Victoria's Citizens' Jury on Obesity
- General Issues
- Specific Topics
- Social Determinants of Health
- Health Care Reform
- Food & Nutrition
- Scope of Influence
- Highlights from the Jury
- Start Date
- End Date
- Time Limited or Repeated?
- A single, defined period of time
- Make, influence, or challenge decisions of government and public bodies
- Make, influence, or challenge decisions of private organizations
- Develop the civic capacities of individuals, communities, and/or civil society organizations
- Spectrum of Public Participation
- Total Number of Participants
- Open to All or Limited to Some?
- Limited to Only Some Groups or Individuals
- Recruitment Method for Limited Subset of Population
- Targeted Demographics
- General Types of Methods
- Deliberative and dialogic process
- General Types of Tools/Techniques
- Facilitate dialogue, discussion, and/or deliberation
- Facilitate decision-making
- Recruit or select participants
- Facilitator Training
- Professional Facilitators
- Face-to-Face, Online, or Both
- Types of Interaction Among Participants
- Discussion, Dialogue, or Deliberation
- Ask & Answer Questions
- Information & Learning Resources
- Written Briefing Materials
- Expert Presentations
- Decision Methods
- If Voting
- Communication of Insights & Outcomes
- Public Report
- Public Hearings/Meetings
- Primary Organizer/Manager
- newDemocracy Foundation
- Type of Funder
- Government-Owned Corporation
- Implementers of Change
- Stakeholder Organizations
- Elected Public Officials
Problems and Purpose
The Victoria citizens' jury on obesity was established to consider the role of food in society and its impact on obesity. The group of 78 Victorian citizens were tasked with establishing a number of 'asks' - recommendations for government, industry and community on how to address the obesity crisis. The jury deliberated online over a period of six weeks before meeting in person to develop their 'asks', in response to the question:
"We have an obesity problem. How can we make it easier to eat better?"
The process established a Steering Group made up of key decision-makers in government, industry and the community including the department of Premier and Cabinet, the Australian Food and Grocery Council, Foodbank Victoria, Coles (major supermarket chain), Melbourne city council and university representatives. The range of stakeholders involved in the process is testament to the scale and complexity of the obesity problem, but also represents the significance of this citizens' jury and the committment of so many agencies to address the challenge.
Background History and Context
VicHealth is a health promotion foundation founded in 1987 as part of the anti-tobacco campaign. It was established by the Victorian government as a statutory authority and played an important role in taxing tobacco and helping reduce smoking in the state. They conduct research into public health issues including mental health, race discrimination, violence against women and healthy eating.
According to VicHealth, two-thirds of Australians are overweight or obese. The economic cost of this problem is huge, with over $50 billion AUD spent per year since 2005 (VicHealth 2015a). This is set to increase Australia-wide and Victoria is no different.
The factors contributing to the obesity epidemic are complex and interdependent:
- individual factors - what you eat, what you want to eat, how much exercise you do
- environmental factors - what food is available to you, food pricing, advertising, how your environment influences your ability to exercise
- biological or genetic factors
Food obviously has a major role to play in all this, as VicHealth point out:
"What we eat has a major influence on our health and wellbeing. A balanced intake of nutritious food and healthy eating patterns support good health and the prevention of many lifestyle diseases and illnesses. Healthy eating habits have a positive impact on the reduction of chronic disease such as diabetes, cardiovascular disease, some cancers, along with overweight and obesity. Enjoying the benefits of a healthy diet is not just down to individual willpower or genetics. While individual choices play a role, differences in our health reflect the differences in the social, environmental and economic conditions of local communities" (VicHealth 2015b)
The citizens' jury on obesity focused on food choices for the reasons above.
Organizing, Supporting, and Funding Entities
The process was instigated by VicHealth, and designed and implemented by newDemocracy Foundation, an independent and non-partisan research organisation.
Participant Recruitment and Selection
newDemocracy Foundation managed the selection of participants. Invites were sent to 20,000 addresses across Victoria, both electronically and by mail. The sources used to draw these addresses from were varied in order to ensure a varied sample and to test different methods of recruitment including:
- VoteCompass database: contains 570,000 people who have opted to take part/expressed interest in events related to public policy
- two student databases: to maximise response of 18-24 age group (typically lowest response group)
After the first round, a second sample of 100 was drawn to provide a representative sample of Victorian residents.
Methods and Tools Used
What Went On: Process, Interaction, and Participation
Over a period of six weeks, the 100 jurors engaged in online deliberation in a facilitated forum. Their task throughout this period was to evaluate a wide range of submissions presented to the jury by stakeholders, experts, individuals and organisations on the topic. 64 submissions were made covering a variety of topics from proposed education and cooking programs to the benefits of breastfeeding in preventing obesity. Submissions were also made by members of the Steering Group which was established to respond to the jury recommendations.
Following the online deliberations, 78 of the jurors met in person over two days in October 2015. The face-to-face deliberation was facilitated by Kimbra White, an experienced facilitator and community engagement expert who is independent from both VicHealth and nDF. Over the two days, the jury heard additional testimony from speakers alongside the submissions they had already been evaluating online. The jury were able to select the witnesses they wanted to hear from based on their knowledge from the online phase. Videos and photos from the deliberation can be found here.
"Jurors were arranged into small groups, both online and in person, which were regularly mixed into new groups to avoid factions. The facilitators used a blend of synchronous (webinars) and asynchronous (example) learning approaches to assist people with the large amount of information in the submissions. This blended approach was essential to provide a balance between structured and self-paced activities during the six weeks of online deliberation. Wildwon’s design approach focused on user experience and informed jury management, communications and the build of an appropriate online environment. The facilitators worked closely with Wildwon to enable a smooth transition for the jurors from online interaction to face-to-face conversation." (VicHealth & newDemocracy 2016)
The main objective of the two days was to enable the 78 jurors to collectively produce a report with recommendations on how to make it easier to eat better, for presentation to the Steering Group. This was achieved through small group deliberations of 20 groups. Each group was tasked with producing an 'ask' - their recommendation. Decisions on what to include in the report were made by supermajoritarian voting (80%+1) but measures were taken to ensure that minority views and dissenting voices were included. The final report included these minority concerns.
