Policy, politics and public health nutrition, with Dr. Katherine Cullerton

Dr. Katherine Cullerton is a Research Fellow in the School of Public Health at the University of Queensland. Katherine has extensive experience working in in a range of public health sectors and settings in Australia and in the UK. Her current research focuses on why evidence doesn’t translate into policy and how advocates can better shape nutrition policy.  We talk all things politics, politicians and public health nutrition and Katherine gives some great ideas on how we can all, as individuals, or as members of organizations easily advocate in our communities and what to look for when assessing policy commitments.
 
For further information, check out Katherine's researcher profile at the University of Queensland, especially the article titled 'Effective advocacy strategies for influencing government nutrition policy: a conceptual model' ; and Katherine's Twitter. 

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CREDITS

Host: Sophie Wright-Pedersen

With thanks to Dr. Katherine Cullerton for her time and thoughts


The Foodies in the Field podcast would like to acknowledge the traditional owners of the land on which this podcast was made and where Katherine was speaking from, the Turrbal and Yuggera people, as well as the lands from where you may be listening from today. We pay respects to elders both past and present and acknowledge that Aboriginal and Torres Strait Islander people were the first foodies of this nation. 

Transcript

Sophie: [00:00:00] Hi, welcome to Public Health Nutrition from Foodies in the Field, a podcast showcasing stories from passionate foodies about who they are and what they do. I'm Sophie Wright-Pedersen, your podcast host. And on today's show we have Dr. Katherine Cullerton, who is a research fellow in the School of Public Health at the University of Queensland.

Katherine has extensive experience working in a range of public health sectors and settings in Australia and in the UK. This has included working at the MRC Epidemiology Unit at the University of Cambridge, where she investigated if it's okay for nutrition researchers to engage with the food industry and if so, under what conditions.

Her current research focuses on why evidence doesn't translate into policy and how advocates can better shape nutrition policy. We talk all things politics, politicians, and Public Health Nutrition in today's episode, and Katherine gives some great ideas on how we can all as individuals or as members of organisations can easily advocate in our communities and also what to look out for when we're assessing policy commitments. Hi Katherine, welcome to the show.

Katherine: Thank you for having me, Sophie.

Sophie: Anytime. So we're officially in the pre-election phase leading up to federal election on the 21st of May this year. And with that comes a lot of election promises, talk of policy and strategies to address some of the key issues, um, in Australia.

I have quite a limited knowledge surrounding the policy process and its relation to Public Health Nutrition work. So I thought it would be best to invite someone like yourself as an expert to give us some credibility and insight into how policy comes to be and how we can all navigate this space maybe a little bit more effectively, or just to understand the process more intrinsically.

But before we dive deep into all of that, I was just wondering if you'd be able to give a brief overview of what led you into Public Health Nutrition and how you came to be where you are today working in the space of public policy.

Katherine: I trained as a Dietitian at university, and my first job was as the Dietitian for the indigenous health program out at Inala.

Uh, which I, I, I never wanted to work in a hospital. I always wanted to work in the community and I absolutely loved that job. I did it for almost five years and I learned so, so much in there and, but that job really helped me understand so that, you know, the importance of the social determinants of health and that just telling people about what they should eat and um, you know, what they should buy really makes a limited impact compared to those broader environmental issues surrounding us. And so then I went off and took off and did various things. I worked as a school's Dietitian in the UK and then I, um, I also worked in health promotion in Northern Sydney, but the opportunity came up to be, uh, apply for a job where I was the National Policy Officer on the National Aboriginal and Torres Strait Island and Nutrition Strategy and Action Plan, which is a real mouthful.

And we, we abbreviated it as NATSINSAP and I was fortunate enough to get that position and it was doing that position that really opened my eyes to the importance of policy and how frustrating it can be. And um, so I did that role for four years in total. I did it for a while, then I went back to the UK and then I did it again.

And it was, to be honest, my frustration in that role in how difficult it was to get evidence informed policy up. And I thought, there's gotta be a better way to do this. You know, how, how can we get evidence into policy? And so I thought, I'm gonna do a PhD and look at this and think, and then I'm gonna go back and I'm gonna go and work like in the non-government sector and implement it all, but I ended up having just so many more questions when I did my PhD and I, I really, really enjoyed doing the PhD and so that's why I'm still in academia now. I still have so many questions that I want the answers to. 

Sophie: Yeah. And what type of questions are those Katherine?

Katherine: Oh my goodness. Well, it's, it's all around. So my research now is all around why evidence doesn't translate into policy and what can we do as advocates to better, uh, enhance that process. And so, you know, at the moment we're looking at, um, the role of spokespeople and, um, how important is it when you are choosing a spokesperson to put forward your advocacy asks, you know, what sort of person should they be?

