A Multiple Streams Framework Analysis of Bill S-228: Lessons for Healthy Public Policy Change in Canada

Abstract

The underlying social, political and economic environment has been shown to significantly impact and shape the health of a population. A key aspect of the overall environment that shapes population health includes the marketing of unhealthy and harmful products such as tobacco, cannabis, alcohol, sugar/sweetened beverages and ultra-processed foods. Marketing of these products and commodities leads to or is associated with youth initiating alcohol at lower ages, normalizing tobacco products and influencing children’s food preferences and consumption patterns. Addressing the impact of marketing of unhealthy products on overall population health has emerged as an area of concern for public policy making processes. With support of key policy actors, including health promotion and public health research and policy communities, Canadian and international policymaking efforts have aimed to regulate, limit and/or restrict the marketing of unhealthy products. These efforts are also regularly, in turn, met with opposition from corporate, economic, legal, political and other interest groups or stakeholders.

Recent attempts to restrict marketing of unhealthy food and beverages in Canada at the federal level have been unsuccessful. This study used the Multiple Streams Framework (MSF) to examine the underlying conditions that led to the failure to adopt Bill S-228, the Child Health Protection Act in the Canadian federal Parliament in 2019. Despite the scientific evidence underpinning the intent of the bill and significant political and government support, what were the factors that closed the policy window on Bill S-228?

Through semi-structured interviews and document review and analysis, the strategies of key policy and political actors were examined, including the identification of policy and political entrepreneurs, and problem brokers active especially in the MSF problem and political streams. The study identified that the failed adoption of Bill S-228 was the result of a combination of factors, including the successful reframing of the policy problem, shifting policymaking attention from the harms of unhealthy food and beverage marketing to the challenges, impacts and drawbacks of the proposed legislation on the agriculture community, the food, beverage and media industries as well as the sport and recreation community. The intensity of the advocacy and lobbying of MPs and Senators by opponents to Bill S-228 outmatched the capacity of health NGOs and parliamentary supporters to respond to critiques of the proposed legislation in a policymaking environment filled with competing priorities. Opponents were successful in stitching together an effective coalition of industry and community sectors in taking advantage of parliamentary procedures and reforms, using their ability to access parliamentarians to draw attention to the impacts of Bill S-228.

There is much to learn from this episode of healthy public policy making in Canada. First, the agenda-setting activities of coupling the policy, problem and political streams illustrates the long-term work needed to sustain policy action. Second, Bill S-228 provides an opportunity to shed light on future steps, including effective advocacy strategies, to support healthy public policy change that encompass protections against food and beverage marketing to children.