1Martin Caraher is a Professor of food and health policy at Centre for Food Policy, Department of Sociology , City University of London (cf. http://www.city.ac.uk/people/academics/martin-caraher); he has worked for and acted as a consultant to the UK Department of Health, the World Bank and the World Health Organisation. He was a member of the original London Food Board and currently acts as an advisor on food matters to a number of social science research groups across Europe, particularly to the European Executive Agency for Health and Consumers. He is a member of the World Obesity Federation (IOTF) scientific committee and the Irish safefood scientific committee (http://safefood.eu).
2Martin Caraher’s main research fields: issues related to food poverty, cooking skills, local sustainable food supplies, the role of markets and co-ops in promoting health, farmers markets, food deserts and food access, retail concentration and globalisation. Recent work has focused on the impact of food advertising on children's food choices and the impact of advertising regulation.
3Isabelle Techoueyres: How did your interest in food and food access develop?
4Martin Caraher: My background is Public health and inequalities work. My training originally was in environmental health and my Masters and Phd were in health promotion and public health. This is probably not so well known in France as it is here; it is probably more an anglocentric approach. It was really meant to be more than health education, more than just public health, more community engagement, that sort of thing. I started off in health not in food. So I was teaching in a medical/ nursing school, health studies, broadly some public health and epidemiological stuff, then I got into food through that direction; but my broad background is health rather than food itself, while my major focus is on food.
5I.T: What would you see as your major research works?
6M.C.: If I talk about the unit I work in, we have three major focuses. One is global food: we look at regulation and we look at future scenarios around food; and I tend to look at the health issues across all of those. My work has concentrated for the past two years on how skills work: largely around cooking: do cooking skills make any impact? Children’s food choices: what choices do they make and why? What’s the influence? And the third big issue I’ve been working on is fast food and fast food outlets and the influence of fast food outlets on food choices: so the social and local environment as social determinants.
7I.T.: And health?
8M.C.: Largely, more from a social perspective. Other people have already done all the relevant measurements, how fast food is unhealthy and so on, so we don’t need this, these type of measurements have been done by other people. I am more interested in why young people do that, why do children make these decisions? They’re not about health, they want to be with their friends, they want to be in these sorts of space where they can escape parents. Fast food outlets offer certain enticement to kids, but if you ask them, about 80% of kids know the health messages, they can tell you that; but that’s not included in their decision making process. So I’m interested in this process. And also the structures of fast food outlets themselves, why in the UK specifically, although this is US as well, there are such concentrations around schools? It might be different on the continent: we have those huge concentrations of fast foods around schools.
9I.T.: We have them too.
10M.C.: We have been looking at that, and what can planning authorities and city councils and municipalities do to control these situations? What policies can do to control that sort of thing? So that’s what we’re interested in.
11I.T.: Do you work as a team?
12M.C.: We are a small unit, there are three of us in the centre but we have partnerships with other institutions, universities, so we work across. So we can work with other people, get maximum coverage of issues and expertise by using a number of people. That’s how we tend to work. Either they work as part of our bids, or we work as part of their bids.
13I.T.: What subjects do you teach?
14M.C.: Mainly the sociology of food, but within a policy context. What we want our students to do is to be able to understand the sociology of food, and how it relates to policy. We don’t want them to become sociologists. They’ll be the policy makers so we have them make a piece of research and how do they interpret that. They’re generally ok about interpreting things like epidemiological data, because that’s about “20% of the kids”… they have more problem with the sociological data. So what I teach is how you manage this sort of data within the frame of policy making, how you commission it, because some will end up having to commission this sort of research. And on our MSc programme, I teach on the methodology for that, how to manage the methodology around the policy making. And then we have the PhD programme.
15I.T.: Are you free to do the research you want and do you have time for that?
16M.C.: As long as we have some income, yes. In our country it is in our contract that all academics do research. But it is easier if you bring money back into the university, you can buy back your time.
