Research Impact

  • Generated awareness of best practice for obesity prevention: The close involvement of the public health community and government representatives as an integral part of the initiative helped improve understanding of global best practice for improving population diets, and awareness of current government efforts in the area.
  • Grew public support via extensive media coverage: Government scorecards and reports outlining the need for a comprehensive government response to improve population diets in Australia generated widespread media coverage, and drove social media engagement.
  • Drove action in policy development: The Food-EPI Australia initiative actively supported government policy processes for obesity prevention at the Federal and State/Territory levels, including support for the adoption of a National Obesity Strategy in 2022.
  • Achieved industry recognition: The Sax Institute presented a key award for research impact to the founder of the Food-EPI Australia initiative, Professor Gary Sacks, for his work to advance obesity prevention policy.

The Need/Challenge

Unhealthy diets and obesity are leading contributors to poor health in Australia, and have substantial impacts on individuals, communities, the health-care system and the economy.

Almost 2 out of 3 (63%) Australian adults, and 1 in 4 (25%) Australian children are overweight or obese[1], while few people in Australia consume a healthy diet consistent with the Australian Dietary Guidelines[2].

There is widespread recognition that unhealthy diets and obesity are driven by food environments in which unhealthy foods and drinks are readily available, heavily promoted, and relatively cheap[3].

To improve population diets and create healthier food environments, a comprehensive government response is needed.

The Global Centre for Preventive Health and Nutrition Research (GLOBE) within Deakin University’s Institute for Health Transformation (IHT) established the Food Policy Index (Food-EPI) Australia initiative under the leadership of Gary Sacks, Professor of Public Health Policy and Co-Director of GLOBE.

The Food-EPI Australia initiative, launched in 2016-17, aims to increase accountability of Australian governments for their role in improving population diets and preventing obesity, and increase knowledge of best practice in obesity prevention policy amongst government officials and the public health community.

The ongoing initiative assesses government policy progress in key policy areas for improving population diets, including specific aspects of food environments (such as food composition, labelling, promotion, prices and provision) as well as infrastructure support (such as leadership, governance, monitoring and funding) for effective policy implementation.

The initiative also provides prioritised recommendations for Australian governments (Federal and State/Territories), using a co-design approach.

Developing the solution

Prof Sacks, a recipient of a National Health and Medical Research Council (NHMRC) Emerging Leadership Fellowship, initiated the Food Policy Index (Food-EPI Australia) initiative in 2016-17. The initiative was based on the Food-EPI tool, developed by the global INFORMAS network and applied in more than 25 countries.

His team collaborated with government officials in each jurisdiction (Federal and State/Territory) to document their actions across more than 40 policy areas. The team then established a panel of over 100 experts from more than 50 organisations, including academics, nutritionists, and senior representatives from health NGOs and community groups, to rate the extent to which each jurisdiction was implementing globally recommended policies. The panel also prioritised associated recommendations for each jurisdiction, tailored to the local context.

This process resulted in the first-ever comprehensive scorecards of Australian governments on their obesity prevention efforts. These were first presented in 2017 as part of the inaugural report, Policies for tackling obesity and creating healthier food environments: scorecard and priority recommendations for the Australian governments – 1st Assessment.

A 2019 Progress Update highlighted policy developments since the release of the first set of scorecards. Prof. Sacks conducted a formal evaluation in 2020 which recommended several updates to the assessment approach. In 2022-23, the full assessment process was repeated to produce the final 2nd Assessment document.

Each assessment also provided examples of good practice from around the world, comparing or juxtaposing these to the leading responses by Australian jurisdictions.

Outcomes

The ongoing Food-EPI Australia initiative has a critical role to play in strengthening accountability for action on obesity prevention. As Prof Sacks observed in the latest Food-EPI Australia report, policy progress in Australia has been slow:

“While Australian governments have taken some important steps to address unhealthy diets, there has been limited policy change in the last five years. The lack of policy progress compared to other countries means that Australia is going backwards.”

The action of compiling, rating and regularly updating scorecards for Federal, State and Territory governments, and assessing policy development against international best practice, has nevertheless achieved several positive outcomes.

