Hostname: page-component-7c8c6479df-94d59 Total loading time: 0 Render date: 2024-03-29T01:54:21.233Z Has data issue: false hasContentIssue false

An accountability framework to promote healthy food environments

Published online by Cambridge University Press:  25 February 2014

Vivica I Kraak*
Affiliation:
World Health Organization Collaborating Centre for Obesity Prevention, Deakin Population Health Strategic Research Centre, School of Health and Social Development, Faculty of Health, Deakin University, 221 Burwood Highway, Melbourne, Victoria 3125, Australia
Boyd Swinburn
Affiliation:
Population Nutrition and Global Health, University of Auckland, Auckland, New Zealand
Mark Lawrence
Affiliation:
Public Health Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Burwood, Victoria, Australia
Paul Harrison
Affiliation:
School of Business, Faculty of Business and Law, Deakin University, Burwood, Victoria, Australia
*
*Corresponding author: Email vivica.kraak@gmail.com
Rights & Permissions [Opens in a new window]

Abstract

Objective

To review the available literature on accountability frameworks to construct a framework that is relevant to voluntary partnerships between government and food industry stakeholders.

Design

Between November 2012 and May 2013, a desk review of ten databases was conducted to identify principles, conceptual frameworks, underlying theories, and strengths and limitations of existing accountability frameworks for institutional performance to construct a new framework relevant to promoting healthy food environments.

Setting

Food policy contexts within high-income countries to address obesity and diet-related non-communicable diseases.

Subjects

Eligible resources (n 26) were reviewed and the guiding principles of fifteen interdisciplinary frameworks were used to construct a new accountability framework.

Results

Strengths included shared principles across existing frameworks, such as trust, inclusivity, transparency and verification; government leadership and good governance; public deliberations; independent bodies recognizing compliance and performance achievements; remedial actions to improve accountability systems; and capacity to manage conflicts of interest and settle disputes. Limitations of the three-step frameworks and ‘mutual accountability’ approach were an explicit absence of an empowered authority to hold all stakeholders to account for their performance.

Conclusions

We propose a four-step accountability framework to guide government and food industry engagement to address unhealthy food environments as part of a broader government-led strategy to address obesity and diet-related non-communicable diseases. An independent body develops clear objectives, a governance process and performance standards for all stakeholders to address unhealthy food environments. The empowered body takes account (assessment), shares the account (communication), holds to account (enforcement) and responds to the account (improvements).

Type
HOT TOPIC – The WHO)s 2004 global strategy on diet, physical activity, and health: status and renewal of effort
Copyright
Copyright © The Authors 2014 

Policy action to improve food environments exists at three levels: (i) development; (ii) implementation; and (iii) monitoring and evaluation. As rates of obesity and non-communicable diseases (NCD) increase worldwide(1), norm-setting institutions such as the WHO recommend that national governments have primary responsibility and authority to develop policies that create equitable, safe, healthy and sustainable food environments to prevent and control obesity and diet-related NCD(26).

Expert bodies recommend that governments engage all societal sectors to successfully reduce NCD(3). Diverse stakeholders can share responsibility to implement, monitor and evaluate policies without compromising the integrity of these efforts(27). However, national governments are increasingly sharing or relinquishing their responsibility for policy development with non-governmental stakeholders, especially unhealthy commodity industries that manufacture and market fast foods, sweetened beverages and alcohol, which is discouraged(Reference Swinburn, Sacks and Hall811).

A century ago, the US Supreme Court Justice, Louis Brandeis, emphasized the need for public information disclosure and law enforcement to hold the government and corporations accountable for their impacts on society(Reference Brandeis12). He is often remembered for the quote: ‘Publicity is justly commended as a remedy for social and industrial diseases. Sunlight is said to be the best of disinfectants; electric light the most efficient policeman.’

This observation is salient today to guide national governments’ engagement strategy with private-sector businesses and non-governmental organizations (NGO) to address unhealthy food environments and improve population health outcomes.

Governments are accountable to the people who elect them and are expected to protect the policy-making process from commercial interests by upholding robust standards to promote public interests over private interests, ensure transparency and manage conflicts of interest(Reference Swinburn, Sacks and Hall811). Some contend that there has been very limited progress to develop policies that support healthy food environments due to commercial interest-group pressures on government policy(Reference Swinburn, Sacks and Hall811).

The purpose of the present paper is to describe the current food policy-making context at the global level and in high-income countries before conducting an interdisciplinary evidence review of principles, frameworks and underlying theories about accountability for institutional performance. The results are used construct a new accountability framework to address unhealthy food environments. We discuss this framework using examples from high-income countries, which are relevant to government, food industry and NGO in low- and middle-income countries, to address obesity and diet-related NCD.

Background

The global context

The WHO's 2004 Global Strategy on Diet, Physical Activity and Health(2) emphasized different priorities for government, businesses and NGO. Governments are responsible for developing policy to support healthy food environments and ensure that all stakeholders follow recommended guidelines and laws. Businesses are responsible for adhering to laws and international standards, and NGO are responsible for influencing consumer behaviour and encouraging other stakeholders to support positive efforts.

Nearly a decade later, explicit language was included in the WHO's 2013–2020 global action plan to prevent and control NCD that encouraged collaborative partnerships among government agencies, civil society and the private sector to reduce NCD by 25 % by 2025(3). The resolution approved by 194 Member States encouraged national governments to ‘ensure appropriate institutional, legal, financial and service arrangements to prevent and control NCDs’(3). The WHO Director, Dr Margaret Chan, has criticized the food industry for opposing government regulation by blaming obesity on a lack of individual willpower instead of acknowledging the failure of governments to regulate ‘Big Business’(11).

Governments are faced with managing power imbalances that influence policy, institutionalized norms and governance processes. Accountability involves how and why decisions are made, who makes decisions, how power is used, whose views are important and who holds decision makers to account(Reference Rochlin, Zadek and Forstater13). Without strong and independent accountability structures, governments are unlikely to implement actions to manage the power imbalances that can influence the policy development and governance processes(Reference Muntaner, Ng and Chung14) to achieve the WHO's global target to reduce NCD morbidity and mortality(Reference Beaglehole, Bonita and Horton15).

In July 2013, the UN Economic and Social Council established a WHO-led Interagency Task Force to coordinate and implement all UN organizational activities supporting the WHO's 2003–2020 global NCD action plan(16). The Task Force represents a transnational governance structure to advise governments, NGO and the private sector on how to reduce obesity and diet-related NCD while safeguarding public health from potential conflicts of interest(16).

Food environments

Food environments are conceptualized and interpreted in different ways(Reference McKinnon, Reedy and Morrissette1722). Empirical research suggests that food environments influence the dietary choices, preferences, quality and eating behaviours of individuals and populations(Reference McKinnon, Reedy and Morrissette1722) at local, national and global levels. In the present paper, healthy food environments are defined as the collective economic, policy and sociocultural conditions and opportunities(Reference Swinburn, Egger and Raza21) across sectors (i.e. macro, meso and micro) and settings (i.e. home, schools, worksites, food retail outlets) that provide people with regular access to a healthy diet to achieve a healthy weight to prevent obesity and diet-related NCD (Fig. 1)(Reference Story, Kaphingst and Robinson-O'Brien2022).

Fig. 1 A socio-ecological model illustrating stakeholders involved in promoting healthy food environments for populations (adapted from references 20–22)

Guidelines for a healthy diet encourage a variety of nutrient-dense foods and modest consumption of energy-dense foods to help people maintain a healthy weight(2, 4, 5, 7, 23, Reference Mozaffarian, Afshin and Benowitz24).

An unhealthy diet is linked to poorer health outcomes(Reference Pérez-Escamilla, Obbagy and Altman25) because it encourages people to overconsume energy, total fat, saturated fat, trans-fats, added sugars and salt(Reference Lin and Guthrie26, Reference Popkin, Duffey and Gordon-Larsen27).