17I.T.: How many hours are you supposed to devote to teaching and administrative work? How much time for research?
18M.C.: It is not specified in my contract because I’m on an old professor style contract, so I’ve got some flexibility. Now in new contracts, it is specified: you’re expected to teach x numbers of hours per week. I don’t have that specification. But the way it works out for me is, counting contact hours with PhD students, it is two days a week of teaching and the other three are for administration and research time. This is roughly how it works out. I tend to do some of my teaching in blocks, so I do a lot of teaching between September, when the semester starts, and beginning of February, which is when grading will end. So then I tend to do much less teaching during the period from January to Easter, so I have blocks of time to do research. But it’s becoming more difficult now to do that, that sort of organisation of time.
19I.T.: Do you pick yourself your research subjects?
20Yes we do, we are very deliberate. There is some work I wouldn’t do and monies we wouldn’t take. Our policy in our unit is never to take any food industry money, no private funding.
21I.T.: Why not?
22M.C.: Because it will compromise our position, we feel. We’re looking at food policies in a broader sense, and if you take some money from the food industry, we think you’ll tend to compromise. We deal with the industry, we talk to them, we’re happy to advise them, but we won’t take their money.
23I.T.: Have you been approached?
24M.C.: Yes, and the university would like us to take the money!
25I.T.: Don’t you get more pressure than that?
26M.C.: No because we find other sources of money. But if those sources dried out, the pressure would be there. But so far it has worked out. We were in a previous institution for five or six years, the unit goes back to about 20 years and we have never taken that kind of money. But times are changing, funding is getting more difficult to find and there is more pressure from the University.
27I.T.: And also there is more private corporation funding available, through foundations…
28M.C.: Yes, we won’t even take this kind of money. Like the tobacco fund funding health researches, now the food industry does similar things, they now have a trust fund, but we would say no to that, even with this hands off situation. Which makes life difficult…
29I.T.: So what kind of funding do you get?
- 1 7th Framework : the European Union’s Research and Innovation funding programme for 2007-13.
30M.C.: One of my colleagues is good at getting European funding, now the 7th framework1. Most of my work gets funding from public health agencies, local public health authorities or some national agencies will fund some money on fast food.
31I.T.: Do you find it difficult to apply?
32M.C.: Yes. Because most of their work tends to be project based; they are not interested in research for the sake of research but in getting an answer very quickly to certain problems. So it tends to be “look you have six months of work, we’d like you to look into children’s consumption of fast food, or fast food outlets”. We’ve had some money from our national food agencies, in the past we’ve had a Food Standards Agency which looked at food in a broader sense; but now this government has changed it and the agency is only responsible for food safety now. But in the past we’ve had money from them, we’ve had commissioned research from our department of health for instance, but now they are very much project-based.
33I.T.: Do your public funders initiate topics, do they commission?
34M.C.: Yes. They might say we want to know something about children and fast food; they won’t say “we want you to do it in London or Birmingham”, they leave it up to us to decide. Now we’re bidding against other people of course, because this is open competition. So they would put out a call for that and we would answer to that and say “this is what we can do, what we can offer”.
35I.T.: Does this happen frequently?
36M.C.: Less now. At the moment it is not happening at all. The public services have been squeezed. There is a move across the UK to look up for funding from Europe, the Frameworks, Horizon 2020, etc.
37I.T.: And this means you have to find partners. And it’s a lot of administrative work.
38M.C.: Absolutely. And this is not my sort of work, and I leave somebody else to do the job… and very often the nature of our work is very immediate. And spending three years is not always necessarily the best use of the time. And I see some colleagues bogged or tied down with the administration part, and spending half their time in Europe; and personally I don’t want to spend my time running over half the globe…
39I.T.: Do you feel free to choose your research subjects or are they inspired by your funding possibilities?
