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Obesity and the Impact of Marketing on Children: Developing an Intersectoral Policy Consensus Conference


I Introduction
II Background
III Marketing to Children
IV About the Conference
V CDPAC position statement
VI Lessons learned

--submitted by Manuel Arango, conference co-chair and Assistant Director, Health Policy (Government Relations & Advocacy), Heart and Stroke Foundation of Canada

I Introduction

Obesity, particularly childhood obesity, is recognized as a growing health concern for health promoters, governments, health organizations and the general public.

II Background

The Chronic Disease Prevention Alliance of Canada (CDPAC), a coalition of organizations working in chronic disease prevention, is interested in developing strategies to address risk factors common to various chronic diseases. Marketing to children was identified as an issue that could be best addressed through a coalition of chronic disease groups.  It was also deemed to be a practice – that if addressed – could potentially have a real impact on childhood obesity. There was also recognition that the issue would be difficult to get traction on politically, and that there would be challenges from industry. A commitment was made to move forward by taking a collaborative approach to develop a policy position on the impact of marketing to children. Around the same time the Canadian Institutes for Health Research was also examining the efficacy of industry self-regulation in this area. As well, more broadly, governments had clearly identified childhood obesity as a critical issue – which was brought to the top of the agenda in part through the advocacy efforts of health groups such as CDPAC and the Heart and Stroke Foundation.

The Healthy Weights for Healthy Kids report by the Standing Committee on Health released in March 2007 confirmed that childhood obesity had become an “epidemic” in Canada. Other research revealed the majority of children were not meeting national nutrition guidelines, including not eating recommended levels of fruits and vegetables, and according to the CAN PLAY study (2005-2006) at least one third of children 5 to 19 years were not getting adequate physical activity.  

III Marketing to Children

Marketing is prolific in society, both in terms of competing messages and multiple media sources, and this is as true for children as it is for adults. In fact, marketing aimed at children takes place through television, the Internet, radio, billboards, magazines and digital phones, and can be found in a variety of settings from home and schools to stores, theatres and recreation centres. Approximately $19 billion is spent on marketing in Canada annually.  However, the extent of all food and beverage marketing to children in Canada is unknown at this time.

The US Institute of Medicine has stated that television advertising influences children’s food preferences and food and beverage purchase requests, and this is backed up by research by Hastings in the UK.

In Canada there is a patchwork of federal, provincial (Quebec) and self-regulatory codes and guidelines. The Canadian Code of Advertising Standards is administered by Advertising Standards Canada and applies to non-broadcast advertising. The national Broadcast Code for Advertising to Children applies to broadcast advertising and outlines how food products can be presented. The Quebec Consumer Protection Act has banned all commercial advertising directed at children since 1978. The Canadian Children’s Food and Beverage Advertising Initiative is a voluntary initiative by 16 of Canada’s largest food and beverage corporations and it publishes annual compliance reports.

In Sweden, TV ads directed at children under 12 are banned. Statutory regulations in the UK ban TV food advertising of products high in fat, sugar and salt to children under the age of 16. French law requires a positive nutritional message and link to a pro-health website on all food ads directed to children in the media, with a penalty for those advertising who do not include the message.

IV About the Conference

On March 4 and 5, 2008 CDPAC held a Consensus Conference on Obesity and the Impact of Marketing to Children in Ottawa. The event was by-invitation only with a broad range of representation from different sectors including academics, government officials, broadcasters, and representatives from food industry, advertising interests, and non-governmental organizations. Three planning committees were struck: a steering committee; a funders advisory committee; and an industry advisory committee. Sponsorship was provided by the Public Health Agency of Canada, the British Columbia Ministry of Health, and the Canadian Institutes of Health Research.

Purpose of the Conference

The concept of consensus conferences involves the evaluation of available scientific evidence on an issue by an independent jury. This jury develops a consensus statement that answers a series of pre-determined questions.

The Jury

Criteria were developed to select a broad range of participants with representation across various sectors. The panel included educators; Aboriginal, community and youth leaders; journalists; public policy researchers; academics; and authors.