Unhealthy diets and food environments drive three major NCD contributing to premature morbidity and mortality(1, 3). In 2010, seven of the top twenty deaths and disabilities worldwide were related to poor diet(Reference Lozano, Naghavi and Foreman28) and excessive salt consumption and inadequate fruit and vegetable intake contributed 10 % of the global burden of disease(Reference Lim, Vos and Flaxman29).

Government responsibility shifting to the private and non-governmental organization sectors

Since the 1970s, many Western democracies have embraced neoliberal governance models that support government de-regulation, privatization of public services and devolution of government responsibility to the private sector and NGO through public–private partnerships to address complex societal problems(Reference Guthman30Reference Peck and Tickell32).

These trends have produced three outcomes. First, national governments have embraced private-interest language that has shifted the state's responsibility to address social problems from collective concerns to individual or family concerns requiring self-help solutions(Reference Guthman30Reference Peck and Tickell32). Second, major public policy choices are framed as what governments can afford rather than what will benefit the public's interests(Reference Guthman30Reference Peck and Tickell32). Third, private entities have used government legislative and legal institutions to secure corporate privileges over citizens’ rights(Reference Guthman30, Reference Wilst33, Reference Piety34).

Neoliberal approaches have fostered governance gaps in an era of industry self-regulation. Certain global food industry stakeholders have used their economic and political power to set policy agendas; engage in corporate lobbying and political campaign financing to legitimize commercial interests; and influence the regulatory decisions of government agencies(Reference Clapp and Fuchs35).

Some suggest that governments have conspired with the food industry to prevent meaningful action by using libertarian paternalism (i.e. ‘nudge approach’) and voluntary partnerships as the primary strategies to address unhealthy food environments(Reference Guthman30, Reference Clapp and Fuchs35Reference Bonnell, McKee and Fletcher37) without adequate accountability structures to ensure that societal needs are met.

One example is the Public Health Responsibility Deal Food Network in England that has evoked criticism of voluntary industry engagement approaches because the government has not established consequences for non-participating companies or sectors(Reference Bonnell, McKee and Fletcher37). These concerns highlight the need for clear accountability structures to prevent the ‘corporate capture of public health’, where private-sector stakeholders can circumvent government regulation by encouraging voluntary cooperation through non-adversarial partnerships and oppose government regulation for economic reasons(Reference Mindell, Reynolds and Cohen36, Reference Bonnell, McKee and Fletcher37).

Responses to voluntary partnerships

Strategic alliances and voluntary partnerships are recommended by numerous authoritative bodies(27, 16, 22, Reference Mozaffarian, Afshin and Benowitz24) to address unhealthy food environments, yet these mechanisms were not intended as the central approach of a national obesity and NCD prevention strategy. Several types of voluntary partnerships have emerged to respond to nutrition-related challenges, ranging from undernutrition to obesity and diet-related NCD(Reference Kraak, Harrigan and Lawrence38). These partnerships remain controversial because evidence of their effectiveness to address specific food environment objectives, without undermining public health goals, is lacking(Reference Moodie, Stuckler and Monteiro10, Reference Kraak, Swinburn and Lawrence39Reference Grynbaum42).

The food industry complex is comprised of many private-sector stakeholders who interact in different ways with government and other public and private entities to influence consumer demand and promote food and beverage product purchases and consumption(Reference Story, Kaphingst and Robinson-O'Brien2022) (Fig. 1).

Food industry stakeholders have responded to obesity and NCD in several ways.

Some have formed alliances and partnerships at global(43), regional(4447) and national(4850) levels by committing to food product reformulation or developing new products with healthier nutrient profiles by reducing salt, energy and saturated fat, and eliminating trans-fats(4345, 4750); implementing community-based obesity prevention programmes(45, Reference Van Koperen, Jebb and Summerbell46); providing nutrition information, out-of-home energy (calorie) and front-of-package labelling to inform marketplace purchases(43, 4951); and improving the quality of foods advertised and marketed to children and adolescents(43, 45, 52, 53) (Table 1). Industry alliances and companies also have disseminated reports outlining their accomplishments(48, 54) or contracted third-party auditors to assess, verify and report on their performance for more contested issues(55, Reference Vladu, Christensen and Pana56).

Table 1 Examples of food industry alliances and intersectoral partnerships to promote healthy food environments

CEO, chief executive officer; EU, European Union; NGO, non-governmental organization; PAHO, Pan American Health Organization.

Many public-interest NGO, professional societies and academics have observed that large food industry stakeholders have privileged access to policy makers that permits financial and political lobbying to support business interests over public health interests(57Reference Wilst60). Corporate lobbying is one of many practices that has fuelled public-interest NGO distrust of food industry practices including voluntary partnerships to address obesity and NCD rates(9, Reference Moodie, Stuckler and Monteiro10, Reference Stuckler, McKee and Ebrahim61Reference Lumley, Martin and Antonopoulos66). Despite the promise of collaborative approaches(Reference Kraak, Harrigan and Lawrence38) certain public health advocates have deemed them to be ineffective at tackling food environment policy issues(Reference Moodie, Stuckler and Monteiro10). Partnerships alone will not mitigate harmful commercial practices. Government legislation and regulatory oversight are also necessary to address unhealthy food environments(Reference Lumley, Martin and Antonopoulos66Reference Sharma, Teret and Brownell69).

The background literature discussed shows that the issue of voluntary partnerships to address unhealthy food environments has primarily focused on establishing boundaries for stakeholders’ responsibility and measuring their effectiveness to achieve goals. There is limited empirical research on the accountability structures, processes and mechanisms required to build trust and ensure credibility for voluntary partnerships to promote healthy food environments. The current paper fills an important research and policy gap by seeking to integrate principles, conceptual frameworks and theories for institutional accountability to develop a new framework that national governments, food industry and NGO stakeholders can use to collectively promote healthy food environments to address obesity and diet-related NCD.

Design

The present review was guided by two research questions:

  1. 1. What types of accountability frameworks, principles and mechanisms are used to hold major stakeholders accountable for institutional performance to implement specific policies and actions to address unhealthy food environments?

  2. 2. How can these findings inform the development of an accountability framework to hold relevant stakeholders accountable for promoting and not undermining healthy food environments?

The accountability literature was initially explored to identify appropriate search terms. Due to the complexity and breadth of this literature, a systematic review was not used. Instead, an interdisciplinary literature review of ten databases (i.e. Academic Search Complete, Business Source Complete, CINAHL, Global Health, Health Business Elite, Health Policy Reference Center, Health Source, MEDLINE Complete, Political Science Complete and SocINDEX) was conducted over six months (November 2012 through May 2013) for English-language documents (from 1 January 2000 through 31 May 2013) to identify principles, conceptual frameworks and their underlying theories related to accountability for institutional performance. A combination of subject heading and text terms were used to search the databases including: accountability, responsibility, framework, government, industry, corporate, food companies, NGOs, civil society, media, partnerships, alliances, performance, commitment, compliance, legislation and regulation.

A total of 180 peer-reviewed journal articles, reports and books were retrieved, screened by title and abstract, and imported into an Endnote database. Full-text versions of potentially relevant sources were screened and read for inclusion. The reference lists of the included documents were searched and supplemented by the grey literature to identify conceptual frameworks, theories and principles related to accountability for institutional performance.

Results

The findings from twenty-six evidentiary sources based on fifteen existing interdisciplinary frameworks included in the current review are summarized in Table 2. These findings were used to develop a new accountability framework that government and other stakeholders can use to promote healthy food environments.

Table 2 Summary of evidence used from fifteen interdisciplinary frameworks to develop the healthy food environments accountability framework

OECD, Organization for Economic Cooperation and Development; IOM, Institute of Medicine; NCD, non-communicable disease; EU, European Union; NGO, non-governmental organization; CSR, corporate social responsibility.

