Abstract
Key actors engaged in debate on obesity in Australia and the UK subscribe to radically different narratives about the nature, extent and even existence of this public health problem. Yet there is a common thread to these clashing narratives: evidence. All are emphatic that their story is ‘evidence-based’. In this paper, I seek to examine this state of affairs by looking at how actors think about, use and interpret evidence across a range of sites of policy debate on this issue. In doing so, I contribute to academic inquiry about the place of evidence in democratic deliberation. Firstly, I find that there is a high degree of consensus among actors who promote differing interpretations of the issue on what evidence means and entails in the abstract. Secondly, I find that the differing narratives on obesity are underpinned by different interpretations of the evidence, but that internal inconsistencies affect each of these competing narratives as well. As such, I argue that policy actors should not be seen just as strategically marshalling convenient evidence to support a preconceived cause. Overall, I suggest that these findings have mixed implications for democratic deliberation on the issue, enhancing the deliberative side of the equation but undermining the democratic. I then point to ways in which the goals of evidence-based and democratic policymaking on this issue may be further reconciled.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Notes
Flyvbjerg makes the point that case researchers in the social sciences ‘must be prepared’ to accommodate and acknowledge that the case they select, and the reasons it is important, differ from their expectations. This also accords with the abductive logic of interpretive inquiry, as described at length in Schwartz-Shea and Yanow (2012).
Though the term ‘coalition’ implies a concerted or deliberative coming together, Hajer explains that convergence on a common narrative (or ‘storyline’) is often unconscious, and that actors who would not consider themselves allies can often be part of the same coalition.
Though the BMI is typically used as a tool in studies of obesity rates, it is known to be imprecise (see Botterill 2006). Moral Panic adherents pounce on this imprecision to question the validity of estimates on obesity rates and links to ill-health (see Guilliatt 2009). The vast majority of actors engaged in debate, however, see these complaints as overblown and insist that, at a population level, the BMI is sufficiently accurate.
The Cochrane and Campbell Collaborations are organizations which undertake and collate systematic reviews of the scientific evidence on topics in the social and medical sciences respectively. See: http://www.cochrane.org/; and http://www.campbellcollaboration.org/.
This is a point that builds on Hajer’s 1995 well-known discussion of the acid rain storyline in the UK and the Netherlands, where he finds elements of contradiction or incoherence across the discourse coalitions in his analysis.
The conflicting epistemological assumptions on display in this analysis are typical of conflicts found within scientific communities. They reflect the different approaches that scientists take to issues of certainty and confidence, and how these manifest in the manner in which they engage in other venues of public deliberation (see Lahsen 2008).
This represents a policy-oriented manifestation of what Gilbert and Mulkay (1984) identify as the ‘the truth will out’ device—a belief that though much is immediately uncertain and contestable, in the long run science can provide clear-cut and accurate answers—which enables scientists’ to reconcile the messy, contested social world they inhabit with their professional identity.
References
Aphramor, L. (2009). All shapes and sizes. The Guardian, May 9.
Banwell, C., Broom, D., Davies, A., & Dixon, J. (2013). Weight of modernity: An intergenerational study in the rise of obesity. New York: Springer.
Berg, C. (2008). Tackling obesity—Should the public pay? The case against. Sunday Age, January 6.
Boswell, J., Niemeyer, S., & Hendriks, C. M. (2013). Julia Gillard’s citizens’ assembly for Australia: A deliberative democratic analysis. Australian Journal of Political Science, 48(2), 164–178.
Botterill, L. (2006). Leaps of faith in the obesity debate: A cautionary note for policy-makers. The Political Quarterly, 77(4), 493–500.
Botterill, L., & Hindmoor, A. (2012). Turtles all the way down: Bounded rationality in an evidence-based age. Policy Studies, 33(5), 367–379.
Campbell, D. (2010). Call for more obesity surgery to cut benefits and NHS bills. The Guardian, September 7.
Campos, P. (2004). The obesity myth: Why America’s obsession with weight is hazardous to your health. New York: Gotham Books.