40M.C.: Well, I think we have chosen them, we have sort of carved out a niche. Having said that, I think some of our topics are not popular in research terms. One of the areas I am interested in, food poverty, food insecurity, there hasn’t been a lot of commissioned work around that. Not in the UK, not from the research funding councils. There has been some project-based work but it’s not been funded. And not just me but colleagues who are much more experts on these matters, so we’ve had the seek-out funding for work like that: the funding goes to charities saying “why don’t you commission this work for me, we’ll do the work for you?” So we don’t actually wait for the bids, we send our proposal saying “have you thought about doing that? You’re doing work about poverty…” so we try to get them interested in the topic. They won’t come and say we have 10 000 Pounds, take it, no; they will say “we want this work, you all bid for that.” That’s what happens.
41I.T..: Yet you manage to influence authorities to study this or that, to attract their attention saying “look, here is a problem”.
42M.C.: Yes, we do. I’d say our work is three parts: teaching, research, and the third is what we call public interest. It is creating a need or awareness of the need, we see ourselves, it is an old public health tradition, to be actively engaged in policy formations. So I sit on boards that make policy, I sat on what was originally the London Food Board, I sit on two scientific committees aiming at policy making, that’s about policy.
43I.T.: How come you got those positions?
44M.C.: Because of our work at the university and, to some extent, because our unit has a rather high media profile in the UK so people tend to know us. And we all see this third part as our pro bono work. The university gets kudos or acknowledgment for our work but doesn’t get paid for our time. Every time I go on a committee meeting, it’s part of my work, the university has been good about that. But things are changing, the economic climate… and in the next couple of years it might be hard to…
45I.T.: That’s another aspect to consider the evolution of things over time. So do you notice changes?
46M.C.: Yes; well in the UK, following the foot and mouth disease crisis and the mad cow, in the 1990s and early 2000, the government set up the Food Standards Agency which has to take a comprehensive look on food; and they commissioned a lot of research on food; and they commissioned across the academic borders, from nutrition science to agriculture science, to food safety, to some aspects of food policy. The current government have broken that up, and that food standards agency now only looks at food safety. So now we’re back to what I call a silo approach. We’ve got a department of agriculture that commissions agricultural issues, a department of health that commissions health issues. It’s more separate. There’s very little links across in the policy world. I don’t think the UK is unusual. I did some work in Australia, an analysis of the Australian food plan, but what happened is that the National food plan was supposed to be the link between those areas and it has become a business plan or national export plan to flood SE Asia with food products from Australia. And health has been written out of it. And they’ve got a separate health policy plan, but it’s out of line of what the food plan has produced. The UK has gone back to those silos: agricultural research, health research,… food security, overseas development research around food,… all separate, they’re not linked in any way.
47I.T.: What subject would you like to develop now?
48M.C.: I think this silo thing is very interesting for me, because even big industry is working in silos. In policy world, the issue is Big Food, what we call the big companies, the big trans-national companies, they’re actually making policies by default from government. And it’s been driven by neo-liberal economics, the free market, creation of jobs, and they’ve got everything on their side; they go to government and say “well if you do this, if you introduce this fat tax or soda tax, you’ll lose jobs and the economy.” Constantly! And that’s the winner! It’s an immediate thing. And we people in the public health we talk about things like “you’ll see benefit of that in 5 or 10 years’ time”… And the government ministry’s saying “I’m going to lose jobs, in the local area, 10 000 jobs in the next 5 years, that’s more important”. So Big Food is making the running. There is a general move in the UK towards the US trends: more eating out, less control on your food, longer food chains, Big Food controls those things. And one of the things we’re finding is that through things like corporate social responsibility deals, the industry will say,… Nescafé, their annual plan, their corporate social responsibility plan is called Pepsi and communities. They’re ticking a box “we’re interested in health” and government is pulling back and saying to the big companies “ok, well you change your product line, you make it healthier, we won’t regulate.” That’s what is happening at the moment here in the UK!
49I.T.: And it works?