Many non-government organizations don't really think about this. They just put forward either their, um, their CEO or their public relations person, or sometimes they'll put forward a sports person or a celebrity because they think they're the best person to cut through, but there's very, very little evidence around this, [00:05:00] particularly in the field of noncommunicable diseases.

So slow moving issues that, um, require, we think a different approach possibly to more crisis communication where there has been a lot of research looking at spokespeople. So that's, that's an area that we're hoping to get some funding for a grant application and, and look at further now. 

Sophie: Yeah. Wonderful. I wanted to just go back a little bit and ask, when you say evidence informing policy, what do you mean by evidence? What, what is evidence and where do we get that from, and who do we get that from? 

Katherine: I mean, in my mind, when I'm thinking of evidence, I'm thinking of peer reviewed literature. So where we know scientists have done various studies and they, there is consensus on an approach in terms of it being effective, um, and feasibly going forward.

However, we know that evidence can take many forms, particularly for politicians. And so for them, evidence can also be, well, what the general public think or what my neighbour thinks that I'm, you know, I'm talking to at a barbecue. So that definitely forms evidence as well for politicians. But however, when I use the term evidence, I am meaning, um, empirically derived evidence and, um, usually found in peer review journals.

Sophie: I guess that that makes it difficult because I would use that same terminology with evidence as what you've used. But when you're communicating with politicians or other key stakeholders that might have more influence over policy, how do you navigate, you know, we're trying to advocate for the evidence we see as something, we've researched it and we know that this is something that should be believed in, and then there's evidence that we might consider as hearsay, but that's the information that they're surrounded by.

How do you navigate trying to get them to listen to your evidence rather than other evidence? 

Katherine: Yeah. Again, such a super important question, and this is something I've really been looking at over the past couple of years, is the role of public opinion. And so firstly, how much do the public support different policies, nutrition policies, but then also too, we've been really delving into the way that they speak about different policies, and we've been looking at the underlying values and beliefs that public use when they're talking about policies. And we've been capturing those and testing and turning them into, uh, various frames that we can test in, uh, framing a framing message experiment. You can talk about an issue in many different ways, and we say that's the way it's framed and underpinning a frame is, you know, you're putting emphasis on certain things.

So who's responsible for the problem? Who's responsible for the solution? That's a real, there are really important parts of a message and how it's framed, and so we're trying to take those commonly held values and beliefs that the general public are telling us about, and we're putting them into, um, an experimental study and we are seeing, well, what, what gets the greatest traction with the general public?

And we we're particularly interested in looking across the political spectrum. So I always get voting intention from any participants that we use in research, which it always surprises me when there's research looking into advocacy related work or policy work, and people don't collect this information. Like it's absolutely crucial to know, you know, these, the political ideology or the voting intentions of your participants, because that's not only really important for policy makers or politicians to know, but it's also important for you as a, a potential advocate to really nuance your message.

So what might appeal to, uh, conservative voters might be very different to progressive voters. And you know, that makes sense. But we can also confirm that in our studies and it gives you a much greater nuance, uh, when you are thinking about messaging 

Sophie: Like you're saying you're testing, yeah, what works when you're trying to communicate different policies within that noncommunicable disease space, is there anything in particular that you found has been more effective?

Katherine: Yeah, so well, this is something that we're looking at right now. We do, we've just recently completed an experimental study looking at how can we sell in sugar, sweet, and beverage taxes, because they are the nutrition policy that the public generally dislike the most. And so we thought if we can sell that in. Then we can sell anything. 

Um, but the, the problem is, firstly, is that what we found was that these framing effects, which is what, what it's called when you're measuring this changing in language, actually only had a pretty small impact to be honest. Uh, we were [00:10:00] a bit disappointed at the, the limited impact that it did have.

But what we found, we found, was that if we appeal to people around, uh, protecting children and protecting teenagers as why this policy is important. That definitely had, uh, traction, particularly with rural voters. They really liked that sort of sentiment and it tended to agree a lot more with the policy when the information was presented in that way.

The other interesting area was that across the political spectrum, people did not like it when we framed the message in terms of, uh, industry, you know, the sugar, sweet and beverage industry has been, you know, creating ill health, they're the cause of all the problems. Um, you know, they've been creating all of these dental caries and poor health amongst the public, costing us lots of money.

People did not like that. They didn't like it when we took the food industry to task, they, they much. And there was another frame we looked at where we were much more supportive of the food industry saying, you know, that this is a great initiative for them. This will help them identify healthier options and they can be part of the solution.

So they really liked these positive messages around the food industry, and they did not like it when we attacked the food industry. So I thought that was a really interesting and easy to incorporate tip for people to use when you're advocating. 