Discussion

This section provides a synthesis of the frameworks reviewed. Although accountability has several different theoretical underpinnings and meanings across the disciplines of international relations(Reference Grant and Keohane70Reference Steets72), trade(Reference Wolfe and Baddeley73) and development(Reference Joshi74, Reference O'Meally75); global governance for health and human rights(Reference Rochlin, Zadek and Forstater13, 76Reference Bonita, Magnusson and Bovet81); business, finance and social accounting(Reference Deegan82Reference Tilt89); social psychology and behavioural economics(Reference Irani, Sinclair and O'Malley90, Reference Dolan, Hallsworth and Halpern91); and public health policy and law(Reference Gostin9294), there are common principles across these diverse disciplines.

Responsibility involves individuals, groups, government agencies and business firms acknowledging their commitments and obligations based on social, moral and/or legal standards(Reference Turoldo95). Accountability entails individuals or stakeholders answering to others empowered with authority to assess how well they have achieved specific tasks or goals and to enforce policies, standards or laws to improve desirable actions and outcomes. Accountability has traditionally entailed gathering information, monitoring and measuring financial or institutional performance against voluntary or mandatory standards, and using information to improve performance(Reference Rochlin, Zadek and Forstater13, Reference Grant and Keohane7094).

Other accountability principles that are similar across existing frameworks are trust, inclusivity, transparency and verification; government leadership and good governance; public deliberations to respond to stakeholders’ interests and concerns; establishing or strengthening independent bodies (e.g. ombudsman or adjudicator); empowering regulatory agencies and using judicial systems to ensure fair and independent assessments; recognizing compliance and performance achievements with incentives (e.g. carrots) and addressing misconduct or non-performance with disincentives (e.g. sticks); and taking remedial actions to improve institutional performance and accountability systems(Reference Rochlin, Zadek and Forstater13, Reference Grant and Keohane7094).

Accountability expectations for partnerships

The literature shows various accountability expectations for transnational alliances and partnerships depending on their purpose(Reference Steets72). Partnerships that raise awareness and advocate for important issues (e.g. Maternal Child Health Integrated Programme) emphasize compliance with rules and regulations, financial accountability and working towards the partnership's mission. Partnerships intended for self-regulation (e.g. Global Reporting Initiative) emphasize transparency and democratic participation. Partnerships for implementing a policy or programme (e.g. Global Alliance for Improved Nutrition) emphasize stakeholders’ performance for clearly defined objectives and performance outcomes. Partnerships used to generate information (e.g. World Action on Salt for Health) emphasize impartiality through professional independence, accuracy and quality(Reference Steets72).

Strengths and limitations of the frameworks reviewed

Of the fifteen accountability frameworks reviewed, ten were developed for the disciplines of international relations, trade and development(Reference Rochlin, Zadek and Forstater13, Reference Grant and Keohane70Reference Steer and Wanthe77), human rights(79, 80) and global health(Reference Bonita, Magnusson and Bovet81).

One general framework was rooted in business, finance and social accounting(Reference Deegan82Reference Tilt89). Two were rooted in social psychology(Reference Irani, Sinclair and O'Malley90) and behavioural economics(Reference Dolan, Hallsworth and Halpern91); and two were rooted in public health policy and law(Reference Gostin9294). None of the frameworks were specific to promoting healthy food environments.

A strength of the public governance framework(Reference Bovens71) is the consideration of four concurrent factors (i.e. setting, stakeholders, conduct and obligations of interest) to achieve accountability outcomes. Many other frameworks included elements of a coherent accountability system but none integrated all of the cross-cutting accountability principles identified earlier.

Several limitations were apparent for the WHO and UN System's three-step frameworks to ‘monitor, review and act’ or ‘monitor, remedy and respond’(79Reference Bonita, Magnusson and Bovet81). There is a need to differentiate between ‘remedy’ and ‘respond’ for an empowered authority to hold all stakeholders to account. Moreover, several frameworks lacked an explicit step to make system-wide changes to improve accountability structures based on continuous learning.

A four-step framework would include monitoring enforcement while also improving accountability structures.

Two shared governance frameworks(Reference Rochlin, Zadek and Forstater13, 76Reference Ruger78) supported the concept of ‘mutual accountability’ whereby two or more partners agree to be held responsible for voluntary commitments they make to each other. However, mutual accountability arrangements lack enforcement structures, thereby requiring formal independent accountability mechanisms(Reference Muntaner, Ng and Chung14, Reference Bonita, Magnusson and Bovet81) to address complex public health problems such as obesity and diet-related NCD(Reference Moodie, Stuckler and Monteiro10, 11, Reference Muntaner, Ng and Chung14, 96).

The Institute of Medicine has identified four accountability steps to promote population health(93) that were central to informing our four-step framework and which include:

  1. 1. Establish a neutral and arms-length body with a clear charge to accomplish goals;

  2. 2. Ensure that the body has authority and capacity to undertake required activities;

  3. 3. Measure accomplishments against a clear charge given to the body; and

  4. 4. Improve accountability effectiveness by establishing a feedback loop to make system-wide improvements.

The Institute of Medicine identified several accountability challenges(93) such as: the limited ability to attribute the impact of promising interventions to a specific stakeholder group; a long time before an intervention's impact is observed; and the need to assess certain stakeholders’ actions that may concurrently support and undermine population health goals.

Accountability framework to promote healthy food environments

The accountability framework that we developed is based on government appointing an empowered and independent body with a well-defined charge to develop clear objectives, a governance process, performance standards and indicators for all stakeholders to address unhealthy food environments, and to report back on progress. The four-step framework involves taking account (assessment), sharing the account (communication), holding to account (enforcement) and responding to the account (improvements; Fig. 2).

Fig. 2 Accountability framework to promote healthy food environments

Although it is a non-linear process, we describe it in a stepwise manner to simplify one's understanding of the accountability dimensions. The governance process should be transparent, credible, verifiable, trustworthy, responsive, fair and timely; and have institutionalized mechanisms to identify and manage conflicts of interest and settle disputes.

Taking the account

This step involves an independent body collecting, reviewing, verifying, monitoring and evaluating meaningful data to establish benchmarks and to analyse each stakeholder's compliance with implementing policies and practices that impact food environments and diet-related population health. Clear reporting expectations and time frames are needed to achieve specific performance goals.

Evidence reviews

UN System bodies, governments and private foundations have appointed expert committees and independent commissions to review public-domain evidence from peer-reviewed and grey literature and trusted advisors(Reference Haynes, Derrick and Redman97), NGO and self-reported industry evidence(55, Reference Vladu, Christensen and Pana56, 98, 99), or investment banking firms and contracted auditors who use specific indices that compare and rank company performance for corporate social responsibility indicators within certain sectors(100, 101).

Monitoring and evaluating policy interventions

The WHO global monitoring framework and action plan to reduce NCD by 25 % by 2025 offers nine voluntary global targets and twenty-five indicators(3, 16) that will require tailoring to national contexts. INFORMAS(Reference Swinburn, Sacks and Vandevijvere102) is a network of researchers from nine universities across fourteen countries who monitor food environment policy interventions to prevent obesity and diet-related NCD. Government progress can be assessed using the Healthy Food Environment Policy Index(Reference Swinburn, Vandevijvere and Kraak103) and food industry progress can be assessed across seven food environment domains (i.e. composition, labelling, promotion, provision, retail, pricing, and trade and investment) using a prioritized, step-based approach(Reference Sacks, Swinburn and Kraak104).