50M.C.: No it doesn’t work! It’s a political and ideological position, the government then doesn’t have to intervene because they can say: the food industry is doing it. I personally don’t have a problem with that; you have to talk to these people, deal with them. What we have done is brought them to the table and given them the table and they have set the agenda. We’ve just done some work on that, on what’s called the Responsibility Deal in the UK. The government says “we will achieve more through working with the industry rather than regulate them”. So they brought them to the table and the public health people said “we can’t work with them”, and the public health people have retreated, so they left the deal. So who’s left at the table? The civil servants and the food industry. And the food industry has re-written the rules. I don’t think they have, I don’t blame the food industry for that, they do what you expect, that’s their job. The civil servants, the government have allowed this to happen. So we’ve tracked how they have changed the rules around things like the reduction of calories… they have re-written the rules! I can show you the article written on this2.
51I.T.: You as a researcher are making a link between these policy events and you report about it: so what happens to your reports?
52M.C.: Well, the old joke is that you produce your papers and four people read it: the two reviewers and the two PhD students whom you say must read it. One of the things we do, we are very media sensitive, so we make a sort of reduced format and send it to the media, saying “this is what’s happening!” We’re trying to create more pressure for action. And we also make it available to a number of public health agencies. It might not come across in a normal scanning of the journal, we do a shorter version of it, it is essentially the abstract and summary, saying “here, this is what we have found. Are you aware of this, are you aware of that?” Because they may not read the actual 20 page-journal article. So they may easily read the abstract and then read the journal article. And we make it available to target people and we lobby.
53I.T.: So you have a direct implication in your research. Do you find it difficult? Or do you feel free?
54M.C.: Yes! I feel free at the moment. In the UK, …well a lot has happened in academia, but one of the things that academics have maintained is the right to, as long as it is based on research, as long as it is not racist, homophobic or unsupported statements, you still have the freedom to talk out about these things. The tensions are there, because I work in a university where we have one of the largest business schools in the country. It’s in the top ten in the world. And the business people look at us making statement on the food industry, and I’m sure they’re going: “oh, that crowd, what are they saying about big business!!...” They don’t see the public health aspect. But nonetheless we still have the right and the power as academics to express that; not to express our personal opinions, but as long as it is research based. The business school might not like it but the university quite likes the publicity that comes with that. They’re not per se interested in what we’re saying but they like to hear “this is coming from City University London”. This will appear on the BBC, people talk about it. It’s their brand name. The three of us, or two of us, probably account for at least 50% of all the media hits in the university! Now that’s good and bad. When they ring up, you’ve got to go to the studio that evening, so that’s, it’s not always…. and we do turn down some. But…
55I.T.: So that means that your research topics are fashionable?
56M.C.: Yes, they tend to hit the fashion at a particular time; but also what journalists say is that “academics are terrible, they won’t come out and talk about their research”. Journalists are always working with deadlines, they want something now, not in ten days’ time. They wanted it yesterday! And they ring up some colleagues of mine, but they don’t get back in time, so it’s gone as a news item. They’ve already moved on to the next item. So you’ve got to be responsive.
57I.T.: So for you it is important that your research impacts current society…
58M.C.: Yes, I think that it is generally the public understanding of science. It is taking your research to a different level, not necessarily to the media, but in order to put your research in a certain significance level, you need to take that to public understanding. “Cooking is important, but this is what the food industry is doing”. You got to say in simple language so that people understand. It is based on what you have written in the article. It’s the public understanding of science.
59I.T.: Not all researchers are prepared to do that.
60M.C.: No. And it is a chicken and egg situation: our media department at our university now knows that we will respond, so they will come at us saying “do you want to do this?”. And they know there are areas where we are not competent, so we have to be clear. I’m not a nutritionist, so sometimes they come up with something highly nutrition based and I have to say “no! you need to go and talk to my colleague over here, that’s not me”.
61I.T.: Who are your colleagues?
