How can power theories be applied to public health nutrition? An exploration using ChatGPT
Good nutrition is a requisite for good health; examining the systems that enable some populations to eat well while others struggle has traditionally been examined using a social determinants of health lens. In today’s post, VicHealth (@VicHealth) postdoctoral researcher Christina Zorbas (@CZ_Christina) of Deakin University (@IHT_Deakin) teams up with Chat GPT to propose how power theories may illuminate inequities in food access and nutrition.
New lenses on an old problem
Theories help us understand the complexity of the world around us. In public health nutrition we often limit ourselves to using the socio-ecological model and frameworks on the social and commercial determinants of health. Using these lenses, public health approaches to improving the nutritional health of populations focus on improving the underlying determinants of what people eat by creating health-enabling policies and programs, environments, monitoring systems and campaigns.
Power theory provides another framework for understanding the complex social, economic, and political factors, including economic structures, social institutions, and gender and race relations, that shape health and health inequities, including inequities in population nutrition (see our Lancet perspective on this topic for World Children’s Day). Whilst we have made preliminary efforts to recognise power imbalances as core components of inequities in nutrition in our previous work, additional scope exists to expand our thinking in this space.
Strong theoretical knowledge of power can be a valuable tool for promoting health equity and social justice in public health, but such theories are not always written about in ways that are easy to understand or are not taught to us in biomedically-focused health systems. In this blog, I have jumped on the Chat GPT bandwagon to get the low-down on why we should use theories that describe the nature and sources of power when working in public health nutrition (and to test Chat GPT’s ability to explore these types of topics!).
Power theories may have application to public health nutrition
Using different theoretical lenses can illuminate different issues when we examine food access inequities. Photo by Adli Wahid on Unsplash
We apply several power theories - including Foucauldian theory, postcolonial theory, feminist theory, critical race theory and Marxist theory - to the context of public health nutrition. It is our hope to convey a more nuanced yet simple description of how power imbalances drive inequities in nutrition and identify strategies for promoting equity in all our public health nutrition work.
1. Foucauldian theory (1960s-80s) emphasizes the role of social institutions and practices in shaping power relations that contribute to social disparities. An example of this in public health nutrition is how food policies and regulations often prioritise the interests of the food industry over public health, and how this can perpetuate power imbalances and limit the agency of individuals and communities in shaping their food environments.
Policy implications: Foucauldian theory suggests that addressing power imbalances in public health nutrition would require challenging dominant institutional interests (e.g., commercial, political, scientific interests), including encouraging all of us to engage with reflexivity, and promoting more participatory decision-making processes.
2. Postcolonial theory (late 20th century) highlights the enduring legacies of colonialism in shaping power relations that contribute to population diets. For example, colonialism has had a profound impact on global food systems, with many former colonies still heavily dependent on food imports or nutrition expertise from the Global North. This can lead to the ongoing displacement of local food systems and promotion of malnutrition in all its forms in many communities that have experienced colonisation.
Policy implications: Postcolonial theorists would argue that the experiences and voices of First Nations groups and many communities in the Global South should guide policies and programs that challenge the legacies of colonialism.
3. Feminist theory emerged as a field of study in the 1960s and can be applied to highlight the intersection of power and gender in shaping diet-related inequities. For example, women are often disproportionately affected by food insecurity and malnutrition due to structural factors such as gender-based discrimination and wage inequality.
Policy implications: Feminist theory highlights the need to centre the experiences and needs of women when working to identify policies and programs that address the underlying structural factors that influence gendered inequities in nutrition.
4. Critical race theory stems from scholars in the US (1970s) who sought to understand how race intersects with law and power, thereby maintaining racial hierarchies. For example, communities of colour are often disproportionately affected by food insecurity and malnutrition due to structural factors such as racism, discrimination and lack of economic opportunity.
Policy implications: As with the other power theories, critical race theory shows the importance of centring the experiences and needs of the most affected communities (i.e., communities of colour), and promoting policies and programs that challenge how systems of oppression contribute to food inequities. This could include policies that promote food sovereignty and community-led food systems, and programs that address systemic racism in education and employment opportunities.
5. Marxist theory (the mid-19th century work of Karl Marx and Friedrich Engels) enables us to understand the role of economic relationships (e.g., capitalism and the exploitation of the working class) in shaping power imbalances that contribute to health inequities. In food systems, those who control the means of food production and distribution (such as large food corporations) have significant power in shaping food environments and determining what foods are available and affordable. This can lead to the promotion and consumption of unhealthy foods that contribute to adverse health outcomes, particularly for populations on low incomes who may not have the resources to access healthier options.
Policy implications: Marxist theory would argue that addressing power imbalances in food systems requires challenging the dominance of large food corporations and promoting alternative models of food production and distribution that prioritise health and equity over profit.
Reflections
Whilst each of these theories have influenced decades of social and political thought, they have each received several criticisms. Some common criticisms are that power theories can lack practical solutions for political and social change, lack empirically tested evidence, overemphasise the role of power in shaping society (compared to other factors, for example economics or culture), seldom recognise diversity and complexity in human experiences, and can lack attention to intersectionality by narrowly focusing on certain aspects of social identity.
In conclusion, power theory offers a valuable lens to understand the ways in which power imbalances in society contribute to widespread issues in population nutrition. Ultimately, equitable improvements in population health will necessitate addressing power imbalances through a multifaceted approach that centres the experiences and needs of communities that have experienced marginalisation, promotes more democratic and participatory decision-making processes, and challenges the dominant paradigms that prioritise profit over equity and health.
As power affects us all, it is also critical to ask how power theories apply to our own lives and institutions and how we can advance our contributions to these theories within the context of public health nutrition.
If you still are not convinced about how you can apply these theories to your work or simply don’t know where to start – we now have Chat GPT to break these concepts down into bite size pieces in no time at all. Note that it is limited in its ability to help with referencing and synthesising more recent concepts – so our human skills aren’t being fully replaced just yet! In any case, I would encourage that you give it a go.
Christina Zorbas currently holds a VicHealth Postdoctoral Research Fellowship. Her research identifies policy mechanisms to reduce inequities in population nutrition. Her views may not reflect the position of VicHealth.
Posted by Susan Maury (@SusanMaury)