Sophie: That is really interesting cause yeah, I mean, it's so great that you're doing this research because I definitely wouldn't have picked that because I think, you know, it's quite easy to make an enemy out of, you know, the food industry and, and I guess like, it sounds like those more positive messaging or those positive frames that you're, um, messaging through or communicating through, seem to be more effective in terms of getting people on side.

And so when you, you've understood that messaging and communication, what would you do then with that kind of information in terms of how does that inform policy and communicating with politicians or other people who are creating policy? 

Katherine: Yeah. Well, as an academic, I write it up into a paper and talk about it at conferences to other academics. So that's step one. But then the other aspect is I work really closely with non-government organizations as well, and so for me, I will only do research that is helpful for them, and so I am constantly communicating with non-government organizations and letting them know about these findings and filling them in on it.

I will share my findings with them at any time. I do not like, I'm not precious about waiting for publication. To me, they are my main stakeholders and I prioritize them above everything else. 

Sophie: Yeah. And then what influence does that non-government organization sector have when it comes to advocacy and policy?

Katherine: Well, it depends on the policy to be honest, but unfortunately, the reality at the moment with the current government that we have in Australia, at a federal level, it, it is fairly limited. So we have a, a government who's in power, who's very neoliberal, but they are also really into protection for farmers and, uh, whether they're sugar growers or beef farmers.

Because they tend to be the big donors, which is another study that we've recently done looking at who's providing money to political parties. Yeah. So they do not wanna, you know, rock the boat in that regard. 

And also too, I mean the, the issue is with the, the current governing party is their ideology, whether they're liberals or nationals, is that, you know, you should be in charge of your own choices. They don't like interfering in people's choices. And so, which makes it really hard for public health, because that's often what we do.

You know, we're trying to make, uh, the healthier choices, the easier choices by altering the environment, whereas their ideology is no, don't interfere in that. Leave it up to the individuals to make the choice. 

And so, even without the influence of the food industry, you know, lobbying and providing donations and all of those things. At the end of the day, their ideology supports no involvement, no intervention in these sorts of spaces. And so we are really, it's a really challenging space for public health advocates to, to work in with this sort of government in power.

Sophie: It really is. And then you get kind of coined as taking a nanny state approach if you do try and intervene. 

In areas where, you know, some, some people or some environments might be highly disadvantaged compared to other areas or, um, like you say, there's a lot of [00:15:00] money going into influencing these environments from other key stakeholders to change them to maybe make the healthier choice the least easiest choice. Um, so that's where government intervention can actually have a positive effect.

And I wanted to follow up on a few points you made there with, you know, those other stakeholders such as the food industry. I mean, how much, when it, when we talk about policy being created and politicians being involved in that, who are the key kind of influences when it does come to policy being made or even certain policies being prioritized over others in that political space generally?

Katherine: Well, the Australian Food and Grocery Council is an incredibly powerful organization. They are, yeah, incredibly powerful. And a lot of their staff now work in government departments or in politicians' offices as well. And so they have that sort of revolving door in amongst themselves and government offices.

So they have great insight into the policy making process, and then they can also influence that process. So they're definitely a big player. The other big players are the National Farmers Federation and the different, and the Meet and Livestock Association. So they're, you know, really big players.

They get invited on prime ministerial, uh, trade tours. So they're up right beside the Prime Minister all the time, uh, and are able to, uh, drip feed the, the Prime Minister with information around how important their sector is to the economy, um, how damaging any policies would be that interfere with that.

And so they've got this really privileged position where they're able to walk in and just demand meetings at any time. Oh, the other big players are the big supermarkets as well. So Woolworths and Coles, also incredibly powerful. Uh, and able to command or demand, I should say, demand meetings whenever they want.

So these are organizations who employ a lot of people. They pay a lot of tax and they make a lot of money themselves and can often provide donations. But these, often the donations are secondary. It's their ability to say that they employ a lot of people and they pay a lot of tax.

Sophie: In considering those organizations. Are they always detrimental to the Public Health Nutrition space? Or can we leverage their power or has their power ever been leveraged in a way that's ever been beneficial? 

Katherine: This is something I, another arm of my research is looking at conflicts of interest and whether it is ever okay for, uh, nutrition researchers to engage with the food industry.

And we, we tend, we're looking at it from a research perspective, but it can also apply to an advocacy perspective as well. And personally I would say anytime there, there really isn't a place in terms of any sort of processed food industry to partner with them. I think it's a really tricky situation because, you know, I think you might have heard people saying, you know, how can you make healthier cigarettes? Type thing.

Like it's, it's a really, you've got ultra processed food trying to be healthier through manipulating various nutrients. It's, it's, you know, it's limited in what can be achieved there. Um, however, I do think this is possibly a role to work with primary producers and particularly, uh, to me it's always about thinking, are my end goals the same as the external stakeholders goals?