62M.C.: There are two: Professor Tim Lang and the other is vacant at the moment. Tim’s main focus at the moment is sustainable diet and health; he is a big thinker and thinks about issues that will come out in about five years’ time. He is not necessarily doing the research on sustainable diet, he’s writing papers, he is a future thinker. He’s more of a theoretician rather than an empirically based researcher. He sets the agenda which other people will follow. And the other focus we have is more around E-U regulations, reflected in the number of EU funded research we have.
63I.T.: You are quite complementary. Do you work as a team or more individually?
- 3 Food Policy: Integrating health, environment and society, 2009.
- 4 The Research Excellence Framework : the means by which the British government will audit and monito (...)
64M.C.: We used to work more as a team; what happened over the last couple of years, is because there is only the three of us, we’ve tended to focus on our own areas which made us become in a sense more isolated. And we’re revisiting that at the moment: we see that as a weakness in our team. We have to re-invest in our partnership. One of our books has brought all that together, Food Policy3. You can tell which bits have been written by whom; they fall into the three categories I have just described. It’s partly driven by what I was saying about the R.E.F.4: we have to produce publications for the current REF so we have to get down and do that and worry less about our individual relationship. The REF is important: the university may or may not decide to support us on the basis of our REF results, so… It is a distraction but an important distraction. We have to have four publications of a certain standard, and the university makes the decision about that standard. And if you didn’t have four you didn’t go in.
65I.T.: Is this a problem or is it stimulating?
66M.C.: Well there’s a lot of pressure. And what you end up doing sometimes is publishing in journals that may not have the best readership, it might be a good journal but it may not have the right readership. So you end up in a journal with a high academic profile, but the group you want to read it may not be the readership of this particular journal… That’s the problem. You’re pressured to produce your work in… I mean you could do both: re write a little and publish in a practitioner journal. But there’s a pressure in getting in a high profile, and we all have a limited time so you say “well I’ll do that later”, then you never get round to doing it then you have to move on to the next high level journal…
67I.T.: So you work a lot with practitioners, people in the field.
68M.C.: Yes. I do lots of conferences and lots of engagements in that way. I think it is important to get out there and hear what they have to say. It’s selfish. Give them something but also hear and listen to what they have to say. Just the other day I was saying that I’ve learned so much just being around practitioners! What it is like in reality. I mean.. It’s a grounding in reality. Because sometimes you do research, and research is fairly isolated, and peculiar; and we do evidence-based research. But practise-based evidence is not the same. And I’m very interested in what I call “practice-based” evidence.
69I.T.: What is it?
70M.C.: You can take evidence on sugar and fat for instance, it’s all in the news at the moment; does it cause diabetes, does it cause obesity? For every paper you take it says that fat is implicated in or sugar, and you get another one casting some doubt on that. That’s evidence-based. And that doesn’t stop you from saying “we want to reduce the amount of sugar in people’s diet”, and how you do that is completely different evidence. The example I have in mind is from clinical medicine, you know how statins work, I’m not making a case for statins but there are cases of coronary heart disease where taking a pill works; but people don’t take statins. So you’ve got to move from the way statins work, reduce coronary heart disease, to how do you get people to take their tablet everyday? So we know the evidence but we don’t know the practical evidence, how to get people to comply or adhere to a healthy eating regime. There is some controversy, like when do you introduce it to a healthy population, but… Like everybody knows “5 a day”: 80% of the people know about the widely shared recognition that you need to eat an average of five fruit and vegetables a day, but only 25% eat that. So how do you move from “evidence of” to “evidence how”? That’s a different level… It is the distinction between the evidence of and the evidence-based practise. You’ve got clinical trials which tell us why, but not how you do something.
71I.T.: Yes it’s the human and social factor.