The Access to Nutrition Index (ATNI) is another independent monitoring effort that rates twenty-five global food and beverage manufacturers on nutrition-related commitments, disclosure practices and performance to address undernutrition and obesity(105). The ATNI used seven indicators (i.e. corporate governance, product portfolio, accessibility of products, marketing practices, support for healthy lifestyles, food labelling and stakeholder engagement) to rate companies for promising or best practice achievements. The 2013 ATNI evaluation found most companies lacked transparency by not publicly sharing their nutrition-related practices and did not adhere to many public commitments(105).

Evaluations of the European Union's (EU) Platform for Action on Diet, Physical Activity and Health revealed that defining clear measurable objectives is essential for policy makers to determine the value of the EU Platform's partnerships(45, 106). Evaluations of the Pan American Health Organization/WHO Trans Fat Free America initiative found that national governments must coordinate all efforts – including tracking industry reformulation, ensuring mandatory food labelling requirements are consistent across countries, and monitoring changes in the food supply and the dietary intake of populations – to effectively eliminate trans-fats from the food supply in the Latin American and the Caribbean region(Reference Monge-Rojas, Colón-Ramos and Jacoby107, Reference Colón-Ramos, Monge-Rojas and Campos108).

In the USA, private foundations are funding independent evaluations to verify and review progress for private-sector pledges to improve food environments. Examples include the sixteen food manufacturers’ 2010 pledge to remove 1·5 trillion calories from the US food supply by 2015 through the Health Weight Commitment Foundation (Table 1)(48, Reference Slining, Wen and Popkin109) and the Partnership for a Healthier America(110).

Sharing the account

This step involves the empowered body communicating results to all stakeholders through a deliberative and participatory engagement process. This step is important to encourage transparency and understanding among stakeholders about the development of the performance standards and accountability expectations; to foster dialogue among stakeholders who hold divergent views and positions on food environment issues; to facilitate shared learning among diverse stakeholders to foster understanding of positions and constraints; to develop timelines for action; and to inform accountability actions at subsequent steps.

Stakeholder engagement can provide insights into accountability needs and challenges related to balancing divergent perspectives. On example is the UK ‘Race to the Top’ project that had convened food retailers and civil society groups to establish sustainability benchmarks(Reference Fox and Vorley111). The evaluation showed that public-interest NGO viewed the engagement process as too conciliatory whereas the food retailers perceived that there was insufficient consensus building. Participating NGO also criticized the overreliance on food retailers’ self-reported data and the lack of consequences for non-participating companies. On the other hand, food retailers were concerned that their participation in the process would be used to develop a new government regulatory framework to raise expectations about their performance(Reference Fox and Vorley111).

Holding to account

Holding to account is the most difficult step in the framework because it involves an empowered group appraising and either recognizing successful performers or enforcing policies, regulations and laws for non-participants or under-performers through institutional, financial, regulatory, legal or reputational mechanisms(Reference Grant and Keohane70). Accountability challenges exist at the international level because treaties, conventions and resolutions have limited sanctioning powers to hold national governments accountable for healthy food environments. The 2010 resolution to reduce unhealthy marketing to children recommended ten actions(112) but the WHO lacks legal authority, oversight or enforcement capacity to compel governments to reduce unhealthy food marketing to children.

National governments can leverage incentives (e.g. tax breaks, investment decisions or praising) and disincentives (e.g. fines, divestment, penalties, litigation, naming or shaming)(Reference Grant and Keohane70) to hold stakeholders accountable for policies and practices that impact food environments. Some of the most effective voluntary agreements include disincentives and reputational costs for non-participation and sanctions for non-compliance(Reference Grant and Keohane70, Reference Bryden, Petticrew and Mays113).

Adjudication is another option where a national government can appoint an ombudsman to mediate and manage disputes to avoid litigation and address complex dilemmas arising from power asymmetries among food environment stakeholders(Reference Burch, Lawrence and Hattersley114). In 2013, an independent UK Groceries Code Adjudicator was appointed to ensure that large food retailers will adhere to the Groceries Supply Code of Practice and treat suppliers fairly within legal guidelines(115).

Holding to account also involves public-interest NGO pursuing ‘social accountability goals’(Reference Joshi74, Reference O'Meally75) by exposing unacceptable practices such as government corruption and food industry lobbying that undermine public health goals(116, 117). NGO can utilize disclosure laws that compel governments to release information(118); work with investigative journalists to expose practices that adversely impact food environments and population health(Reference Schlosser119Reference Taubes and Couzens121); use consumer and company boycotts(Reference Hines and Jernigan122Reference Chapman124); use parents’ juries(125); praise companies that meet performance expectations and name or shame non-participating or under-performing businesses(Reference Dorfman, Wilbur and Lingas126128); encourage corporations to endorse investors’ statements that recognize health, wellness and nutrition as drivers of future economic-sector growth(99, Reference Dorfman, Wilbur and Lingas126, Reference Kropp129); and spearhead shareholder advocacy to change corporate practices(Reference Dorfman, Wilbur and Lingas126, 130) and persist even when resolutions are rejected by company boards(Reference Baertlein131).

Responding to the account

Responding to the account involves stakeholders taking remedial actions to improve their performance and strengthen systemic accountability structures. This step involves monitoring the fidelity of government policy implementation (which differs from monitoring stakeholders’ compliance with existing policies), as well as government's enforcement of policies, regulations and laws. It also involves assessing how effectively the empowered authority applies incentives and disincentives to promote healthy food environments.

Step 4 involves building stronger internal and external approaches to track a company's performance on commitments and targets. Finally, this step addresses ‘pseudo accountability’, by challenging weak regulations that give an appearance of enforcing high standards but do not lead to meaningful changes(Reference Kassirer132).

Implications

The proposed accountability framework has several implications. First, it can be used to inform, guide and model private-sector practices to optimize good performance and minimize undesirable or unintended corporate practices. Second, holding to account and responding to the account offer recommendations that have been weak in existing frameworks. Third, the framework encourages stakeholders to explicitly examine power relationships and accountability expectations at all four steps. Fourth, several formal and informal mechanisms are provided for stakeholders to hold each other to account. Finally, the proposed framework requires empirical testing for relevant issues, and especially to evaluate whether the accountability structures of voluntary partnerships can be strengthened to improve credibility, quality of engagement and produce a positive impact on healthy food environments.

Conclusions

National governments’ reliance on food industry partnerships to develop and implement policies to address unhealthy food environments requires explicit, transparent and independent accountability structures. The proposed accountability framework involves an empowered body developing clear objectives, a governance process and performance standards for all stakeholders to promote healthy food environments. The body takes account (assessment), shares the account (communication), holds to account (enforcement) and responds to the account (improvements). The governance process must be transparent, credible, verifiable, trustworthy, responsive, fair and timely, and manage conflicts of interest and settle disputes. The proposed framework requires empirical testing to evaluate whether the accountability structures can be strengthened to improve partnership credibility, engagement and impact on healthy food environments within a broader government-led strategy to address obesity and diet-related NCD.

Acknowledgements

Sources of funding: This paper was supported by the World Health Collaborating Centre for Obesity Prevention and the Population Health Strategic Research Centre at Deakin University in Melbourne, Victoria, Australia. V.I.K. received PhD research support from Deakin University's World Health Collaborating Centre for Obesity Prevention and the Population Health Strategic Research Centre to complete this paper, and otherwise has no financial disclosures. B.S., M.L. and P.H. have no financial disclosures. Conflicts of interest: V.I.K., B.S., M.L. and P.H. have no conflict of interest related to the content in this paper. Ethics approval: This study was a desk review of the literature and did not involve human subjects; therefore ethics approval was not required. Authors’ contributions: V.I.K. developed the initial concept, conducted the literature review, wrote the first draft, coordinated feedback for subsequent revisions and led the submission process. B.S., M.L. and P.H. further developed the concepts and provided feedback on drafts of the paper. All authors read and approved the final manuscript. Acknowledgements: The authors are grateful to Juan Quirarte for designing Figs 1 and 2.

