A Qualitative Exploration of the Barriers and Enablers to New Zealand City Councils Developing and Implementing Food and Nutrition Policy

Background: Diet- related non communicable diseases and obesity are the biggest cause of ill health and mortality in New Zealand. Current government public health approaches do not appear to be effective in preventing non- communicable diseases and obesity as rates continue to increase. To combat the obesity epidemic research suggests government regulative policy which positively shapes food environments is needed. New Zealand’s current government’s ideologies’ reject public health nutrition regulative policy so are unlikely to be an effective agency to reduce obesity and non- communicable disease rates. Local Authorities have been proposed as an alternative government organisation that has the ability to positively influence local food environments through developing and implementing food and nutrition policy. However, no New Zealand Local Authorities have food and nutrition policy and currently, there is no research regarding Local Authority food and nutrition policy in a New Zealand context. Objective: This research project aims to explore factors which enable, hinder and influence New Zealand City Councils’ ability to develop and implement food and nutrition policy. Methods: This public health nutrition study is set in a policy context so qualitative research was used to explore the social and organisational factors influencing City Councils’ development of food and nutrition policy that supports health food environments. Semi- structured in depth telephone and face-to-face interviews were carried out with 21 participants with representation from each of the 12 City Councils and Auckland Council. These interviews consisted of nine core questions which were informed by a review of the literature. All interviews were recorded and selectively transcribed. A general inductive approach was used to thematically analyse the data to categorise it into six major themes underpinned by minor themes. A single case study design was used to portray emerging themes and to understand the context of New Zealand City Councils’ capacity to develop food and nutrition policy. Results: The results of this study identified an array of factors which influenced City Councils’ decision making to develop and implement food and nutrition policy to improve local food environments. Six overarching categories emerged as being prominent to explaining City Councils’ capacity to influence food environments. These categories are council resources, community influence, political factors, long term plans, national-level governments and research, case studies and nutrition guidelines. All of these influencing factors had the potential to act as a barrier or an enabler dependant on the local political environment. The main finding is City Councils’ have the capacity to develop food and nutrition policy when there is a widespread awareness and prioritisation of food environment issues in the agenda of three key groups; the community, elected members of council and council staff. Conclusion: New Zealand City Councils capacity to develop and implement food and nutrition policy is determined by a host of external, internal, national and local influence factors. A multi pronged approach of strong local political support, partnerships, credible champions and local or case study research are needed for food environment issues to be addressed by City Councils through the LTP and subsequent food and nutrition policy. To achieve this New Zealand’s public health community need to be active advocates at a City Council level and be involved with activating communities and raising awareness around food and nutrition issues