Generated awareness of best practice for obesity prevention

The close involvement of the public health community and government representatives as an integral part of the initiative helped improve understanding of global best practice for improving population diets, and awareness of current government efforts in the area.

Each report and set of scorecards was also sent directly to the Prime Minister plus the Health Ministers in each respective state and territory, to prompt high-level discussion about governmental responsibilities and actions.

Excerpt from a letter from Jeremy Rockliff, Premier of Tasmania, on 25 July 2023:

“I appreciate you sharing the findings of this work, including the scorecards and recommended actions, with the Premier’s Health and Wellbeing Advisory Council in Tasmania. It is valuable to have an independent expert assessment of Tasmania’s progress and further recommendations.”

Grew public support via extensive media coverage

To increase awareness and drive demand for action, government scorecards and reports were widely distributed to the media.

Each launch of reports from the Food-EPI Australia initiative generated saturation national media coverage in Australia, including on all major television networks and high-profile print media and radio.

For example, distribution of the 2017 reports generated over 60 online media reports, and over 130 print and broadcast items, whilst similar coverage in 2022/23 included articles in the Australian Financial Review, the Herald Sun and SBS News.

Drove action in policy development

A formal evaluation conducted in 2020 (Kwon J, Reeve E, Mann D, Swinburn B, Sacks G, Benchmarking for accountability on obesity prevention: evaluation of the Healthy Food Environment Policy Index (Food-EPI) in Australia (2016-2020) concluded that the Food-EPI Australia initiative had positively supported government policy processes in the area of obesity prevention.

Interviews with senior decision-makers conducted as part of the evaluation revealed the initiative’s assessments had improved understanding of the suite of recommended policy options and evidence, helping to inform their prioritisation.

Most notably, the 2019 report highlighted the development of a National Obesity Strategy as the top priority action, and this recommendation was adopted by Australian governments in 2022.

Several other examples were cited in which the initiative contributed to shifts in policy. One state/territory policymaker used the information to justify the need for additional resources: “I drew [a senior decision-maker’s] attention to [the Food-EPI Australia results] when I was advocating to get more public health nutrition positions within our branch.”

Another noted: “[Food-EPI Australia] really helped keep [an existing policy] alive at a time when there was quite a bit of pressure to disinvest.”

The evaluation also indicated results from the initiative were utilised by non-government stakeholders as part of direct advocacy to government decision-makers.

Prof Sacks:

“Policy makers told us they have used the results of this project to continue funding for some work that was recognised in these scorecards as world-leading. They have also indicated it has helped to generate whole-of-government support for some of the actions they wanted to take.”

Achieved industry recognition

In 2023, the Sax Institute – an independent, not-for-profit organisation dedicated to improving health and wellbeing by driving better use of evidence in policies, programs and services – presented one of two annual Research Action Awards to Prof Sacks for his work to advance obesity prevention policy.

The Institute described the Food-EPI Australia initiative as an “outstanding example of how public health research can make a concrete difference to people’s health and wellbeing”.

Project details

Project Title

Food Policy Index: Policies for tackling obesity and creating healthier food environments in Australia

Project time period 2016 – ongoing

Funding

National Health and Medical Research Council (NHMRC), The Australian Prevention Partnership Centre, National Heart Foundation of Australia

Research Lead

Professor Gary Sacks, Professor of Public Health Policy and Co-Director of the Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University

Research team and collaborators:

  • Dr Davina Mann
  • Dr Ella Robinson
  • Janelle Kwon

Partners and supporters:

  • Food for Health Alliance
  • The Australian Prevention Partnership Centre

Research references:

More information: foodpolicyindex.org.au

[1] Australian Bureau of Statistics 2018. Overweight and obesity, Australia

[2] Australian Bureau of Statistics. 4364.0.55.007 – Australian Health Survey: Nutrition First Results – Foods and Nutrients, 2011-12: Discretionary foods, Australian Government; 2015

[3] Swinburn et al. Lancet 2011

Written by Steve Colquhoun

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