References

1.World Health Organization (2011) Global Status Report on Noncommunicable Diseases 2010. Geneva: WHO; available at http://whqlibdoc.who.int/publications/2011/9789240686458_eng.pdfGoogle Scholar
2.World Health Organization (2004) Global Strategy on Diet, Physical Activity, and Health. Report no. WHA57.17. Geneva: WHO; available at http://www.who.int/dietphysicalactivity/strategy/eb11344/en/index.htmlGoogle Scholar
3.World Health Organization (2013) Follow-up to the Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases, 25 May. http://apps.who.int/gb/ebwha/pdf_files/WHA66/A66_R10-en.pdf (accessed May 2013).Google Scholar
4.World Cancer Research Fund/American Institute for Cancer Research (2007) Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global Perspective. Washington, DC: AICR; available at http://www.dietandcancerreport.org/downloads/summary/english.pdfGoogle Scholar
5.European Heart Network (2011) Diet, Physical Activity and Cardiovascular Disease Prevention in Europe. Brussels: EHN; available at http://www.ehnheart.org/publications/publications.htmlGoogle Scholar
6.World Health Organization (2011) Intersectoral Action on Health. A Path for Policy-Makers to Implement Effective and Sustainable Action on Health. Kobe: WHO Centre for Health Development; available at http://www.who.int/kobe_centre/publications/ISA-booklet_WKC-AUG2011.pdfGoogle Scholar
7.Committee on Preventing Obesity in Children and Youth, Institute of Medicine (2005) Preventing Childhood Obesity: Health in the Balance [JP Koplan, CT Liverman and VI Kraak, editors]. Washington, DC: The National Academies Press; available at http://www.nap.edu/catalog.php?record_id=11015Google Scholar
8.Swinburn, BA, Sacks, G, Hall, KDet al. (2011) The global obesity pandemic: shaped by global drivers and local environments. Lancet 378, 804814.CrossRefGoogle ScholarPubMed
9.Conflicts of Interest Coalition (2011) Statement of Concern. http://info.babymilkaction.org/sites/info.babymilkaction.org/files/COIC150_0.pdf (accessed April 2013).Google Scholar
10.Moodie, R, Stuckler, D, Monteiro, Cet al. (2013) Profits and pandemics: prevention of harmful effects of tobacco, alcohol, and ultra-processed food and drink industries. Lancet 381, 670679.CrossRefGoogle ScholarPubMed
11.World Health Organization (2013) WHO Director-General addresses health promotion conference. Opening address at the 8th Global Conference on Health Promotion, Helsinki, Finland, 10 June. http://www.who.int/dg/speeches/2013/health_promotion_20130610/en/index.html (accessed June 2013).Google Scholar
12.Brandeis, LD (1913) What publicity can do. Harper's Weekly, 20 December. http://www.law.louisville.edu/library/collections/brandeis/node/196 (accessed May 2013).Google Scholar
13.Rochlin, S, Zadek, S & Forstater, M (2008) Governing Collaboration. Making Partnerships Accountable for Delivering Development. London: AccountAbility; available at http://www.accountability.org/images/content/4/3/431/Governing%20Collaboration_Full%20report.pdfGoogle Scholar
14.Muntaner, C, Ng, E & Chung, H (2012) Making power visible in global health governance. Am J Bioeth 12, 6364.CrossRefGoogle ScholarPubMed
15.Beaglehole, R, Bonita, R & Horton, R (2013) Independent global accountability for NCDs. Lancet 381, 602605.Google ScholarPubMed
16.World Health Organization (2013) United Nations to establish WHO-led Interagency Task Force on the Prevention and Control of Noncommunicable Diseases. Media release, 22 July. http://www.who.int/mediacentre/news/notes/2013/ncds_ecosoc_20130722/en/index.html (accessed August 2013).Google Scholar
17.McKinnon, RA, Reedy, J, Morrissette, MAet al. (2009) Measures of the food environment: a compilation of the literature, 1990–2007. Am J Prev Med 36, 4 Suppl., S124S133.CrossRefGoogle ScholarPubMed
18.Glanz, K (2009) Measuring food environments: a historical perspective. Am J Prev Med 36, 4 Suppl.,S93S98.CrossRefGoogle ScholarPubMed
19.Ball, K & Thornton, L (2013) Food environments: measuring, mapping, monitoring and modifying. Public Health Nutr 16, 11471150.CrossRefGoogle ScholarPubMed
20.Story, M, Kaphingst, KM, Robinson-O'Brien, Ret al. (2008) Creating healthy food and eating environments: policy and environmental approaches. Annu Rev Public Health 29, 253272.CrossRefGoogle ScholarPubMed
21.Swinburn, B, Egger, G & Raza, F (1999) Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity. Prev Med 29, 563570.Google ScholarPubMed
22.Committee on Progress in Preventing Childhood Obesity, Institute of Medicine (2007) Progress in Preventing Childhood Obesity: How Do We Measure Up? [JP Koplan, CT Liverman, VI Kraak et al., editors]. Washington, DC: The National Academies Press; available at http://www.nap.edu/catalog.php?record_id=11722Google Scholar
23.US Department of Agriculture & US Department of Health and Human Services (2010) Dietary Guidelines for Americans, 2010, 7th edition. Washington, DC: US Government Printing Office; available at http://www.cnpp.usda.gov/Publications/DietaryGuidelines/2010/PolicyDoc/PolicyDoc.pdfGoogle Scholar
24.Mozaffarian, D, Afshin, A, Benowitz, NLet al. (2012) Population approaches to improve diet, physical activity, and smoking habits: a scientific statement from the American Heart Association. Circulation 126, 15141563.CrossRefGoogle ScholarPubMed
25.Pérez-Escamilla, R, Obbagy, JE, Altman, JMet al. (2012) Dietary energy density and body weight in adults and children: a systematic review. J Acad Nutr Diet 112, 671684.CrossRefGoogle ScholarPubMed
26.Lin, BH & Guthrie, J (2012) Nutritional Quality of Food Prepared at Home and Away From Home, 1977–2008. Economic Information Bulletin no. EIB-105. Washington, DC: US Department of Agriculture, Economic Research Service; available at http://www.ers.usda.gov/media/977761/eib-105.pdfGoogle Scholar
27.Popkin, BM, Duffey, K & Gordon-Larsen, P (2005) Environmental influences on food choice, physical activity and energy balance. Physiol Behav 86, 603613.CrossRefGoogle ScholarPubMed
28.Lozano, R, Naghavi, M, Foreman, Ket al. (2012) Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380, 20952128.Google ScholarPubMed
29.Lim, SS, Vos, T, Flaxman, ADet al. (2012) A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380, 22242260.CrossRefGoogle ScholarPubMed
30.Guthman, J (2008) Thinking inside the neoliberal box: the micro-politics of agro-food philanthropy. Geoforum 39, 12411253.CrossRefGoogle Scholar
31.Clarke, J (2004) Dissolving the public realm?: the logics and limits of neo-liberalism. J Soc Policy 33, 2748.CrossRefGoogle Scholar
32.Peck, J & Tickell, A (2002) Neoliberalizing space. Antipode 34, 380404.CrossRefGoogle Scholar
33.Wilst, WH (2011) Citizens United, public health, and democracy: the Supreme Court ruling, its implications, and proposed action. Am J Public Health 101, 11721179.Google Scholar
34.Piety, TR (2011) Citizens United and the threat to the regulatory state. Michigan Law Review First Impressions 109, 1622.Google Scholar
35.Clapp, J & Fuchs, D (2009) Agrifood corporations, global governance, and sustainability: a framework for analysis. In Corporate Power in Global Agrifood Governance, pp. 128 [J Clapp & D Fuchs, editors]. Cambridge, MA: The MIT Press.CrossRefGoogle Scholar