72M.C.: Yes and the fact there is a supermarket round every corner and they dictate more about our food choices than messages around eating five fruit and vegetable a day! ….. A question struck me: what influence may research have on social representations? I think at the moment, some has been reported in France, but here there’s been a lot of contradictory messages. How the sugar issue has suddenly become very important, and fat has receded in public health messages, and people now say that fat is not as important as we formerly thought. And everything from health is driven by obesity now! And in my terms, what they are looking at is stereotypes. They’re also looking at the symptoms rather than the causes of those problems. Obesity is an issue in itself, I’m not questioning that! But they’re not looking at the social determinants of obesity. They’re not looking back and say “what’s the real cause of this”. Is it food companies, is it social structures, is it inequalities?
73I.T.: Poverty of life, feeling of uselessness…
74M.C.: Exactly. Or lack of employment, or whatever. And it is reinforcing these stereotypes: the obese are those making bad decisions! We are back to this notion of individual culpability. And I think that that suits governments. It suits policy makers. They could go to the local supermarket round the corner and make the right choice; and if they don’t, it’s not our problem. There’s a real lack in policy of confronting these situations. And also I think that very often policy makers are sometimes not strong enough in tackling those prejudices and stereotypes around people’s behaviours. Because behaviours don’t exist outside social and cultural patterns, they exist within those frameworks. We end up reinforcing those stereotypes by default. Even as researchers, we’re not tackling the real problems. We’ve got a huge problem at the moment. We’re working on food banks. The foodbanks have massively increased within a few years; we’ve gone from 1 in 2000 to thousands of them today. Two new ones opening every week.
75I.T.: Who creates those food banks?
76M.C.: Largely Christian charities. Mostly the Church of England. They work a franchised system, like MacDonald’s: you pay the money and you can use their name and networks.
77I.T.: There’s no public food banks?
79I.T.: No public food aid policy?
80M.C.: No. the majority of food banks are faith based. The government has changed its policy. That happened in Germany: it’s called the "Hartz IV" Law that is the 2005 welfare law that slashed benefits for Germans who have been out of work for over a year. They’ve cut back on welfare payments and the funding for food. And in the UK the national government has devolved that to local authorities, local councils, which means that municipalities are responsible for this budget; so because of the recession, we see more people using food banks and local authorities have to stretch that money, make it go further. And they haven’t been spending that money on food. So if they send somebody in a food bank, they don’t have to spend that money on food, they can use it for other purposes. So the government can say “this is not our fault”. And the food banks have stepped in and they fill a gap. They were never meant for long term aid. They are emergency food aid, if something didn’t work they were there, they were never meant or designed to tackle the underling causes of food poverty or insecurity. But they are now becoming the major part of food provision for large sections of the population. And people now consider that there is no problem because food banks are there to help people. But this is charity, this is not welfare, this isn’t a State provision anymore. And now in the UK we see the rise of Muslim food banks because they’re worried about Christian food banks proselytising to their members. So we’re seeing more divisiveness around the food banks issue. And it is contributing to the breakup of state provision. I argue that there is a right for people to healthy, sustainable, affordable, and culturally appropriate food system. Access to food through foodbanks doesn’t meet any of those criteria. But that’s our default position. For large sections of our population, ½ million people are using food banks. And that certainly means 3 million people, because it’s ½ million turning up, but that’s only one member of the family…
81I.T.: Do you present your results on this issue to public agencies? What kind of reception do you get?
82M.C.: Mixed. I’ve done something a couple of months ago in Liverpool and apparently they thought that what I said was incredibly radical! And I was thinking I’m so middle of the road, this is not radical! But there is a problem; in a sense I’m critiquing food banks which people see as good. But the food banks are symptomatic of something else. I’m questioning why we need food banks at all! But for those who work in food banks, I’m really challenging them, I’m challenging the fact they’re faith based, I’m challenging ideas around the “feckless poor” or undeserving poor. The poor are not feckless, they are not unconcerned, they just don’t have the money; but there is this model that they are feckless. The current government is painting the food banks as “there is free food on offer”, so that’s why people turn up. But we are saying “it’s highly demoralizing to go to food banks, this is the last choice for most people!” And at best the people who are giving out that charity are doing it, you know, they are not necessarily proselytising, but they are on church premises, and there is this model where we’re moving away from State provision. That’s what is very challenging.
