Policy Ideation, Actors, and Institutional Dynamics: A Historical Institutional Analysis of Childhood Obesity Policies in Australia

Susannah L Nichols

Childhood obesity is a complex policy problem that policymakers within Australia have yet to solve. Nearly one in four Australian children are overweight or obese, a rate that has remained unchanged for almost three decades. As a result, it has become an important issue for governments and policymakers. The dominant policy approach across Australia emphasises addressing individual health behaviours through physical activity and diet changes. However, as suggested by the ongoing rate of childhood obesity, policies introduced to address the issue are not producing the intended change. Evidence suggests that policy change is needed in the form of addressing systemic/environmental drivers of childhood obesity, alongside policies addressing individual health behaviours. Despite this, governments at the state and federal levels continue to implement policies that target individuals instead of their environment. Thus, the key research question explored in this thesis is why, despite the evidence for systemic policy change, the dominant policy narrative remains centred around individual responsibility. Specifically, this research examines the dynamics of policy change within childhood obesity policy and how this process has promoted an individual health-based conception of the issue. It looks at the interaction between actors and institutions in filtering policy ideas to preference those that align with the narrative of individual responsibility and marginalises alternative ideas that target systemic drivers. It is argued that the process of policy change has been reinforced over time by policy actors whose perceptions and decisions are shaped by their institutional context. This has led to a situation where policy change has been incremental. This research employs a historical institutionalism frame to explore how the interaction of actors, ideas, and institutions has shaped childhood obesity policy processes in Australia. This framework enables an understanding of how actors interact within their institutional environment and how this influences their decision-making. It provides a framework to understand the dominant policy paradigm that embodies childhood obesity policy across Australia. Policy actors operating within their established institutional setting can ‘lock in’ a policy trajectory. This research applies a structured methodology within historical institutionalism. It uses state and federal Hansard parliamentary records as the primary data source to trace policy debates across Australia from 1970 to 2022. Hansard data provides contextual insight that informs how the issue was conceptualised and subsequent decisions – parliamentarians explain their position and decisions within the records. Additionally, interviews were conducted with policy actors currently engaged in childhood obesity policy ideation. This provides complementary insight into how policy actors currently conceive the issue and any potential barriers to policy change. These data sources are synthesised and examined through the lens of historical institutionalism to inform the research findings. The research identifies three key themes that explain the process of policy change and policy ideation within the issue of childhood obesity: incremental change and policy layering, contradictions and tensions in policy ideation, and institutional influence and actor dynamics. These themes demonstrate how childhood obesity policy ideation has been reinforced over time by incremental change through policy layering. However, this was seen to produce contradictions and tensions. Firstly, incremental policy change has achieved stability within the policy trajectory. Secondly, actors perpetuate incremental change and reinforce the established policy approach despite acknowledging its deficiencies in addressing childhood obesity. Yet, this can be explained through policy actors’ interests being embedded within their institutional context. As a result, actors are seen to make decisions that reinforce their institutional context instead of transforming it – this has further embedded the individual responsibility narrative within childhood obesity policy ideation and prevented transformative change within the issue. This research shows significance across three key areas. Firstly, it demonstrates the value of historical institutionalism in identifying and understanding policy change dynamics, including the drivers and barriers. Secondly, the research offers a framework that enables policy stakeholders to consider how to navigate institutional constraints and embedded narratives that shape policy ideation. It suggests a role for broadening policy communities around an issue – this may challenge dominant policy frames to enable engagement with alternative policy ideas. Finally, this research builds on the health policy literature, with a specific focus on the Australian context. It broadens the application of historical institutionalism in this field, emphasising policy layering and the dynamics of health policy change. Overall, this research provides a building block for future studies in historical institutionalism, health policy, and change.

Policy Ideation, Actors, and Institutional Dynamics: A Historical Institutional Analysis of Childhood Obesity Policies in Australia

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