So, the only food industry partner, I can think of where my end goals would be the same would be fruit and vegetable producers or farmers. So to me, I think that there's an, we could do a natural alignment with fruit and vegetable farmers and, and really support each other because we want people eating more fruit and veg. They wanna sell more fruit and veg.

So to, that's, that's definitely a clear group. It gets a lot hazier when we move into, say, dairy companies or, or meat, you know, seafood, meat companies. It's, it's so challenging and we're just, I'm working with, uh, Sherri Russell at the moment. She's coming to the end of her PhD, but also works as a research assistant with me.

And we're looking at applying a tool that I developed with colleagues at the University of Cambridge where we assess different companies to work out whether how high the risk factor is to engaging with them. And so we were just literally talking about a dairy company and thinking, this is really tricky, and it turns out they're a moderate risk, but it's, it's a really, it's a really challenging area for many people.

Sophie: I just wanted to ask a bit of background information on how much has the industry have on something like the Australian Guide to Healthy Eating and how that evidence is put together? 

Katherine: What I'm gonna say to you now is from what I've heard from Professor Amanda Lee, in discussions with her, she's also here at the School of Public Health.

So Mandy has mentioned previously to me, she was the previous chair of the [00:20:00] Australian Dietary Guidelines, and she has mentioned to me about the how, uh, influential the food industry was in terms of keeping certain issues out of the dietary guidelines. So there was a push for the last dietary guidelines to include sustainability, but the, uh, food industry representatives would not allow that, allow that to go in.

They wouldn't sign off on it if that was included. And so it was kept out. So clearly, um, previously they have had a strong, uh, level of influence and we know that with, you know, at the Health Star Rating. They developed the algorithm for the Health Star Rating. They determined it was voluntary, not mandatory.

Um, they've been pushing back against, you know, various changes to improve inverted commerce, uh, the algorithms and the labelling. So, you know, they've got incredible influence. But I think we can't just give them all the credit here. We have to acknowledge as well that the, the party in charge, this ruling party in charge, our liberal national, um, coalition, they equally fully support that as well.

So I, I'm always wary of giving them too much power because it's also, they've got a, an audience, these policy makers who absolutely agree with that approach as well. 

Sophie: Yeah. Yeah. And is there any kind of transparent process of, or is there any way to find out like who has informed policy around that space?

Katherine: No . So we have got, in Australia, we have got some of the worst transparency requirements for lobbying. It's pretty good at some of the state levels. So particularly in Queensland, we're really leading the way in terms of transparency. So ministers here publish all their diaries, having said that, the level of information in the diaries has definitely decreased over time.

Uh, New South Wales does that as well, but again, they've always had a fairly low level of information in there and ACT has just started. So I mean, that's great. It's better than nothing. 

To be honest, the federal government is terrible, like really, really terrible. We've got no idea who is going in and speaking to the ministers, except if you are on the, uh, lobbyists register and the only people who are on the lobbyists register are third party lobbyists. And so these are people who are employed by lobbying firms. Which, when it comes to food, the great majority of lobbyists are employed by food companies. They're not employing external firms to lobby on their behalf.

They have their own people to do that. So in Australia, the only thing that's captured is when a person on the lobbyist register goes to meet with, uh, federal politicians. We don't find out when they're going to meet with bureaucrats or even advisors. We only know when they meet with the politicians. It's, it's a really, really disappointing situation.

You can see there's amazing examples of transparency in other countries around the world, namely Canada. They're doing a really good job. Even the US is better than us, in this space. So it's very, very disappointing from a transparency perspective.

Sophie: That's actually really upsetting to hear, and it kind of, you can kind of see maybe how we've got to where we are today with some of the policies and other processes that we have.

And so for anyone working in the space of Nutrition, Public Health Nutrition, or you know, more broadly Public Health or in those non-government organizations, what are kind of the best channels or levers to actually advocate for certain things to make it into public policy? 

Katherine: I just wanna say to is to always remember that policy change is really complex. It's dynamic and it takes a really long time, a lot of, a lot of the time. Although occasionally it can be very quick. This is the, this is the problem. You never know what you're gonna get, but you've gotta be in it for the long haul, for starters. But the strategy that I always say to anyone who wants to start advocating in any, for any health issue is to make connections with your local members of parliament.

And depending on your issue, it will either be the state or federal or both, or maybe local, depending on, on the issue. But if you can develop a relationship with your local MP, it can be incredibly valuable. What, one, they may be in the party that's currently governing, so you've got a, a root into that governing party and you never know, like the, they could actually be in a position of power, which is fantastic.