83I.T.: It’s unusual for a researcher to be that much involved in current affairs.
84M.C.: Is it? I think we’re just holding up a mirror. That’s our understanding of science. Not to say we are right, but say: this is what our findings are. Here is what we’re doing, some media analysis of how the media are covering food banks. We find, in terms of how the newspapers have covered it, here is how the political content is related to it.
85I.T.: Are you interested in such burning, topical, subject because of your background in health policies?
86M.C.: Well I think it is social justice and good public health. I really don’t know enough about European public health, but I know public health circles in the UK and in Ireland, people being activists as well. The original public health people changed the sewers. They went out and they built hospitals. They didn’t just do the research, they went out and changed things. Myself and people I work with come from this tradition of activism and being interventionist and my understanding of French public health is that it’s not that unusual. My reading of Parisian public health model is similar. Public health professionals are getting out there and encouraging the builders of sewers and the provision of potable water alongside better housing. Being the people who actually implemented the building process. I think we’re a bit like that. And I think it is more accepted in the public health world.
87I.T.: Do you think you have more authority because of your public health background? Because very often the food subject is not taken seriously among academics…
88M.C.: No, I think it is the academic background. I think the media is, we call that the media balance: they will tend to make a programme around a story, often using or backing up with the story with commentary from a scientific advisor or academic. So they’ll have the voice of the users. They go to the food banks and they won’t interview the users, they’ll interview the people running the foodbanks, they have politicians saying this is good or this is bad, then there is someone like me, an academic, because they’re balancing that sort of .. they think that academics provide that balance, I often think we’re in that role.
89I.T.: I’m not used to that: the media promoting your research…
90M.C.: Yes. I’ve done something for Al Jazeera TV on food poverty, and for some Spanish TV.
91I.T.: There is this demand for experts…
92M.C.: Yes but you have to be careful, because you can spend your life doing that! I’m careful it has to be related to my research. So I just say no! If they want someone to talk … I got a call last week, she’s a medical officer and launching a report on obesity, saying obesity is the new norm, three out of five people are overweight; I got three phone calls that night to comment on that; and I personally couldn’t that night, but I said this is really not my research and I don’t quite relate to that, and it is quite outside my field, you should really go to somebody else.. But the media are funny: you’ve got to respond to them and it’s not tomorrow, not even today, but yesterday!
93I.T.: Don’t you find that difficult to combine?
94M.C.: There are times we have to say no. It really has to be connected to our research and to areas we want to develop.
95I.T.: And you are able to do that because you have your institution backing you up?
97I.T.: Did you ever feel you had to adapt your choices of research topics to suit your funders or hierarchy?
98M.C.: No. There are some contracts that I will not bid for because of this. Concerning results, there are always issues of appropriateness and whereas the analysis might be okay, the prescription for action might sometimes need to be amended in the light of local knowledge. So we had a recent piece of research on food take-aways and the funders wanted the final report changed in two ways. The first was they wanted a style of reporting with the methodology shortened as the general reader would not read this. The second thing was they wanted the recommendations to be more specific to local circumstances, this did not mean changing the recommendations but making them more specific.
99I.T.: What about your experience with multi-disciplinary teams?
100M.C.: Easy when doing the work, more problematic when it comes to deciding where to publish. Different disciplines want to publish in their disciplinary journals. I have had a problem when research teams try to do multiple publications from the same piece of research when they are essentially the same. I have no problem if publications are substantially different.
101I.T.: In your own opinion, what influence may research have upon social representations and the evolution of social and cultural categories of thinking, such as « obesity », « poverty », « food charity »,… ?
102M.C.: Small but key. Sometimes it depends where you send your research and how you publicise it in the public domain. The public understanding of science is something that I am keen on and promote. Sometimes the key audience is not the public but those who might influence public opinion, these could be civil servants, other academics, funders, journalists and other media reporters.
