword(s):  
New Zealand ◽  
Food Environment ◽  
Expert Panel ◽  
Healthy Food ◽  
Environment Policy

Implementing Healthy Food Environment Policies in New Zealand: Nine Years of Inaction.

2020 ◽  
Author(s):  
Sally Mackay ◽  
Sarah Gerritsen ◽  
Fiona Sing ◽  
Stefanie Vandevijvere ◽  
Boyd Swinburn
Keyword(s):  
New Zealand ◽  
Policy Implementation ◽  
Food Environment ◽  
Best Practice ◽  
Good Practice ◽  
Healthy Food ◽  
Government Officials ◽  
Stimulate Action ◽  
National Governments ◽  
Implementation Gaps

Abstract Background: The INFORMAS Healthy Food Environment Policy Index (Food-EPI) was developed to evaluate the degree of implementation of widely recommended food environment policies by national governments against international best practice, and has been applied in New Zealand in 2014, 2017 and 2020. This paper outlines the 2020 Food-EPI process and compares policy implementation and recommendations with the 2014 and 2017 Food-EPI. Methods: In March-April 2020, a national panel of over 50 public health experts participated in Food-EPI. Experts rated the extent of implementation of 47 ‘good practice’ policy and infrastructure support indicators compared to international best practice, using an extensive evidence document verified by government officials. Experts then proposed and prioritised concrete actions needed to address the critical implementation gaps identified. Progress on policy implementation and recommendations made over the three Food-EPIs was compared. Results: In 2020, 60% of the indicators were rated as having ‘low’ or ‘very little if any’ implementation compared to international benchmarks; less progress than 2017 (47%) and similar to 2014 (61%). Of the nine priority actions proposed in 2014, there was only noticeable action on one (Health Star Ratings). The majority of actions were therefore proposed again in 2017 and 2020. In 2020 the proposed actions were broader, reflecting the need for multi-sectoral action to improve the food environment, and the need for a mandatory approach in all policy areas. Conclusions: There has been little to no progress in the past three terms of government (nine years) on the implementation of policies and infrastructure support for healthy food environments, with implementation overall regressing between 2017 and 2020. The proposed actions in 2020 have reflected a growing movement to locate nutrition within the wider context of planetary health and with recognition of the social determinants of health and nutrition, resulting in recommendations that will require the involvement of many Government entities to overcome the existing policy inertia. The increase in food insecurity due to Covid-19 lockdowns may provide the impetus to stimulate action on food polices.

scholarly journals The INFORMAS healthy food environment policy index ( Food‐EPI ) in M exico: A n assessment of implementation gaps and priority recommendations

2019 ◽  
Vol 20 (S2) ◽  
pp. 67-77 ◽  
Author(s):  
Claudia Nieto ◽  
Estefania Rodríguez ◽  
Karina Sánchez‐Bazán ◽  
Lizbeth Tolentino‐Mayo ◽  
Angela Carriedo‐Lutzenkirchen ◽  
...  
Keyword(s):  
Food Environment ◽  
Healthy Food ◽  
Environment Policy ◽  
Implementation Gaps

Discharge policies for homeless people and immigrants: Compromising professional ethics

2020 ◽  
Vol 27 (5) ◽  
pp. 1355-1363
Author(s):  
Nathan Hodson ◽  
Rose Glennerster
Keyword(s):  
Best Practice ◽  
Ethical Issues ◽  
Homeless People ◽  
Social Needs ◽  
Hostile Environment ◽  
Environment Policy ◽  
The United Kingdom ◽  
Health And Social Care ◽  
Healthcare Professions

Discharging a homeless patient from hospital raises ethical issues which are compounded when the patient is from outside the United Kingdom. This article begins with an extended case study of a 30-year-old homeless man from Lithuania describing his complex medical and social needs. It is best practice for all homeless patients to have their housing needs planned for prior to discharge, but this is made more difficult by the United Kingdom’s ‘hostile environment’ policy which creates a subclass of homeless people who are not eligible for support. This means healthcare professionals discharge patients back to homelessness, even when this is likely to adversely affect their health and dignity both directly and indirectly through impairing access to care for chronic conditions. Policies in health and social care which compel professionals to treat some patients with second-class care undermine the ethics of healthcare professions.

scholarly journals Children’s Intake of Food from Non-Fast-Food Outlets and Child-Specific Menus: A Survey of Parents

Children ◽  
2019 ◽  
Vol 6 (11) ◽  
pp. 123
Author(s):  
Li Kheng Chai ◽  
Sze Lin Yoong ◽  
Tamara Bucher ◽  
Clare E Collins ◽  
Vanessa A Shrewsbury
Keyword(s):  
Childhood Obesity ◽  
Healthy Child ◽  
Fast Food ◽  
Sociodemographic Characteristics ◽  
Fast Food Restaurant ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Food Outlets ◽  
High Prevalence ◽  
Eating Out

Eating out-of-home is associated with higher energy intakes in children. The continued high prevalence of childhood obesity requires a greater understanding of child menu options and eating out frequency to inform appropriate regulatory initiatives. The majority of studies to date have focused on menus from fast-food outlets with few focused on non-fast-food outlets. This study aimed to describe parents’ reports of their child(ren)’s (aged up to 6 years) frequency of consuming foods at non-fast-food outlets, observations of child menus at these outlets, and their purchasing behaviours and future preferences regarding these menus; and if their responses were influenced by sociodemographic characteristics. Ninety-five parents completed a 15-item cross-sectional survey. Overall, children from 54% of families consumed food from non-fast-food outlets at least monthly. Of the 87 parents who reported that their child eats at a non-fast-food restaurant, 71 had children who ordered from child menus every time (7%, n = 5), often (29%, n = 22), sometimes (42%, n = 32) or rarely (16%, n = 12), with a further 7% (n = 5) never ordering from these menus. All parents indicated that they would like to see a higher proportion of healthy child menu items than is currently offered. Parents’ responses were not influenced by sociodemographic characteristics. Parents’ views support implementation of initiatives to increase availability of healthy options on child menus at non-fast-food outlets.

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