Or they could even be friends with a person in position of power. So, a lot of people think, well, why would I go and see my MP when they're a shadow, that they're in the [00:25:00] opposition, they're not even a shadow minister. What's the point? The point is they may be governing after the election and they may be in a position of power, or they may be friends with the person in position of power. But you've got to start developing these relationships, and so this is something that I do with my local MP's.

And all it requires really is making contact with them every, once every six months, even, you know, six to nine months. Yeah. I, I will never, ever email them. Don't do that. That's an absolute waste of time. Their admin staff will see it and they'll respond to it. If you want to get their attention, you either need to call them or you need to send them a hard copy letter.

And I remember my MP was saying she loves getting hard copy letters. She only gets about seven or eight each day, and they're put on her chair or her desk, and she personally opens them up each morning. 

Sophie: Wow. 

Katherine: So, whereas she barely looks at email. So it's a really clever way of getting people's attention. If you can send a hard copy letter.

Sophie: What types of things would you put in that letter? Cause I think, you know, for people who might not have ever done that before, not even really knowing what you're trying to communicate, like are you trying to advocate there and then, or are you just making contact? 

Katherine: Well, if you, if you wanna advocate for a certain solution, I would just, and, and you don't have a relationship, I would put it in a letter.

I think that's a really quick and easy way to do it. On the flip side, if you wanna build the relationship, I think you either call the office, and this is the beauty of, of doing this in your local electorate because your member of parliament has a requirement to see you as someone in that electorate.

They have to see you, or their chief of staff will see you, and that's okay. Like chief of staffs are fantastic, like they're not a waste of time. So I would call them, or often they have mobile offices where, you know, they're out in the front of Woolworths or in a park or something. Go up to them during their mobile office and introduce yourself and ask if you can arrange a time to come and chat with them to tell you them about, you know, your work or your interests or an issue that you are really concerned about, or, or if they've got no one talking to them at the um, the mobile office, they might wanna have a good chat with you then and you could send them some follow up information.

But what I've found in all of my meetings with various politicians is they love to have a chat with people they really like, particularly, uh, people who can have a good conversation and who are offering solutions. So often they're speaking to people who are complaining. And they may not have a solution.

And you know, they don't know what to do in those situations. And so if they can speak to someone who's articulate, who can identify a problem, but then they've got a solution as well, and they talk to them in a really nice conversational way. They love it. You've gotta remember too, particularly for independence, they're always looking for new ideas that they can take forward and draw attention to themselves.

So you might be presenting that to them. So always think you're coming to help them. You know you are coming to give them some new ideas and some solutions to a problem that they may not know anything about or they may have heard about. 

Sophie: Anything else that you think is like some really good channels or levers?

Katherine: Yeah, I mean, the other thing is really intelligence gathering. So that's a really important, um, component because often that will provide you with opportunity. You know, you'll know when opportunities are going to appear, and it, and it, it's tied in with, with relationship building. So if you meet your politician and then your building a relationship and you can say to them, let me know if anything comes up here.

Or can you put me in contact with someone else and you can speak with them and build up a relationship. But also, let's not forget our bureaucrats. So these are the people who work in government departments. They can be amazing sources of intelligence, you know, they know what's going on a lot of the time, um, internally. 

And so if you can also reach out to them, say hello, saying you wanna help, you know, is there anything you can do to help progress policy in this area? Um, you know, that's really, really beneficial. And they may provide you with some, I know I'm not gonna say that they do this, but , you know, like off the record information that may help you as an outsider advocate really effectively.

So they, they're a great group to get involved with. And then also too, you, you've gotta start reading or watching the news to know what's going on. To be a really effective advocate, you've got to, got to be aware of issues and you know, if there's leadership challenges or you know, what, what is happening in that space.

So really I would recommend everyone to start taking a bit more of an interest in politics. And again, that might give you some opportunities or at least give you insight into the process.

Sophie: And that's kind of at an individual level. But what about other groups? Like we've got [00:30:00] things like, I guess the Dietetics Association, but also the Public Health Association of Australia, and then you might work for your organization.

Are there different ways in which those types of institutions can influence policy as well? 

Katherine: For sure, and I. This is our real strength as public health advocates is we've got the numbers. If we can mobilize our organizations that are membership based organizations in a more effective way, in a more unified way, that is really, really powerful.

I, I have a friend who's a lobbyist, a private sector lobbyist, and he basically reiterated that to say, you know, like, that is your power. If you can mobilize those individuals to go and either write a hard copy letter, not an email, a hard copy letter, or try and make an appointment to see your member for Parliament and talk about the issues you've all agreed on.

And so there might be a nutrition policy or something, or a sugar sweetened beverage tax. We would get the, the language that we wanted to use around that issue agreed upon, and then we could all go out and say, look, could every one of you either write a letter or go and speak to your local member? And that's incredibly powerful.

