Is ‘Health in All Policies’ everybody’s responsibility? Discourses of multistakeholderism and the lifestyle drift phenomenon

ABSTRACT

In relation to health promotion, the lifestyle drift is a phenomenon whereby health policymakers begin with a recognition of the social, political and economic determinants of health (‘distal’ determinants of health), only to drift back into designing policies targeted largely at modifying individual behavior (‘proximal’ determinants of health). Looking at the ‘Health in All Policies’ (HiAP) agenda in the European Commission (EC), this article investigates the discursive construction of the lifestyle drift. It starts by analyzing why, in the EC context, HiAP is interpreted as inherently about multistakeholder engagement. It then draws on the EU Diet Platform as a contrasting example to explore the relation between this multistakeholder interpretation and the lifestyle drift. The article then unpacks the discursive legitimation of the multistakeholder rationale, and shows how multistakeholder engagement is presented as a reasonable and normatively neutral way to approach public policy problems. Finally, the article critically reflects upon the technocratizing effects of the normatively neutral language deemed to be required of policy-relevant knowledge.

KEYWORDS:

• Health promotion
• lifestyle drift
• multistakeholder governance
• interpretive policy analysis
• critical discourse analysis

Acknowledgments

Acknowledgements: I would like to thank the two anonymous reviewers for their thorough engagement with the article and their extremely constructive and encouraging feedback. Many thanks also to Gabriel Siles- Brügge, Simon Rushton, Owen Parker, and Meri Koivusalo. I would also like express my gratitude to all the research interviewees for their time and insights.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1. However, chameleonic ideas do not necessarily originate in academia: another example would be the EU Better Regulation agenda (Smith et al. 2015; European Commission 2015) (see section 3.2.)

2. Interviewees 27, 31, 32, 33, 34.

3. Interviewees 27 and 31.

4. See EU Council Conclusions on Common values and principles in European Union Health Systems (2006/C 146/01).

5. Interviewee 32.

6. Interviewees 31 and 32.

7. Interviewee 32.

8. Interviewees 1 and 13.

9. Interviewees 1, 9, 12, 20, 26.

10. Interviewee 1.

11. Interviewees 1, 2, 4, 6, 10, 13.

12. The yearly meeting frequency decreased from initially five, to now only two.

13. Interviewees 1, 9, 13, 20, 26.

14. Interviewee 9.

15. Interviewees 3, 7, 8, 28, 29.

16. Interviewees 13 and 16.

Additional information

Funding

This article was written in the frame of Charlotte Godziewski’s PhD research, undertaken in the Department of Politics and International Relations at the University of Sheffield. Her project was funded by the Department of Politics Anniversary Studentship 2016. The argument as well as sections of the paper have been integrated in the thesis

Notes on contributors

Charlotte Godziewski

Charlotte Godziewski is a lecturer in Sociology and Policy at Aston University. Her current research focuses on the political determinants of non-communicable diseases in the EU. Previous publications include: Godziewski, C. (2020) Evidence and Power in EU Governance of Health Promotion: Discursive Obstacles to a ‘Health in All Policies’ Approach. Journal of Common Market Studies. DOI: https://doi.org/10.1111/jcms.13042