Chambers, S. (2003). Deliberative democratic theory. Annual Review of Political Science, 6, 307–326.
Cowell, L. (2010). The women who want to be obese. The Guardian, March 18.
Dixon, J., & Broom, D. H. (Eds.). (2007). The seven deadly sins of obesity: How the modern world is making us fat. Sydney: UNSW Press.
Dryzek, J. S. (1990). Discursive democracy: Politics, policy, and political science. Cambridge: Cambridge University Press.
Elster, J. (Ed.). (1998). Deliberative democracy. London: Cambridge University Press.
Estlund, D. (1997). Beyond fairness and deliberation: The epistemic dimension of democratic authority. In J. Bohman & W. Rehg (Eds.), Deliberative democracy: Essays on reason and politics. Cambridge, MA: The MIT Press.
Farrelly, E. (2009). The fat of the land. Sydney Morning Herald, June 18.
Fischer, F. (1995). Evaluating public policy. Chicago: Nelson-Hall.
Fischer, F. (2003). Reframing public policy—Discursive politics and deliberative practices. Oxford: Oxford University Press.
Flyvbjerg, B. (2006). Five misunderstandings about case-study research. Qualitative Inquiry, 12(2), 219–245.
Foresight. (2007). Tackling obesities: Future choices—Project report (The Foresight Report). London: The Stationery Office.
Freiberg, A., & Carson, W. G. (2010). The limits to evidence-based policy: Evidence, emotion and criminal justice. Australian Journal of Public Administration, 69(2), 152–164.
Gard, M., & Wright, J. (2001). The obesity epidemic. Science, morality and ideology. New York: Routledge.
Gastil, J. (2008). Political communication and deliberation. Thousand Oaks, CA: Sage.
Gilbert, G. N., & Mulkay, M. (1984). Opening Pandora‘s box: A sociological analysis of scientists’ discourse. Cambridge: Cambridge University Press.
Greenhalgh, T., & Russell, J. (2006). Reframing evidence synthesis as rhetorical action in the policy making drama. Healthcare Policy, 1(2), 34–42.
Guilliatt, R. (2009). Off the scale. The Australian, 8 May.
Gutmann, A., & Thompson, D. (1996). Democracy and disagreement. Cambridge: The Belknap Press.
Hajer, M. A. (1995). The politics of environmental discourse: Ecological modernization and the policy process. Oxford: Clarendon Press.
Henderson, J., House, E., Coveney, J., Meyer, S., Ankeny, R., Ward, P., et al. (2013). Evaluating the use of citizens’ juries in food policy: A case study of food regulation. BMC Public Health, 13, 596.
Hendriks, C. M. (2007). Praxis stories: Experiencing interpretive policy research. Critical Policy Studies, 1(3), 278–300.
Henry, J. (2008). ‘Obesity crusade’ drives children to anorexia. The Daily Telegraph, April 20.
Hess, D. J. (2004). Medical modernisation, scientific research fields, and the epistemic politics of health social movements. Sociology of Health & Illness, 26(6), 695–709.
Hood, C. (1991). A public management for all seasons? Public Administration, 69, 3–19.
Hoppe, R. (1999). Policy analysis, science and politics: From ‘speaking truth to power’ to ‘making sense together’. Science and Public Policy, 26(3), 201–210.
Innes, J. (1990). Knowledge and public policy: The search for meaningful indicators (2nd ed.). New Jersey: Transaction.
John, P. (1998). Analysing public policy. London: Continuum.
Jolly, R. (2011). Marketing obesity? Junk food, advertising and kids. Research Paper no. 9, 2010–11, Australian Parliamentary Library, Canberra.
Lahsen, M. (2008). Experiences of modernity in the greenhouse: A cultural analysis of a physicist ‘trio’ supporting the backlash against global warming. Global Environmental Change, 18, 204–219.
Lang, T., & Rayner, G. (2007). Overcoming policy cacophony on obesity: An ecological public health framework for policymakers. Obesity Reviews, 8, 165–181.