Objective of the Consensus Conference: To develop a policy consensus statement on obesity and the impact of marketing on children to inform public policy makers, Canadians, and the media.

The jury was asked to assess the following questions:

  • What is the impact of marketing on children?
  • What is the current federal system governing marketing to children? Does it work?
  • What are the options available to mitigate the impact of marketing on children? Do they work?

During the first day of the two-day conference sixteen presentations were made – half by industry and half by public health representatives. The jury began working at the end of the day, and worked through the night, assessing the evidence and developing the consensus statement. The next day the consensus statement was presented to the participants who were invited to comment or ask for clarification. Minor amendments were made to the statement as a result of this feedback.

The jury noted the volume and complexity of the information, but stressed that it had nonetheless been able to consider it and to reach a consensus. The definition of marketing that was used by the jury involved the, “…planning and carrying out the conception, pricing, promotion and distribution of goods and services.”  It was also noted that advertising is one component of marketing which also includes pricing, product placement, merchandising, labeling, branding, packaging, in-store displays, online advergames, branded toys and clothing, sponsorship, character creation and celebrity endorsements, among others.

It was agreed that the marketing of food and beverages to children has an impact on their food and beverage choices. That foods and beverages marketed to children are predominantly unhealthy, and unhealthy food and beverage choices are contributing to obesity.  Further, it was deemed that the system of self-regulation of advertising to children is insufficient and was not designed to deal with the public health crisis of rising rates of childhood obesity. And that access to our children is a privilege and not a right, and as such should be subject to stringent regulation.

The Plan

The jury affirmed that marketing regulation should be only one piece of an integrated society-wide battle against obesity and all its many causes including poverty, geographic vulnerability and increasingly sedentary lifestyles. It also commented on the need to define what constitutes unhealthy food and beverages and the age of children that the policy should apply to. Other highlights of the plan include:

  • A call to the federal government to exercise its authority to regulate Internet marketing to children.
  • A call to the federal government to create, approve and enforce a regulatory regime that ends all marketing of unhealthy food and beverages to children within two years, including the indirect marketing to children through parents.
  • If the above noted time frame is not met a ban should be put in place ending marketing of all food and beverages to children, either directly or indirectly.
  • Re-opening the longstanding societal debate about corporate sponsorship of children’s activities, sports teams etc.
  • A call to government to appoint a panel of public health experts to define the age threshold for which marketing prohibitions should apply and to define what constitutes unhealthy foods and beverages.

The conference consensus statement was formally released one month after the meeting and received widespread media coverage. CDPAC endorsed the statement and then used it as the basis to develop its own position statement and encouraged other member organizations to do the same.

V CDPAC position statement

CDPAC used the consensus statement to inform the development of its own position statement on the issue. The CDPAC statement is in line with the conference consensus statement, but with several differences:

  • The reference to ban indirect marketing to children through their parents or guardians was removed as it was felt that this would be too difficult to implement.
  • The two-year time frame to put the regulatory regime in place was not included.
  • A call for the development of criteria that determines the extent to which food and beverage related corporate sponsorship bans, e.g., of children’s activities and team sports, should apply.

An advocacy strategy has been developed and discussions are underway to determine how a campaign might be rolled out.

VI Lessons learned

The use of this innovative and comprehensive policy consensus conference process can result in the integration of differing perspectives around a goal, and buy-in from a broad range of stakeholders. The results of the conference were exceptional given the diverse groups with often differing points of view and areas of interest. Some of the lessons learned that added to the success of the conference include:

  • Assemble representatives from different groups with shared interests and goals to tackle complicated issues.
  • Establish clear criteria for selecting the individuals to be involved in the consensus panel or jury to ensure societal representation and “fair mindedness.”
  • Be thorough in the jury selection process but be prepared to work hard to attract panelists. The time commitment is significant for panelists.
  • Focus on intersectoral collaboration and input. Ensure that all of the stakeholders are at the table who need to be part of the solution, including those with competing interests.
  • Ensure participation in the conference development process is balanced and fair with all stakeholders being truly engaged. This is a logistically complex undertaking.