Is ‘Health in All Policies’ everybody’s responsibility? Discourses of multistakeholderism and the lifestyle drift phenomenon

Abstract

In relation to health promotion, the lifestyle drift is a phenomenon whereby health policymakers begin with a recognition of the social, political and economic determinants of health (‘distal’ determinants of health), only to drift back into designing policies targeted largely at modifying individual behavior (‘proximal’ determinants of health). Looking at the ‘Health in All Policies’ (HiAP) agenda in the European Commission (EC), this article investigates the discursive construction of the lifestyle drift. It starts by analyzing why, in the EC context, HiAP is interpreted as inherently about multistakeholder engagement. It then draws on the EU Diet Platform as a contrasting example to explore the relation between this multistakeholder interpretation and the lifestyle drift. The article then unpacks the discursive legitimation of the multistakeholder rationale, and shows how multistakeholder engagement is presented as a reasonable and normatively neutral way to approach public policy problems. Finally, the article critically reflects upon the technocratizing effects of the normatively neutral language deemed to be required of policy-relevant knowledge.