Situating commercial determinants of health in their historical context: a qualitative study of sugar-sweetened beverages in Jamaica.
Situating commercial determinants of health in their historical context: a qualitative study of sugar-sweetened beverages in Jamaica.
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DOI：
10.1186/s12992-023-00962-5
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发表时间：
2023-09-12
影响因子：
10.8
通讯作者：
Guell, Cornelia
中科院分区：
文献类型：
--
作者：
Barnett-Naghshineh, Olivia;Warmington, Sheray;Altink, Henrice;Govia, Ishtar;Morrissey, Karyn;Smith, Matthew J.;Thurstan, Ruth H.;Unwin, Nigel;Guell, Cornelia
关键词：
非传染性疾病是整个加勒比和类似区域的主要死亡原因。结构性决定因素包括对粮食进口的依赖显著增加，以及加工食品，包括加糖饮料的扩散。我们把牙买加作为一个案例研究和SSB的健康挑战，并将当代行动，经验和政策置于其历史背景下，以调查健康的商业决定因素的潜在驱动因素，并试图应对这些因素。我们问：牙买加高水平SSB消费驱动因素的历史视角如何有助于加深对旨在减少其摄入量的公共卫生政策背景的理解？远程数据收集的人种学方法包括与牙买加22名当地卫生、农业和营养专家和从业人员进行在线半结构化访谈和举办讲习班，并参加加勒比地区关于SSBs和非传染性疾病行动的相关区域公共网络研讨会。我们的分析是在对加勒比粮食经济的历史研究进行审查的基础上进行的，重点是二十世纪。牙买加和英国的研究人员收集并从人种学角度分析了这些数据，并与更广泛的跨学科团队讨论了调查结果。我们强调三个关键领域的历史事件塑造了SSB消费的背景因素。在牙买加漫长的殖民历史中，糖作为经济作物的贸易地位高于粮食生产，1980年代以来，通过结构调整放松了对贸易的管制，为跨国公司打开了市场。这些变化增加了牙买加对这些公司的大规模广告和营销的接受度，而长期的权力不平衡阻碍了当代公共卫生行动的税收和监管。民间社会的努力对于促进结构性变革以遏制SSB的过度消费和下放这种根深蒂固的权力关系至关重要。牙买加SSBs当前面临的挑战是一个深刻的案例研究，涉及健康的商业决定因素、全球市场驱动型经济的重要背景以及私营部门利益参与公共卫生政策和治理。从历史上看，将这些决定因素置于背景中对于理解当今牙买加的制糖生态至关重要，并且可以帮助阐明根深蒂固的权力动态及其关键参与者。
Non-communicable diseases (NCDs) are the leading cause of mortality across the Caribbean and similar regions. Structural determinants include a marked increase in the dependency on food imports, and the proliferation of processed foods, including sugar-sweetened beverages (SSBs). We focused on Jamaica as a case study and the health challenge of SSBs, and situated contemporary actions, experiences and policies within their historical context to investigate underlying drivers of commercial determinants of health and attempts to counter them. We asked: how can a historical perspective of the drivers of high level SSB consumption in Jamaica contribute to an enhanced understanding of the context of public health policies aimed at reducing their intake? An ethnographic approach with remote data collection included online semi-structured interviews and workshops with 22 local experts and practitioners of health, agriculture and nutrition in Jamaica and attending relevant regional public webinars on SSBs and NCD action in the Caribbean. Our analysis was situated within a review of historical studies of Caribbean food economies with focus on the twentieth century. Jamaican and UK-based researchers collected and ethnographically analysed the data, and discussed findings with the wider transdisciplinary team. We emphasise three key areas in which historical events have shaped contextual factors of SSB consumption. Trade privileged sugar as a cash crop over food production during Jamaica’s long colonial history, and trade deregulation since the 1980s through structural adjustment opened markets to transnational companies. These changes increased Jamaican receptiveness to the mass advertisement and marketing of these companies, whilst long-standing power imbalances hampered taxation and regulation in contemporary public health actions. Civil society efforts were important for promoting structural changes to curb overconsumption of SSBs and decentring such entrenched power relations. The contemporary challenge of SSBs in Jamaica is a poignant case study of commercial determinants of health and the important context of global market-driven economies and the involvement of private sector interests in public health policies and governance. Historically contextualising these determinants is paramount to making sense of the sugar ecology in Jamaica today and can help elucidate entrenched power dynamics and their key actors.
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DOI：
10.1136/bmj.h3576
发表时间：
2015-07-21
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Imamura F;O'Connor L;Ye Z;Mursu J;Hayashino Y;Bhupathiraju SN;Forouhi NG
通讯作者：
Forouhi NG
影响因子：
1
作者：
Hatch, Anthony Ryan;Sternlieb, Sonya;Gordon, Julia
通讯作者：
Gordon, Julia
影响因子：
5.4
作者：
Guell, Cornelia;Brown, Catherine R.;Unwin, Nigel
通讯作者：
Unwin, Nigel
影响因子：
4.5
作者：
Paraje G;Gomes FS
通讯作者：
Gomes FS
影响因子：
10.8
作者：
Abdool Karim S;Kruger P;Hofman K
通讯作者：
Hofman K