The Role of the Public Health Workforce in Securing Political Commitment for Tackling Childhood Obesity in Local Government.

Local government is well placed to provide leadership for the national ambition in England to halve childhood obesity by 2030 and has delegated authority for many policies thought necessary for effective action. However, with currently constrained local government finances, resources may not be prioritized for the wide range of policies and interventions necessary. Thus, local political commitment is vital for directing local government investment to tackle the issue. This qualitative study investigated how political commitment has been demonstrated in local government, the strategies used to build such political commitment, and the role of the public health workforce. Public health staff from 13 local authorities participated in semi-structured telephone interviews using questions informed by a conceptual framework composed of five previously defined levels of political commitment: rhetorical, institutional, operational, embedded, and system-wide. Thematic analysis showed that public health officers secured a political commitment by framing childhood obesity in line with existing priorities to build support among councillors in a position to advocate for the issue. Public health officers also engaged with multiple stakeholders, gathering data and insights to develop operational and embedded commitment. The study shows that effective health promotion practice requires a skilled and committed public health workforce, acting as policy entrepreneurs to secure system-wide political commitment in local government by proactively navigating local governance and policy processes, to build in opportunities for feedback and accountability.