36.Mindell, JS, Reynolds, L, Cohen, DLet al. (2012) All in this together: the corporate capture of public health. BMJ 345, e8082.CrossRefGoogle ScholarPubMed
37.Bonnell, C, McKee, M, Fletcher, Aet al. (2011) Nudge smudge: UK government misrepresents ‘nudge’. Lancet 377, 21582159.CrossRefGoogle Scholar
38.Kraak, VI, Harrigan, P, Lawrence, Met al. (2012) Balancing the benefits and risks of public–private partnerships to address the global double burden of malnutrition. Public Health Nutr 15, 503517.CrossRefGoogle ScholarPubMed
39.Kraak, VI, Swinburn, B, Lawrence, Met al. (2011) The accountability of public–private partnerships with food, beverage and restaurant companies to address global hunger and the double burden of malnutrition. SCN News issue 39, 1124; available at http://www.unscn.org/files/Publications/SCN_News/SCNNEWS39_10.01_high_def.pdfGoogle Scholar
40.Watzman, N (2012) Congressional Letter Writing Campaign Helps Torpedo Voluntary Food Marketing Guidelines for Kids. Washington, DC: Sunlight Foundation Reporting Group; available at http://reporting.sunlightfoundation.com/2012/congressional_letter_writing_campaign/Google Scholar
41.Yanamadala, S, Bragg, MA, Roberto, CAet al. (2012) Food industry front groups and conflicts of interest: the case of Americans Against Food Taxes. Public Health Nutr 15, 13311332.CrossRefGoogle ScholarPubMed
42.Grynbaum, MM (2013) In N.A.A.C.P. industry gets ally against soda ban. The New York Times, 23 January. http://www.nytimes.com/2013/01/24/nyregion/fight-over-bloombergs-soda-ban-reaches-courtroom.html?ref=health&_r=1& (accessed April 2013).Google Scholar
43.International Food and Beverage Alliance (2013) Our Commitments. https://www.ifballiance.org/our-commitments.html (accessed April 2013).Google Scholar
44.Cereal Partners Worldwide SA, Nestlé and General Mills (2009) CPW Commitments. http://www.cerealpartners.com/cpw/euPledge.html (accessed April 2013).Google Scholar
45.European Commission (2013) Public Health. Nutrition and Physical Activity. The EU Platform for Action on Diet, Physical Activity and Health. http://ec.europa.eu/health/nutrition_physical_activity/publications/index_en.htm (accessed April 2013).Google Scholar
46.Van Koperen, TM, Jebb, SA, Summerbell, CDet al. (2013) Characterizing the EPODE logic model: unravelling the past and informing the future. Obes Rev 14, 162170.CrossRefGoogle ScholarPubMed
47.Pan American Health Organization/World Health Organization (2008) Healthy Oils and the Elimination of Industrially Produced Fatty Acids in the Americas. Washington DC: PAHO; available at http://www.healthycaribbean.org/nutrition_and_diet/documents/TransFats.pdfGoogle Scholar
48.US Healthy Weight Commitment Foundation (2013) Home page. http://www.healthyweightcommit.org/ (accessed April 2013).Google Scholar
49.UK Department of Health (2013) Public Health Responsibility Deal. https://responsibilitydeal.dh.gov.uk/ (accessed April 2013).Google Scholar
50.Australia Food and Grocery Council (2012) Healthier Australia Commitment. http://www.togethercounts.com.au/healthy-australia-commitment/ (accessed April 2013).Google Scholar
51.Facts Up Front (2013) Facts Up Front nutrition education initiative launches digital platform to help Americans make informed decisions when they shop for food. A Joint initiative of the Grocery Manufacturers Association and the Food Marketing Institute. Press release, 17 April. http://www.factsupfront.org/Newsroom/6 (accessed April 2013).Google Scholar
52.Better Business Bureau (2013) US Children's Food and Beverage Advertising Initiative. http://www.bbb.org/us/childrens-food-and-beverage-advertising-initiative/ (accessed April 2013).Google Scholar
53.Advertising Standards Canada (2013) Canadian Children's Food and Beverage Advertising Initiative. http://www.adstandards.com/en/childrensinitiative/default.htm (accessed April 2013).Google Scholar
54.International Food & Beverage Alliance (2011) Five Commitments to Action in support of the World Health Organization's 2004 Global Strategy on Diet, Physical Activity and Health. 2011 Progress Report. https://www.ifballiance.org/sites/default/files/IFBA%20Progress%20Report%202011%20%28FINAL%2029%204%202012%29.pdf (accessed April 2013).Google Scholar
55.Accenture (2012) 2011 Compliance Monitoring Report for the International Food & Beverage Alliance on Global Advertising on Television, Print and Internet. https://www.ifballiance.org/sites/default/files/IFBA%20Accenture%20Monitoring%20Report%202011%20FINAL%20010312.pdf (accessed April 2013).Google Scholar
56.Vladu, C, Christensen, R & Pana, A (2012) Monitoring the European Platform for action on Diet, Physical Activity and Health activities. Annual Report 2012. Brussels: IBF International Consulting; available at http://ec.europa.eu/health/nutrition_physical_activity/docs/eu_platform_2012frep_en.pdfGoogle Scholar
57.Union of Concerned Scientists (2012) Heads They Win, Tails We Lose. How Corporations Corrupt Science at the Public's Expense. Cambridge, MA: UCS Publications; available at http://www.ucsusa.org/assets/documents/scientific_integrity/how-corporations-corrupt-science.pdfGoogle Scholar
58.European Court of Auditors (2012) Management of Conflicts of Interest in Selected EU Agencies. Special report no. 15. Luxembourg: European Court of Auditors; available at http://eca.europa.eu/portal/pls/portal/docs/1/17190743.PDFGoogle Scholar
59.Freudenberg, N & Galea, S (2008) The impact of corporate practices on health: implications for health policy. J Public Health Policy 29, 86104.CrossRefGoogle ScholarPubMed
60.Wilst, WH (2006) Public health and the anticorporate movement: rationale and recommendations. Am J Public Health 96, 13701375.Google Scholar
61.Stuckler, D, McKee, M, Ebrahim, Set al. (2012) Manufacturing epidemics: the role of global producers in increased consumption of unhealthy commodities including processed foods, alcohol, and tobacco. PLoS Med 9, e1001235.CrossRefGoogle ScholarPubMed
62.Brownell, KD & Warner, KE (2009) The perils of ignoring history: Big Tobacco played dirty and millions died. How similar is Big Food? Milbank Q 87, 259294.CrossRefGoogle ScholarPubMed
63.Which? (2012) Government must do more to tackle the obesity crisis, says Which? The Government's Responsibility Deal is inadequate. Press release, 15 March. http://www.which.co.uk/news/2012/03/government-must-do-more-to-tackle-the-obesity-crisis-says-which-281403/ (accessed April 2013).Google Scholar
64.Ludwig, DS & Nestle, M (2008) Can the food industry play a constructive role in the obesity epidemic? JAMA 300, 18081811.CrossRefGoogle ScholarPubMed
65.Brownell, KD (2012) Thinking forward: the quicksand of appeasing the food industry. PLoS Med 9, e1001254.CrossRefGoogle ScholarPubMed
66.Lumley, J, Martin, J & Antonopoulos, N (2012) Exposing the Charade: The Failure to Protect Children from Unhealthy Food Advertising. Melbourne: Obesity Policy, Coalition; available at http://www.aana.com.au/data/AANA_in_the_News/OPC_Exposing_the_Charade_report_2012.pdfGoogle Scholar
67.Batada, A (2013) Kids’ Meals: Obesity on the Menu. Washington, DC: Center for Science in the Public Interest; available at http://cspinet.org/new/pdf/cspi-kids-meals-2013.pdfGoogle Scholar
