Legal and regulatory instruments for NCD prevention: a scoping review and descriptive analysis of evaluations in OECD countries
Abstract Context Public health law is an important tool in non-communicable disease (NCD) prevention. There are different approaches available for achieving policy objectives, including government, co-, quasi- and self-regulation. However, it is often unclear what legal design features drive success...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-024-18053-4 |
| _version_ | 1827325802371350528 |
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| author | Maddie Heenan Ashleigh Chanel Hart Katherine Cullerton Stephen Jan Janani Shanthosh |
| author_facet | Maddie Heenan Ashleigh Chanel Hart Katherine Cullerton Stephen Jan Janani Shanthosh |
| author_sort | Maddie Heenan |
| collection | DOAJ |
| description | Abstract Context Public health law is an important tool in non-communicable disease (NCD) prevention. There are different approaches available for achieving policy objectives, including government, co-, quasi- and self-regulation. However, it is often unclear what legal design features drive successes or failures in particular contexts. This scoping review undertakes a descriptive analysis, exploring the design characteristics of legal instruments that have been used for NCD prevention and implemented and evaluated in OECD countries. Methods A scoping review was conducted across four health and legal databases (Scopus, EMBASE, MEDLINE, HeinOnline), identifying study characteristics, legal characteristics and regulatory approaches, and reported outcomes. Included studies focused on regulation of tobacco, alcohol, unhealthy foods and beverages, and environmental pollutants. Findings We identified 111 relevant studies evaluating 126 legal instruments. Evaluation measures most commonly assessed implementation, compliance and changes to the built and lived environment. Few studies evaluated health or economic outcomes. When examining the design and governance mechanisms of the included legal instruments, government regulation was most commonly evaluated (n = 90) and most likely to be reported effective (64%). Self-regulation (n = 27) and quasi-regulation (n = 5) were almost always reported to be ineffective (93% and 100% respectively). There were few co-regulated instruments evaluated (n = 4) with mixed effectiveness. When examining public health risks, food and beverages including alcohol were more likely to be self- or quasi-regulated and reported as ineffective more often. In comparison, tobacco and environmental pollutants were more likely to have government mandated regulation. Many evaluations lacked critical information on regulatory design. Monitoring and enforcement of regulations was inconsistently reported, making it difficult to draw linkages to outcomes and reported effectiveness. Conclusions Food and alcohol regulation has tended to be less successful in part due to the strong reliance on self- and quasi-regulation. More work should be done in understanding how government regulation can be extended to these areas. Public health law evaluations are important for supporting government decision-making but must provide more detail of the design and implementation features of the instruments being evaluated – critical information for policy-makers. |
| first_indexed | 2024-03-07T14:35:37Z |
| format | Article |
| id | doaj.art-2078cc144c0c4d21820ed6334c5ad751 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-03-07T14:35:37Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-2078cc144c0c4d21820ed6334c5ad7512024-03-05T20:38:45ZengBMCBMC Public Health1471-24582024-02-0124111710.1186/s12889-024-18053-4Legal and regulatory instruments for NCD prevention: a scoping review and descriptive analysis of evaluations in OECD countriesMaddie Heenan0Ashleigh Chanel Hart1Katherine Cullerton2Stephen Jan3Janani Shanthosh4The George Institute for Global Health, University of New South WalesThe George Institute for Global Health, University of New South WalesSchool of Public Health, University of QueenslandThe George Institute for Global Health, University of New South WalesThe George Institute for Global Health, University of New South WalesAbstract Context Public health law is an important tool in non-communicable disease (NCD) prevention. There are different approaches available for achieving policy objectives, including government, co-, quasi- and self-regulation. However, it is often unclear what legal design features drive successes or failures in particular contexts. This scoping review undertakes a descriptive analysis, exploring the design characteristics of legal instruments that have been used for NCD prevention and implemented and evaluated in OECD countries. Methods A scoping review was conducted across four health and legal databases (Scopus, EMBASE, MEDLINE, HeinOnline), identifying study characteristics, legal characteristics and regulatory approaches, and reported outcomes. Included studies focused on regulation of tobacco, alcohol, unhealthy foods and beverages, and environmental pollutants. Findings We identified 111 relevant studies evaluating 126 legal instruments. Evaluation measures most commonly assessed implementation, compliance and changes to the built and lived environment. Few studies evaluated health or economic outcomes. When examining the design and governance mechanisms of the included legal instruments, government regulation was most commonly evaluated (n = 90) and most likely to be reported effective (64%). Self-regulation (n = 27) and quasi-regulation (n = 5) were almost always reported to be ineffective (93% and 100% respectively). There were few co-regulated instruments evaluated (n = 4) with mixed effectiveness. When examining public health risks, food and beverages including alcohol were more likely to be self- or quasi-regulated and reported as ineffective more often. In comparison, tobacco and environmental pollutants were more likely to have government mandated regulation. Many evaluations lacked critical information on regulatory design. Monitoring and enforcement of regulations was inconsistently reported, making it difficult to draw linkages to outcomes and reported effectiveness. Conclusions Food and alcohol regulation has tended to be less successful in part due to the strong reliance on self- and quasi-regulation. More work should be done in understanding how government regulation can be extended to these areas. Public health law evaluations are important for supporting government decision-making but must provide more detail of the design and implementation features of the instruments being evaluated – critical information for policy-makers.https://doi.org/10.1186/s12889-024-18053-4NCD preventionPublic health lawRegulationEvaluationTobaccoFood |
| spellingShingle | Maddie Heenan Ashleigh Chanel Hart Katherine Cullerton Stephen Jan Janani Shanthosh Legal and regulatory instruments for NCD prevention: a scoping review and descriptive analysis of evaluations in OECD countries BMC Public Health NCD prevention Public health law Regulation Evaluation Tobacco Food |
| title | Legal and regulatory instruments for NCD prevention: a scoping review and descriptive analysis of evaluations in OECD countries |
| title_full | Legal and regulatory instruments for NCD prevention: a scoping review and descriptive analysis of evaluations in OECD countries |
| title_fullStr | Legal and regulatory instruments for NCD prevention: a scoping review and descriptive analysis of evaluations in OECD countries |
| title_full_unstemmed | Legal and regulatory instruments for NCD prevention: a scoping review and descriptive analysis of evaluations in OECD countries |
| title_short | Legal and regulatory instruments for NCD prevention: a scoping review and descriptive analysis of evaluations in OECD countries |
| title_sort | legal and regulatory instruments for ncd prevention a scoping review and descriptive analysis of evaluations in oecd countries |
| topic | NCD prevention Public health law Regulation Evaluation Tobacco Food |
| url | https://doi.org/10.1186/s12889-024-18053-4 |
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