Lowy, I. (1992). The strength of loose concepts—Boundary concepts, federated experimental strategies and disciplinary growth: the case of immunology. History of Science, 30, 371–396.
Marmot, M. (2010). Ignorance is as big a killer as obesity. The Observer, August 15.
Milewa, T., & Barry, C. (2005). Health policy and the politics of evidence. Social Policy and Administration, 39(5), 498–512.
Milne, S. (2010). The corporate grip on public life is a threat to democracy. The Guardian, November 17.
Nutley, S., Davies, H., & Smith, P. (2000). What works? Evidence-based policy and practice in public services. Bristol: The Policy Press.
O’Dea, J. A. (2010). Developing positive approaches to nutrition education and the prevention of child and adolescent obesity: First, do no harm. In J. A. O’Dea & M. E. Eriksen (Eds.), Childhood obesity prevention—International research, controversies and interventions (pp. 31–42). Oxford: Oxford University Press.
Orsini, M., & Scala, F. (2006). Every virus tells a story: Toward a narrative centred approach to health policy. Policy and Society, 25(2), 109–130.
Ospina, S., & Dodge, J. (2005). It’s about time: Catching method up to meaning—The usefulness of narrative inquiry in public administration research. Public Administration Review, 65(2), 143–157.
Parsons, W. (2002). From muddling through to muddling up: Evidence based policy making and the modernization of British government. Public Policy and Administration, 17(3), 43–60.
Preventative Health Taskforce. (2009). Australia: The healthiest country by 2020. Canberra: Australian Government, Department of Health and Ageing.
Proietto, J. (2008). Surgery will do more than education to fix the obesity epidemic. The Age, February 19.
Randall, J. (2009). We’re in denial: Afraid to face up to the real causes of recession. The Daily Telegraph, February 5.
Roe, E. (1994). Narrative policy analysis: Theory and practice. Durham, NC: Duke University Press.
Ryan, S., & Bita, N. (2009). Childhood obesity epidemic a myth, says research. The Australian, January 9.
Sammut, J. (2008). CIS submission to the standing Committee on Health and Ageing. Canberra: Inquiry into Obesity in Australia, House of Representatives, Australian government.
Schwandt, T. (1997). Evaluation as practical hermeneutics. Evaluation, 3, 69–83.
Schwartz-Shea, P., & Yanow, D. (2012). Interpretive research design: Concepts and processes. New York: Routledge.
Shugart, H. A. (2011). Shifting the balance: The contemporary narrative of obesity. Health Communication, 26(1), 37–47.
Smith, G. (2005). Power beyond the ballot: 57 democratic innovations from around the world. London: The Power Inquiry.
Stone, D. A. (2002). Policy paradox and political reason: The art of political decision making, revised edn. WW Norton & Company, New York.
Swierstra, T. (2011). Behaviour, environment or body: Three discourses on obesity. In M. Korthals (Ed.), Genomics, obesity and the struggle over responsibilities (Vol. 18, pp. 27–38). London: Springer.
Tenbensel, T. (2006). Policy knowledge for policy work. In H. K. Colebatch (Ed.), The work of policy: An international survey (pp. 199–216). Lanham: Lexington Books.
The Australian. (2008). More nanny state. The Australian, May 19. http://www.theaustralian.com.au/news/more-nanny-state/story-e6frg72o-1111116374935. Accessed January 17, 2013.
Throgmorton, J. A. (1991). The rhetorics of policy analysis. Policy Sciences, 24(2), 153–179.
Toynbee, P. (2007). We need to start a social revolution by truly putting children first. The Guardian, October 19. http://www.guardian.co.uk/commentisfree/2007/oct/19/comment.children. Accessed January 18, 2013.
Wood, M., Ferlie, E., & Fitzgerald, L. (1998). Achieving clinical behaviour change: A case of becoming indeterminate. Social Science and Medicine, 47(11), 1729–1738.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Boswell, J. ‘Hoisted with our own petard’: evidence and democratic deliberation on obesity. Policy Sci 47, 345–365 (2014). https://doi.org/10.1007/s11077-014-9195-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11077-014-9195-4