68.Hawkes, C & Harris, JL (2011) An analysis of the content of food industry pledges on marketing to children. Public Health Nutr 14, 14031414.CrossRefGoogle ScholarPubMed
69.Sharma, LL, Teret, SP & Brownell, KD (2010) The food industry and self-regulation: standards to promote success and to avoid public health failures. Am J Public Health 100, 240246.CrossRefGoogle ScholarPubMed
70.Grant, RW & Keohane, RO (2005) Accountability and abuses of power in world politics. Am Polit Sci Rev 99, 2943.CrossRefGoogle Scholar
71.Bovens, M (2007) Analysing and assessing accountability: a conceptual framework. Eur Law J 13, 447468.CrossRefGoogle Scholar
72.Steets, J (2010) Accountability in Public Policy Partnerships. UK: Palgrave Macmillan.Google Scholar
73.Wolfe, R & Baddeley, S (2012) Regulatory Transparency in Multilateral Agreements Controlling Exports of Tropical Timber, E-waste and Conflict Diamonds. OECD Trade Policy Papers no. 141. http:dx.doi.org/10.1787/5k8xbn83xtmr-en (accessed April 2013).Google Scholar
74.Joshi, A (2013) Context Matters: A Causal Chain Approach to Unpacking Social Accountability Interventions. Brighton: Institute of Development Studies; available at http://www.ids.ac.uk/files/dmfile/ContextMattersaCasualChainApproachtoUnpackingSAinterventionsAJoshi2013.pdfGoogle Scholar
75.O'Meally, SC (2013) Mapping Context for Social Accountability: A Resource Paper. Washington, DC: The World Bank, Social Development Department; available at http://siteresources.worldbank.org/EXTSOCIALDEVELOPMENT/Resources/244362-1193949504055/Context_and_SAcc_RESOURCE_PAPER.pdfGoogle Scholar
76.Organization for Economic Cooperation and Development (2009) Mutual Accountability: Emerging Good Practice. http://www.oecd.org/dac/aideffectiveness/49656340.pdf (accessed April 2013).Google Scholar
77.Steer, L & Wanthe, C (2009) Mutual Accountability at Country Level: Emerging Good Practice. ODI Background Note, April 2009. London: Overseas Development Institute; available at http://www.aideffectiveness.org/media/k2/attachments/3277_1.pdfGoogle Scholar
78.Ruger, JP (2012) Global health governance as shared health governance. J Epidemiol Community Health 66, 653661.CrossRefGoogle ScholarPubMed
79.World Health Organization (2011) Keeping Promises, Measuring Results. Geneva: WHO Commission on Information and Accountability for Women's and Children's Health; available at http://www.who.int/topics/millennium_development_goals/accountability_commission/Commission_Report_advance_copy.pdfGoogle Scholar
80.United Nations Human Rights Office of the High Commissioner (2011) Guiding Principles on Business and Human Rights. Implementing the United Nations ‘Protect, Respect and Remedy’ Framework. http://www.ohchr.org/Documents/Publications/GuidingPrinciplesBusinessHR_EN.pdf (accessed April 2013).Google Scholar
81.Bonita, R, Magnusson, R, Bovet, Pet al. (2013) Country actions to meet UN commitments on non-communicable diseases: a stepwise approach. Lancet 381, 575584.CrossRefGoogle ScholarPubMed
82.Deegan, C (2002) The legitimizing effect of social and environmental disclosures – a theoretical foundation. Account Audit Accountability J 15, 282311.Google Scholar
83.Isles, A (2007) Seeing sustainability in business operations: US and British food retailer experiments with accountability. Bus Strat Environ 16, 290301.CrossRefGoogle Scholar
84.Moerman, L & Van Der Laan, S (2005) Social reporting in the tobacco industry: all smoke and mirrors? Account Audit Accountability J 18, 374389.CrossRefGoogle Scholar
85.Newell, P (2008) Civil society, corporate accountability and the politics of climate change. Global Environ Polit 8, 122153.Google Scholar
86.Stanwick, PA, Stanwick, SD (2006) Environment sustainability disclosures: a global perspective and financial performance. In Corporate Social Responsibility. vol. 2: Performance and Stakeholders, pp. 84104 [J Allouche, editor]. New York: Palgrave Macmillan.Google Scholar
87.Swift, T (2001) Trust, reputation and corporate accountability to stakeholders. Bus Ethics Eur Rev 10, 1626.CrossRefGoogle Scholar
88.Tilling, MV & Tilt, CA (2010) The edge of legitimacy: voluntary social reporting in Rothmans’ 1956–1999 annual reports. Account Audit Accountability J 23, 5581.CrossRefGoogle Scholar
89.Tilt, CA (2010) Corporate responsibility, accounting and accountants. In Professionals’ Perspectives of Corporate Social Responsibility, pp. 11–32 [SO Idowu and WL Filho, editors]. Berlin: Springer-Verlag; available at http://link.springer.com/content/pdf/10.1007%2F978-3-642-02630-0_2Google Scholar
90.Irani, T, Sinclair, J & O'Malley, M (2002) The importance of being accountable: the relationship between perceptions of accountability, knowledge, and attitude toward plant genetic engineering. Sci Commun 23, 225242.CrossRefGoogle Scholar
91.Dolan, P, Hallsworth, M, Halpern, Det al. (2010) MINDSPACE: Influencing Behaviour Through Public Policy. London: Institute for Government; available at http://www.instituteforgovernment.org.uk/publications/2/Google Scholar
92.Gostin, LO (2008) A theory and definition of public health law (Georgetown University/O'Neill Institute for National & Global Health Law Scholarship Research Paper no. 8). In Public Health Law Power, Duty and Restraint, revised and expanded 2nd ed., pp. 3–41 [LO Gostin, editor]. Berkley, CA: University of California Press/Millbank Memorial Fund; available at http://ssrn.com/abstract=1269472Google Scholar
93.Institute of Medicine, Committee on Public Health Strategies to Improve Health (2011) For the Public's Health: The Role of Measurement in Action and Accountability. Washington, DC: The National Academies Press; available at http://www.nap.edu/catalog.php?record_id=13005Google Scholar
94.Institute of Medicine, Committee on Public Health Strategies to Improve Health (2011) For the Public's Health: Revitalizing Law and Policy to Meet New Challenges. Washington, DC: The National Academies Press; available at http://www.iom.edu/Reports/2011/For-the-Publics-Health-Revitalizing-Law-and-Policy-to-Meet-New-Challenges.aspxGoogle Scholar
95.Turoldo, F (2009) Responsibility as an ethical framework for public health interventions. Am J Public Health 99, 11971202.CrossRefGoogle ScholarPubMed
96.World Health Organization (2013) Key issues for the development of a policy on engagement with nongovernmental organizations. Report by the Director-General. EB 132/5 Add.2, 18 January. http://apps.who.int/gb/ebwha/pdf_files/EB132/B132_5Add2-en.pdf (accessed April 2013).Google Scholar
97.Haynes, AS, Derrick, GE, Redman, Set al. (2012) Identifying trustworthy experts: how do policymakers find and assess public health researchers worth consulting or collaborating with? PLoS One 7, e32665.Google ScholarPubMed
98.Corporate Responsibility Organization (2012) CR's 100 Best Corporate Citizens 2012. http://www.thecro.com/files/100BestF.pdf (accessed April 2013).Google Scholar
99.Bank of America & Merrill Lynch (2012) Globesity – the Global Fight Against Obesity. ESG & Sustainability. http://www.foodpolitics.com/wp-content/uploads/Globesity-Report_12.pdf (accessed April 2013).Google Scholar
