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Globalization and Health
Published in: Globalization and Health 1/2015

Open Access 01-12-2015 | Research

Understanding the United States and Brazil’s response to obesity: institutional conversion, policy reform, and the lessons learned

Author: Eduardo J. Gómez

Published in: Globalization and Health | Issue 1/2015

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Abstract

Background

In the United States (US) and Brazil, obesity has emerged as a health epidemic. This article is driven by the following research questions: how did the US and Brazil’s federal institutions respond to obesity? And how did these responses affect policy implementation? The aim of this article is therefore to conduct a comparative case study analysis of how these nations’ institutions responded in order to determine the key lessons learned.

Methods

This study uses primary and secondary qualitative data to substantiate causal arguments and factual claims.

Results

Brazil shows that converting preexisting federal agencies working in primary healthcare to emphasize the provision of obesity prevention services can facilitate policy implementation, especially in rural areas. Brazil also reveals the importance of targeting federal grant support to the highest obesity prevalence areas and imposing grant conditionalities, while illustrating how the incorporation of social health movements into the bureaucracy facilitates the early adoption of nutrition and obesity policies. None of these reforms were pursued in the US.

Conclusions

Brazil’s government has engaged in innovative institutional conversion processes aiding its ability to sustain its centralized influence when implementing obesity policy. The US government’s adoption of Brazil’s institutional innovations may help to strengthen its policy response.
Footnotes
1
This study focuses on particular obesity prevention policies, such as those affecting healthy lifestyles and the environment through the government’s funding of parks, gyms, and school playgrounds; the government’s provision of healthy lifestyle and nutritional information to families and schools; and the government’s provision of nutritious foods in schools through mandated school partnerships with farmers.
 
2
Henceforth the terms “reform actor” or “change actor” will refer to those individuals within institutions seeking to transform it in order to achieve their objectives.
 
3
There is no guarantee and evidence that the presence of farm-to-school programs reduces childhood obesity. Nevertheless, recent studies suggest that these programs have improved children’s eating habits, such as consuming more vegetables and fruits; increased children’s knowledge of healthier food options; and increased their participation in healthier school lunch programs [101].
 
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Metadata
Title
Understanding the United States and Brazil’s response to obesity: institutional conversion, policy reform, and the lessons learned
Author
Eduardo J. Gómez
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Globalization and Health / Issue 1/2015
Electronic ISSN: 1744-8603
DOI
https://doi.org/10.1186/s12992-015-0107-y

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