Rather than asking jurors to vote 'yes or no' to a recommendation, Kimbra sometimes asked the group "can you live with it?". This technique draws participants towards a middle ground rather than reinforcing disagreement. However, it still allows for dissent.
The jury considered a total of 110 asks and over the course of an intensive two days of deliberating, settled on 20 to include in the final report.
Influence, Outcomes, and Effects
The final citizens' report comprises 20 'asks' of the Steering Group. It was prsented collectively at the end of deliberations on 18 October. The jury's recommendations included:
- healthy food discounts for those on low incomes
- incorporating healthy eating and cooking into the school curriculum
- funding for community health programs
- ban junk food marketing for children under 16
- increased taxes and regulation on junk food and high-sugar drinks
- government mandated health star labelling
- include green and edible spaces in planning new developments
The Steering Group considered the jury's asks and provided a formal response in December 2015. The response to the report is generally positive, although it is worth noting the following:
- some of the asks were not within the authority of the Steering Group or Victorian government eg. donations from food and drink industry to political parties
- some of the asks were already implemented or advocated by members of the Steering Group or Victorian government eg. promoting water fountains and taps in public places
VicHealth is committed over the coming year to working with stakeholders and government to promote the jury's recommendations and to monitor progress on implementation.
The obesity jury was the largest of its kind to tackle a public health issue. The topic resonated well with jurors and the wider community and the process received a fair amount of media attention. The majority of this was positive, although one article expressed skepticism on two fronts: firstly, that a citizens' jury process was not needed to tackle obesity because health experts already know what needs to be done and secondly, that involving industry representatives in the Steering Group was dubious given their obvious vested interests. However, VicHealth defended the decision to involve industry and involving stakeholders is a key aspect of newDemocracy Foundation's design process. Furthermore, as their 2016 insights report indicates that the primary aim of the process 'was about providing a new process to enable community to build consensus on action needed, in order to collaboratively build a more cohesive environment for action by government, industry and civil society' (VicHealth & newDemocracy Foundation 2016, p22).
Analysis and Lessons Learned
In 2016 VicHealth and newDemocracy produced a report of insights into the obesity jury, upon which this analysis is based.
The process differed from most previous citizens' juries in Australia in several ways. Many juries have been commissioned by state or local government, but the obesity jury was initiated by a health promotion foundation who pursued the initiative independently of government. The jury was also innovative in its use of a Steering Group as the responsive authority to the jury. The aim of the Steering Group was to establish a representative committee of key decision-makers from government, industry, community organisations, health experts and advocates. Finally, the obesity jury was experimental in its use of online platforms for deliberations, and the number of citizens involved. 117 Victorians began the online deliberative process, with 78 coming together to meet face-to-face for the final two days. This is a break from the usual format for citizens' juries, which typically involve less than 30 people, and are conducted primarily in person with online forums sometimes complementing the process or used for wider community engagement.
VicHealth's leadership as a statutory authority was useful as it is non-partisan and independent, which helped establish the jury as a politically neutral process. This helped build trust in the process from the jury and the wider community.
The role of online technoology was central to this process and whilst the platform enabled jurors to familiarise themselves with the material, juror feedback suggested that functionality of the platform could be better. Furthermore, evaluation suggested that the jury most enjoyed the face-to-face deliberation and meeting in person was key in fostering consensus for the final report (VicHealth and newDemocracy Foundation 2016, p22).
The insights report recognises the importance of timely action following the jury process. This is key because after the empowering experience of participating in a citizens' jury, satisfaction can plummet if recommendations are not followed up, or receive a negative response. This is challenging because 'policy development inherently takes a longer term view and, often, considerable time. The jury’s asks are likely to influence policy in the long term, but more immediate actions and commitments are necessary to demonstrate that government, industry and community stakeholders take the public’s views seriously.' (VicHealth and newDemocracy Foundation 2016, p23).
The report concludes:
"This process has demonstrated that citizens’ juries are an effective mechanism for collaboratively working with citizens in public policy development. Of the stakeholders surveyed, 69 per cent saw citizens’ juries as an effective way to involve everyday Victorians in public decision making. However, we recognise it will take more time, advocacy and increased public accountability to determine the enduring impact of a citizens’ jury process on driving multisector action to address complex public health issues such as obesity. Over the coming year, VicHealth will continue to monitor progress against the asks. We will actively work with policy makers, public health and consumer advocates and industry to promote the jury’s asks" (VicHealth and newDemocracy Foundation 2016, p28)
newDemocracy Foundation (2015) Process Design - Victoria's Citizens' Jury on Obesity [online], newDemocracy Foundation, available at: http://www.newdemocracy.com.au/docs/activeprojects/vichealth/Process%20D...
VicHealth (2015a) Obesity and food: an overview in Victoria [video online], available at: https://youtu.be/57-Z3nkhQqE
VicHealth (2015b) About citzens' jury on obesity [online], VicHealth, available at: https://collab.vichealth.vic.gov.au/cjo/p/about
VicHealth & newDemocracy Foundation (2016) Victoria's Citizens' Jury on Obesity Insights Report 2016 [online], available at: https://www.vichealth.vic.gov.au/programs-and-projects/citizens-jury-ins...
newDemocracy Foundation (links to media, process design, videos of process):
VicHealth (all documents, reports and submissions related to the jury):