Um, there's something about a politician getting hit multiple, multiple, multiple times about the same issue, across electorates as well. 

Sophie: I wanted to ask your thoughts on the role of the media are in terms of how policy works and maybe how we can leverage that space a bit more? 

Katherine: We've been doing quite a few media analyses and um, what you just said was absolutely right in terms of how we can leverage it more because currently we are not leveraging it enough.

So we did a media analysis looking at, you know, what issues are journalists reporting on, how frequently are they reporting on these issues? And what we found was that in comparison to smoking, you know, we have covered like four times less than smoking has ever been. When we compare it to successful policy issues such as smoking. Um, we are really not getting anywhere close. 

And so I think there's, again, this is something that members from different public health membership organizations could really play a powerful role in amplifying the voice. Making contact with their, uh, local journalists, their local publications or radio services, and getting that information out there in a more effective way.

And I know from speaking to journalists, one of the things that they look for the most in terms of their contacts that they interview is responsiveness. And so the, I think the problem, certainly in academia, a problem a lot of us have is we really wanna be prepared and ready to answer questions. And so a journalist will call us and we'll be like, oh, okay, I can speak to you tomorrow about this issue.

You know, cause you feel like you need to prepare and get everything, all your ducks lined up. But they want an answer now or you know, in 30 minutes. And if they can't get that from you, they'll move on to someone else. 

Sophie: With policies, you'll have a policy and then you might have like an action plan or a strategy attached, or you know, we've got the new National Obesity Strategy and then we've got the National Preventative Health Strategy.

What's the difference between a policy and a strategy and is one better than the other in terms of affecting change or you know, getting money allocated to certain things? Or how does that kind of work? 

Katherine: First of all, there's various definitions of policy, I should say, but the definition that I use when I'm talking about policy is from Thomas Dye and its policy is anything the government chooses to do or chooses not to do.

So you can talk about strategies, um, and they could be strategies that you've developed, you know, you've developed, um, an obesity strategy. But until the government says, yes, we agree with this, and this is it, it, this becomes their policy. So if they've agreed to the strategy, it becomes policy. Whereas if they haven't agreed to it, you could also say that's policy in that they haven't agreed, you know, their policy is to do nothing in that area.

So policies is a catchall phrase for what the government has decided to do or decided not to do on an issue. So the wording that you use, it doesn't really matter, you know, it could be strategy, it could be an action plan. The policy aspect of it is whether the government has agreed to it or not, and to me, the most important part of it all, is if there's an implementation plan and money associated with that [00:35:00] implementation.

Because I think many of us know, my God, how many strategies have gone through that the government has signed off on, so it's become their policy and then it's done absolutely nothing, because there's been no money for implementation.

And so, I mean, and that was the, that was my frustration in NATSINSAP. So it was a 10 year strategy that the government had agreed to. So that was their policy. I guess we could say that we were lucky than others in that we were given one full-time person for one year, to start with. And then we were like scrambling for money every, you know, we'd come to six months and we're like, please, please, could we have some more money to, to implement this 10 year strategy.

And you know, and then they'd give you like another six months or maybe, maybe you'd get a year. And so it was just ridiculous in terms of how can you implement a 10 year strategy that's got multiple components with one person. 

Sophie: Yeah, for one year, you got nine more years to go.

Katherine: Exactly, exactly. And so this sort of piecemeal, you know, it's an easy, let's shut them up with this. Let's throw a little appetence of money to say we're gonna develop a document that has some aspirational statements in there, but then give them no money to implement it and we won't support the implementation. But we've got the document. 

Sophie: The liberal government has allocated their budget, which in that says, you know, there's 0.7 million, so seven hundred thousand dollars over four years to develop a national nutrition policy framework, which isn't a lot per year. 

Katherine: 175,000 each year.

Sophie: Which is like maybe 1.5 FTE's depending on who you're employing. And then no project cost, which I've seen a lot of in this space where someone will be employed, but there'll be absolutely no money allocated to actually performing the project, to develop a national nutrition policy framework. And then there's half a million dollars over two years. So $250,000 a year to undertake a feasibility study on safeguarding children from unhealthy food and drink advertising. Which I thought we'd kind of already done in this, um, in, in our space.

But I guess like if I'm looking at that, you know, if anything else comes up in any other budget in the future, how, how can you assess whether or not that's actually a genuine commitment to something? What kind of things are you looking for? 

Katherine: Well, I think looking at the word implement, you know, is the word implement there and is there enough money to implement it is the key thing.