103I.T.: Do you think that the shift in funding towards larger scale funding, such as European Frameworks, as compared to local councils or national agencies, may impact your choice of research topics?
104M.C.: Yes, the move to EU funding means researchers become bogged down in the minutia of filling in forms. Also many of these projects are evaluative based so they don’t contribute much to big thinking and the formation of theory. I personally will not bid for EU project money as I see it as highly bureaucratic. I need more flexibility in my research work. Also lots of EU research monies on food now have conditions such as food business partnerships and contributions to the financial economy. These are difficult to incorporate when you are researching BIG FOOD.
105I.T.: What about the transfer of research findings into action, into policy making? How do you see your role? - i.e. when you sit in boards and committees?
106M.C.: As an activist within the tradition of public health. But with the proviso that this is research based opinion, something that calls for expert opinion when the evidence base is not fully formed. Also when the evidence base is not designed for practice there is a matter of translating research .The following from a book5 chapter sets this out.
- 6 PHN : Public Health and Nutrition.
“‘Evidence-based practice’ is a term that has arisen from a drive across sectors to ensure that public money is not spent wastefully or haphazardly. Put simply, it means current practice is based on past practice that has been observed and known to have worked (Booth 1997). ‘Evidence’ in this context can take many forms including both quantitative data (such as statistical data, which tells us how many) and qualitative data (such as interviews that tell us the why and what) (Punch 1998; Valente 2002). This means that it is likely that some of the PHN6 initiative can be premised on existing practice rather than having to start from scratch. For many programmes or projects the discovery of an existing evidence base has three possible implications:
it may provide sufficient data/information on which to base the initiative;
help guide the new initiative in to new or unexplored areas;
it may shift the focus from a full evaluation of the proposed project to monitoring against criteria established from other studies.
The existing literature, drawn from the fields of general health promotion, public health and public health nutrition cannot yet tell us conclusively that nutrition prevention action works (see Box 1 for some examples). There are many reasons for the lack of evidence about what works, including the poor design of and assumptions behind many nutrition programmes or projects (International Union for Health Promotion and Education 2000; Oliver and Peersman 2001; Summerbell et al 2005).
What if there is a gap in the evidence?
Many nutrition prevention projects face the problem of a lack of existing evidence of effectiveness. In this case there are two options: do nothing or intervene? Taking the findings from the systematic review by Summerbell et al (2005) in Box 1 above it appears that little can be done to prevent childhood obesity. In common with other areas of prevention work, PHN work suffers from a lack of evidence-based, well-designed intervention projects (Oakley 1998 and 2000; Peersman et al, 1999). One way of addressing this is by adopting what Robinson and Sirard (2005) call a solution-orientated approach. This means that past orientation or lack of evidence of cause can be overruled in favour of future orientation. They give the example of soft or carbonated drinks and say that:
‘What is the justification for skipping over the requirement to prove soft drinks cause obesity and jump directly to an experiment testing elimination of soft drink sales? In the case of childhood obesity, it is universally accepted (and has been for at least eight centuries) that energy imbalance results in changes in weight. Therefore, without knowing the true underlying cause(s) of any individual’s or any population’s obesity or risks for obesity, any intervention that produces a deficit in energy balance, by increasing energy expenditure and/or decreasing energy consumption, will lead to prevention or reduction in weight gain. As described, there is face validity to the hypothesis that eliminating soft drink sales in schools will result in a negative energy balance (future orientation) regardless of whether soft drink consumption was the cause of obesity (past orientation)’ (p 196)
In essence, this moves the focus of future work away from developing more descriptions of the problem to working on solutions and hence the importance of a strong evaluation strand. As mentioned earlier, as well as evidence-based practice, there is also a need to be mindful of generating practice-based evidence. This is evidence that arises from actually trying to solve a problem from first principles, as in the example above (we are grateful to Prof Boyd Swinburn for this distinction).”