Policy Interventions for Healthier Diets: Insights from Scotland

Professor Leigh Sparks, Professor of Retail Studies, Institute for Retail Studies, Stirling Management School, University of Stirling

I recently had the opportunity to present to Finnish Ministries and Finnish retailing cooperative S-Group, discussing policy interventions for healthier diets and drawing on recent developments in Scotland. The presentation came at the invitation of Hannu Saarijarvi.  As noted before on the Stirling Retail blog, I have co-authored a book chapter with Hannu and Sonja Lahtinen on Transformative Food Retailing. Hannu is doing interesting work with loyalty card data and Sonja is completing her Phd on Transformative Sustainability.

The discussion drew on our review for Food Standards Scotland, which was previously covered on the Stirling Retail blog. These presentations were an opportunity to reflect some months on and to bring things up to date with the recent consultation and other papers on this subject from the Scottish Government.

Below is a summary of what I said.

“There is a crisis in obesity, diet and health amongst western and developed economies. Our food consumption has switched to a diet focused on unhealthy processed products. Our response to this has been to emphasise personal responsibility and choice and to focus attention on education and advice and then medical interventions when these fail.

What we eat however is much more complex than personal choice, being the outcome of varying personal, societal, cultural, government and business influences. It is a highly valid question as to whether personal choice can be exercised in what is an unfair environment. In retail stores this is seen clearly in the promotional, positioning, pricing and product mix that privileges unhealthy over healthy products. The outcome is both societal and locational health inequalities.

Government responses to date have tended to focus on better information, labelling, education, advice and promotion of the benefits of eating healthily and having a good diet. This has sought to rebalance the environment, by emphasising the benefits of a good diet, but has had limited success. It is now the time to consider if a more restrictive and interventionist approach to the environment, including retailing, is required. Rebalancing needs not just to involve enhanced spending by government on positive messages, but reduced spending by industry on the negative messages.

The diet in Scotland is poor and has not been improving. As a consequence the Scottish Government has begun to lead on intervening in the retail environment, as seen with restrictions on tobacco (displays and packaging) and alcohol (including promotional and sales time restrictions and most recently Minimum Unit Pricing) and positive support for healthy eating displays and information in smaller stores. In hospital settings, the Healthcare Retail Standard has restricted the amount and promotion of unhealthy products. At the same time UK government interventions, such as the Soft Drinks Industry Levy (the “sugar tax”) have also been introduced and seen product reformulation.

In 2017, we published our review for Food Standards Scotland on policies that could be developed to intervene in the in-store retail environment. The approach suggested was to focus on disrupting and altering the context and choice architecture faced by consumers in retail stores. By better understanding how retailers construct the in-store environment (“what consumers see”), the possible steps to intervene to improve the choice architecture and situational context can be understood. There are a range of possible interventions that can be developed, but real issues in the scope, scale and practicalities of possible policy, as well as its acceptance.

It is clear that the current situation is unsustainable and that emphasising personal responsibility in such an unfair context will not work. The environment needs to be rebalanced and it is clear that this will not happen voluntarily.

Thus, between October 2018 and January 2019 the Scottish Government consulted on possible restrictions on promotion and marketing in retailing (and other out of home consumption sites) of foods that have next to nil nutritional value. This would constitute a ground-breaking set of interventionist policies on retail (and other sector) operations and if taken forward into policy would rebalance the retail environment. It would restrict the ability to promote (in the widest possible sense, and including price, place, position and visual merchandising) many unhealthy discretionary food and drink products.

There will be resistance to this approach, both from consumers (“the nanny state”) and the various industry sectors involved in the supply chains. Policy has to be drafted carefully to minimise unintended consequences e.g. on small stores, sectors and the internet. It is also clear that such policy alone is not the answer; food consumption is a multi-faceted construct and needs to be addressed accordingly. However it is clear that the current state is unsustainable and has to be challenged and that a reconstruction of the in-store environment would be a major step forward.

Scotland is not unique in having these issues, though it has distinctive problems. The steps that have been taken and are potentially in the pipeline are strong responses to these problems. But, they are necessary to address our health crisis. There are potential lessons for other countries, though they will undoubtedly have to be tailored for specific situations.”

Slides from my presentation can be found at on the Stirling Retail blog.

This article was first published on the Stirling Retail blog on 25 March 2019.

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