I mean, these really are pittances when, you know, you think what we're spending on nuclear submarines, like it's billions and billions of dollars. And so to me the red flags in these are very small amounts of money and the fact that it's all, you know, developing this and feasibility studies, like it doesn't, it's, it's not a commitment to do anything.

It's just a commitment to potentially create a document or two different documents. And like you said, with the feasibility study, my goodness, that's been done so many times in other countries and you know, people have even haven't looked at this in Australia as well. 

Sophie: And because it says, I'm literally reading it verbatim, but to develop a national nutrition policy framework, we could develop that, just say, a framework could be developed, but the government would still have to sign off on that for it actually to go up as a policy. 

Katherine: Yes, yes. But then the problem is too, they can still sign off on it, but still do nothing. So that was what happened with NATSINSAP. We had the health ministers sign off on it, the National Aboriginal and Torres Strait Island and Nutrition Strategy signed off on, but then nothing happened. There was, you know, no money or no, like there was no reporting against it. So that's the other really important component. There's the implementation, but you need to be reporting against that as well, being held accountable for implementing it. So without implementation and accountability, it, I think it's worthless, really. 

Sophie: I think that's a really important point to make. What is the process of policy actually making its way to being approved by a government and then acted upon? And where does evidence, as you've defined evidence, how does that fit into the policy and, and how do we make sure that it's getting embedded in there?

Katherine: Policy is made in so many different ways, so you've got a standard way, you've got a burning problem, and, uh, people, different stakeholders will come in and offer solutions to this problem. And then, uh, policymaker. So when I say policymaker, I'm talking about politicians usually. So they're the ones who can, you know, make decisions around, um, [00:40:00] policy items.

They'll think, hey, that's a great idea. I can see that working. I'm gonna take it to cabinet. Um, so cabinet will then discuss it, and, and this is, this is only, it only goes to cabinet if it's something that's a big, you know, like often a regulatory change or a legislative change. If we're just talking about allocating money to, um, like a, a food program. 

Often that doesn't need that, that won't need cabinet approval, that will just mean they need the health minister's approval. So you've got different policy tools that will require different levels of agreement. So clearly the hardest ones to get agreement on are regulatory, um, policy initiatives.

Sophie: That would be like the Health Star Rating or something. 

Katherine: Correct. Correct. Well, actually that wasn't cabinet that, but that required all of the health and food ministers from around the different states and territories to agree on that. And again, this is why, the other, that just raises an important issue is sometimes, depending on the policy solution, your state members can be really important. So your state health minister and the state food or agricultural minister can be really powerful advocates.

Or, or people who can stop policy. So we know, for example, in Tasmania, I'm just going to do a hat tip to Judy Seal down there. She's the chief nutrition person down in the Tasmanian Department of Health. She's got a great relationship there with her senior execs and the, the health minister there. And Tasmania has played a really important role over the, you know, past decade in terms of supporting or blocking various policies.

That's one way, but the other way is literally what I was saying to you before. You could be talking to your politician down at the shops, you know, telling them about a problem that you have and that you saw this amazing solution for it. And if they think it's a goer, they could go back and take that to their colleagues and say, hey, look, we should, we should support this.

We should, um, have this as a policy issue. Like it can happen that quickly. And particularly often there's times when the government is looking for distraction. They'll be looking for something to take attention off, you know, a disaster or something they've done, they've stuffed up. And so they'll be looking, quick, what's a good news story? What's a good news story?

And generally that's gotta be about children. So that would be the time, um, that they would announce a cooking program for children. Policy is made in so many different ways. So it's, and that's what makes it so challenging and why I'm so fascinated by it.

And this, again, this has happened with me, not for a policy item, but for other things. They'll call you and they'll say, hey, look, we've got a problem here. Have you got a solution that we can have to quickly, quickly, you know, slap together? And so this happens where if they feel they can trust you, and that you are a, you know, a person with good ideas, that speaks perhaps on behalf of many people. They will trust you and they will call you and ask for your advice or guidance in these areas.

Sophie: Yeah, because they aren't experts in everything. 

Katherine: No. 

Sophie: Yeah. You were talking about monitoring before with policies, but once a policy is created, what's the next step? Like, we've got a couple of new policies in this space that have come out. How can we guarantee that change will be made?

Katherine: Well, the key thing, like we were talking about before, is ensuring there is money for implementation and that there are monitoring requirements and standards that you're monitoring against. And I would say the non-government organizations really come into play here where they can hold the government accountable for that. 

Sophie: I mean, we've talked a lot about talking to your local MP's about certain things. Once a policy is, you know, in place and has been signed off by the government, and you notice maybe that there isn't a lot of money allocated to it or things aren't really going the way that they've planned. Is it worth going and talking to your MP? Is there a space, I guess, for saying, hey, this is fantastic, this policy's here, but maybe we're a little bit concerned about the fact that there just isn't enough money allocated? 