100.Ethical Investment Research Services (2006) Obesity Concerns in the Food and Beverage Industry. SEE Risk Briefing February 2006. London: EIRS; available at http://www.eiris.org/files/research%20publications/seeriskobesityfeb06.pdfGoogle Scholar
101.Global Reporting Initiative (2013) Global Reporting Framework. https://www.globalreporting.org/reporting/reporting-framework-overview/Pages/default.aspx (accessed April 2013).Google Scholar
102.Swinburn, B, Sacks, G, Vandevijvere, Set al. (2013) INFORMAS (International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support): overview and key principles. Obes Rev 14, 112.CrossRefGoogle Scholar
103.Swinburn, B, Vandevijvere, S, Kraak, Vet al. (2013) Monitoring and benchmarking government policies and actions to improve the healthiness of food environments: a proposed Government Healthy Food Environment Policy Index. Obes Rev 14, 2437.CrossRefGoogle ScholarPubMed
104.Sacks, G, Swinburn, B, Kraak, Vet al. (2013) A proposed approach to monitor private-sector policies and practices related to food environments, obesity and non-communicable disease prevention. Obes Rev 14, 3848.CrossRefGoogle ScholarPubMed
105.Global Alliance for Improved Nutrition (2013) Access to Nutrition Index. Global Index 2013. http://s3.amazonaws.com/ATN/atni_global_index_2013.pdf (accessed April 2013).Google Scholar
106.European Commission (2011) EU Platform for Action on Diet, Physical Activity and Health. 2011 Annual Report. http://ec.europa.eu/health/nutrition_physical_activity/docs/eu_platform_2011frep_en.pdf (accessed April 2013).Google Scholar
107.Monge-Rojas, R, Colón-Ramos, U, Jacoby, Eet al. (2011) Voluntary reduction of trans-fatty acids in Latin America and the Caribbean: current situation. Rev Panam Salud Publica 29, 126129.CrossRefGoogle ScholarPubMed
108.Colón-Ramos, U, Monge-Rojas, R & Campos, H (2013) Impact of WHO recommendations to eliminate industrial trans-fatty acids from the food supply in Latin America and the Caribbean. Health Policy Plan (Epublication ahead of print version).Google ScholarPubMed
109.Slining, MM, Wen, S & Popkin, BM (2013) Food companies’ calorie-reduction pledges to improve US diet. Am J Prev Med 44, 174184.Google Scholar
110.Partnership for a Healthier America (2013) In It For Good. PHA 2012 Annual Progress Report. http://ahealthieramerica.org/wp-content/themes/pha/images/files/assets/common/downloads/PHA%20FINAL%20022213.pdf (accessed April 2013).Google Scholar
111.Fox, T & Vorley, B (2004) Stakeholder Accountability in the UK Supermarket Sector. Final Report of the ‘Race to the Top’ Project. London: International Institute for Environment and Development; available at http://www.racetothetop.org/documents/RTTT_final_report_full.pdfGoogle Scholar
112.World Health Organization (2010) Set of Recommendations on the Marketing of Foods and Non-Alcoholic Beverages to Children. Geneva: WHO; available at http://whqlibdoc.who.int/publications/2010/9789241500210_eng.pdfGoogle Scholar
113.Bryden, A, Petticrew, M, Mays, Net al. (2013) Voluntary agreements between government and business; a scoping review of the literature with specific reference to the Public Health Responsibility Deal. Health Policy 110, 186197.CrossRefGoogle Scholar
114.Burch, D, Lawrence, G & Hattersley, L (2013) Watchdogs and ombudsmen: monitoring the abuse of supermarket power. Agric Hum Values 30, 259270.CrossRefGoogle Scholar
115.Department for Business, Innovation and Skills (2013) Groceries Code Adjudicator Bill receives Royal Assent. Press release, 25 April. http://news.bis.gov.uk/Press-Releases/Groceries-Code-Adjudicator-Bill-receives-Royal-Assent-68b9a.aspx (accessed April 2013).Google Scholar
116.The Sunlight Foundation (2012) Issues we cover. http://sunlightfoundation.com/issues/ (accessed April 2013).Google Scholar
117.Center for Responsive Politics (2013) Food Industry 2012. http://www.opensecrets.org/lobby/issuesum.php?id=FOO&year=2012 (accessed April 2013).Google Scholar
118.World Resources Institute (2006) Freedom of Information Laws by Country. Washington, DC: World Resources Institute; available at http://www.wri.org/map/freedom-information-laws-country-2006Google Scholar
119.Schlosser, E (2001) Fast Food Nation. The Dark Side of the All-American Meal. Boston, MA: Houghton Mifflin Company; available at http://www.amazon.com/Fast-Food-Nation-Dark-All-American/dp/0547750331Google Scholar
120.Moss, M (2013) Salt Sugar Fat: How the Food Giants Hooked Us. New York: Random House; available at http://michaelmossbooks.com/Google Scholar
121.Taubes, G & Couzens, CK (2012) Big sugar's sweet little lies. Mother Jones, November/December issue. http://www.motherjones.com/environment/2012/10/sugar-industry-lies-campaign (accessed April 2013).Google Scholar
122.Hines, A & Jernigan, DH (2012) Developing a comprehensive curriculum for public health advocacy. Health Promot Pract 13, 733737.CrossRefGoogle ScholarPubMed
123.Devlin-Foltz, D, Fagen, MC, Reed, Eet al. (2012) Advocacy evaluation: challenges and emerging trends. Health Promot Pract 13, 581586.CrossRefGoogle ScholarPubMed
124.Chapman, S (2004) Advocacy for public health: a primer. J Epidemiol Community Health 58, 361365.Google ScholarPubMed
125.The Parents’ Jury (2012) Fame and shame awards 2012. http://www.parentsjury.org.au/ (accessed April 2013).Google Scholar
126.Dorfman, L, Wilbur, P, Lingas, EOet al. (2005) Accelerating Policy on Nutrition: Lessons Learned from Tobacco, Alcohol, Firearms, and Traffic Safety. Berkeley, CA: Berkeley Media Studies Group; available at http://www.bmsg.org/pdfs/BMSG_AccelerationReport.pdfGoogle Scholar
127.Utting, P (2008) The struggle for corporate accountability. Dev Change 39, 959975.CrossRefGoogle Scholar
128.Robert Wood Johnson Foundation (2014) Major food, beverage companies remove 6.4 trillion calories from U.S. marketplace. http://www.rwjf.org/en/about-rwjf/newsroom/newsroom-content/2014/01/major-food--beverage-companies-remove-6-4-trillion-calories--fro.html (accessed January 2014).Google Scholar
129.Kropp, R (2013) Investors support launch of Access to Nutrition Index. Sustainability Investment News, 27 March. http://dev.socialfunds.com/news/article.cgi/article3778.html (accessed May 2013).Google Scholar
130.Interfaith Center on Corporate Responsibility (2011) Taking Stock: Shaping the New Age in Corporate Responsibility. Annual Report 2010–2011. http://www.iccr.org/publications/index2.php (accessed April 2013).Google Scholar
131.Baertlein, L (2012) Anti-obesity proposal fails again at McDonald's. Reuters, 24 May. http://www.reuters.com/article/2012/05/24/us-mcdonalds-obesity-idUSBRE84N1CI20120524 (accessed April 2013).Google Scholar
132.Kassirer, JP (2001) Pseudoaccountability. Ann Intern Med 134, 587590.CrossRefGoogle ScholarPubMed
Figure 0

Fig. 1 A socio-ecological model illustrating stakeholders involved in promoting healthy food environments for populations (adapted from references 20–22)

Figure 1

Table 1 Examples of food industry alliances and intersectoral partnerships to promote healthy food environments

Figure 2

Table 2 Summary of evidence used from fifteen interdisciplinary frameworks to develop the healthy food environments accountability framework

Figure 3

Fig. 2 Accountability framework to promote healthy food environments