Katherine: In answer to the first bit of the question, yes, you can always go and talk to your local MP about this. I think give any excuse. You've got to go and talk to them. Take it. Like so, yes, definitely you could talk to them about that. And yeah, we see that with numerous issues where an initial amount has been allocated for a different policy solution. And then, government will top it up or they'll provide even more. It may not be in this, uh, year, but with the next budget, there's opportunities for for more money to come in. 

Sophie: Is there ever a better time to be lobbying governments or, or members of government to get certain things in place, like, you know, leading up to an election or after an election?

Katherine: There are clearly important milestones throughout an electoral cycle, which you can take advantage of. So prior to budget, [00:45:00] not the week or two before the budget, but you know, two to three months before the budget, that's when people are looking for ideas. So that's clearly a really good time. And also in the lead up to an election, before the different parties have announced what they're doing. So again, this is where they're looking. They're looking for great ideas. They're looking for ideas that will resonate with the public. 

But the other, you know, you raised this, is the other really important time is particularly if a new minister or a new party comes to power. We've been analysing minister's diaries, and it's really interesting to see, particularly for the health minister anyway, the rush of people to come in when a new minister comes in to play and so all the big players are in there in that first month or two meeting the new health minister.

It doesn't matter if it's the same party or a different party, if it's a new minister, it's new opportunities. And so it's, it's clearly very important for our commercial, uh, colleagues to be doing that. So I always try and follow what the commercial sector does, and I think if they're doing it, they must know that it's important, so we should do it too.

Sophie: Is there maybe some key take home messages? 

Katherine: Uh, the importance of building relationships with your local MP at the state and the federal level? I think that's super important. Becoming interested in politics generally, and gathering that intelligence from the news, but also, you know, the politicians that you're meeting, but also those bureaucrats, those people out there who work in government, they can be amazing sources of information. 

I would think about mobilizing, um, membership associations in, in the health sector. I think realize that there is tremendous power and influence that can occur if you approach an issue in a unified way and you mobilize your forces in that way. 

But then also think about the language you are using when you are communicating about an issue. Try and be positive. Try and be solutions focused. Try not to slag off the industry too much. And also if you can get a sense of how popular the solution is within that electorate or with the the voters, and particularly swinging voters. That's really, really important information for politicians to know. 

Sophie: For people who might be wanting to get into those more formal kind of policy positions. Is there anything that helps you get into those? 

Katherine: I teach into the Master of Public Health program here at UQ and you know, we focus a lot on policy. When I was working as a community dietitian and I wanted to try and influence policy more. I did an MPH and I found it incredibly insightful to, to challenge the way I was thinking about issues.

The other thing is to try and get a job in government. Like in like the central office of government. And so you might need to start down low and then work your way up. And they're often looking for project management skills there. 

And the other thing that I would encourage people to think about is maybe even think about getting a job in an electoral office, you know, or a political office. You know, that's, you'll get an amazing insight into the policy making process there. 

Sophie: And then my final question for you is, what's been your favourite food experience? 

Katherine: I think, what I would put forward is my, one of my most recent ones, which was actually in Brisbane at a good friend of ours, um, Arthur and Teresas.

And Arthur is a Greek man and he is an amazing cook and I'd often talk food with him. And we have children the same age. And so he invited us over for a Greek feast at their house and he cooked us, uh, like a seven course Greek feast and it was amazing. It was so impressive. He'd been cooking all day and I think even the day before.

And you could just see there was so much love in every dish that came out. It was oh, such a nourishing, wonderful experience. And um, so that's the one that's the top of my head because it was the most recent. 

Sophie: Yeah. Yeah, yeah. No, that's, that sounds so beautiful. Thank you so much, Katherine, for coming on the show. It's, it's actually been so insightful for myself and I'm sure it will be for a lot of other people because like you said at the start, policy is such a complex beast. But I think from this, I've definitely understood that it doesn't really matter who you are or where you work, or yeah, what you're doing. Everyone can have an impact. And it might be through just writing a letter or picking up the phone, which gives you a sense of a hope, I guess, an agency around actually having some power in your local, and even, you know, national community as well. So, thank you so much. 

Katherine: My pleasure. It's been lovely chatting with you, Sophie. Thank you for inviting me. 

Sophie: So, thanks for listening. There'll be some links to Katherine's research profile in the show notes, where you can also get in contact with her and read further into all of her amazing work in this [00:50:00] space. And remember, we are on Instagram and Twitter. If you'd like to get in touch to ask us any questions or even suggest any foodies that you know, who you think should come on this show. And if you do get the chance. Please share this podcast with people who you think might be interested and leave a review to help us spread the word all about Public Health Nutrition.