The problem: The liberalisation of gambling is strongly associated with a marked rise in gambling activity and increases in gambling-related harm experienced at a population level. Programs to address gambling-related harm have traditionally focused on individual behaviour rather than a collective, system wide approach, despite clear evidence of the effectiveness of a public health approach. Minimal discussion is evident of the complex contributory factors associated with gambling-related harm, including the participation of the commercial actors and the role of economic and regulatory aspects that can negatively impact on individuals.
Methods: Commissioned by the Victorian Responsible Gambling Foundation, using a rapid review of evidence approach, we searched for evidence on programs designed to reduced gambling-related harm at a population level, via a public health and harm reduction lens. MEDLINE, ProQuest Central and PsychInfo databases were searched systematically. Included studies were published in English between 2017 – 2023 from all countries with gambling policy contexts and public health systems comparable to Australia’s; included primary data; and focused on primary and/or secondary prevention of gambling-related harm or problems.
Results: One hundred and sixty-seven citations were eligible for inclusion. Themes noted from the literature included: risk and protective factors; primary prevention; secondary prevention; tertiary prevention; target group; and public health approach. The evidence review revealed a gap in empirical evidence around effective system interventions to reduce gambling-related harm at the population level, particularly from a public health perspective. Moreover, there was a clear lack of discussion around the commercial and political determinants of health as they may relate to gambling-related harm.
Conclusion: Addressing gambling-related harm requires a nuanced, multi-layered approach that acknowledges the social, environmental and commercial determinants of gambling and associated harms. A lack of attention to commercial, social and political aspects may reduce the impact of public health measures in gambling harm reduction.

Sustainability and health have recently converged in global dietary guidelines, a synergy which strengthens systems-oriented actions to address the common underlying drivers of environmental degradation and noncommunicable disease. These synergies are gaining traction with consumers who seek sustainability labelling on food products. To address potential concerns around 'greenwashing' in Australia, the aim of this paper was to understand the proliferation of sustainability labels used on packaged food.
Labelling data on packaged food were collected at five supermarkets in Sydney, Australia, in 2023. We determined the prevalence of sustainability labels overall, and by label type. Sustainability labels were categorised as either (1) self-declared text claims, or (2) graphical logos endorsed either in-house by manufacturers or by third parties. Altogether, 49 unique text claims, and 16 graphic logos were identified. Approximately one quarter of products displayed at least one sustainability label. Text claims were far more prevalent than logos, with three-quarters of labelled products displaying only text claims. The only food category where logos were more prevalent than text claims was seafood products.
The results demonstrate the breadth of sustainability label types used on packaged foods. Given limited regulation of this area, there is a risk that unverified text claims may mislead consumers. The wide variety of labels may also limit consumers ability to compare different products. A fragmented approach to sustainability labelling runs contrary to systems thinking. Adopting lessons from nutrition labelling, a standardised government-led sustainability label may improve consumer trust and comparability across products as part of comprehensive policies to promote and healthy and sustainable food systems.

Almost half of the world’s publicly listed mining companies—with sites in approximately 100 countries—are headquartered in Canada. While economic benefits serve fiscal, corporate and government interests, mining often occurs in remote and rural areas inhabited by Indigenous and other minoritized communities, and has been linked to worsening health, social, and environmental conditions. Extractive companies often operate with virtual impunity for their human rights, health and environmental impacts. Some sign on to Responsible Business Conduct norms, but these are insufficient to prevent harms and ensure accountability and redress for communities.

To examine the multiple, intersecting effects of Canadian mines on the health of the local populace, we are collaborating with the Quilombolas community in Paracatu, Brazil; local Kyrgyz in Issyk-Kul, Kyrgyzstan; and Igorot peoples, in Benguet, Philippines, sites of Kinross, Kumtor, and Solfotara mines. Evidence from initial community consultations drew attention to: short- and long-term environmental damage that further impacts food security and access to clean water; threats to Indigenous and minority cultural integrity and bodily security linked to repression of dissent; poor working conditions, and occupational exposures. Importantly, many were forced to make trade-offs between individual and social health and wellbeing and income due to a lack of other economic options.

Next steps include deploying a host of interlinking participatory methods including environmental monitoring, community storytelling about changes to environmental, social, and health, collection of health services and occupational health data, GIS mapping, surveys, interviews, focus groups, policy and documentary analysis, and arts-based methods with current and former miners and their families, health care workers, activists, policymakers, and industry officials. This constellation of data will enable actions to arm community members and advocacy groups with critical evidence to advance environmental, health, Indigenous, and social rights, and advocate for legal reforms in Canada and the host states.

Introduction. Despite alcohol’s significant contribution to disease burden in Australia and globally, the alcohol industry increasingly exploits the health consciousness of some population subgroups by marketing products as ‘better for you’ using claims such as low sugar, organic, and natural. These claims have the potential to mislead consumers and undermine public health efforts to reduce alcohol-related harm, particularly among young people who are targeted with this form of marketing.

Materials and Methods. To investigate effects of health-oriented marketing claims on perceptions and intended consumption of alcohol products, N=1,009 Australian young adults aged 18-24 participated in an online between-subjects experiment comprising a ‘control’ (no claims) and ‘claim’ (low sugar/carb, low calorie, natural, organic, and preservative free) condition. Participants in each condition rated 10 otherwise identical alcohol products (with equivalent labelled alcohol and energy content), with the respective health-oriented marketing claims displayed in the ‘claim’ condition.

Results. Overall, alcohol products with health-oriented marketing claims were rated as significantly healthier, less harmful to health, lower in sugar and kilojoules, and more suitable for weight management and a healthy diet than those without (p=.002 to p<.001, except ‘natural’ claims did not influence ‘healthy diet’). Claims did not influence product appeal, perceived alcohol content, or intended consumption, except that when products displayed a ‘natural’ claim, participants intended to consume a higher number of serves of that product than when no claim was displayed.

Conclusions. Findings demonstrate how health-oriented claims currently permitted on alcohol labels and in marketing in Australia can mislead young adults to perceive alcohol products as healthier on many dimensions even in the presence of information to the contrary (e.g., equivalent labelled energy and alcohol content). There is a need to strengthen the regulation of alcohol labelling and marketing in Australia by prohibiting misleading health-oriented marketing claims made about this harmful commodity.

Background: In Australia, New Zealand, and many other countries, government policy on nutrition currently relies on voluntary food company action in areas such as food labelling, marketing to children, and product formulation. However, the drivers of, and barriers to, voluntary food company action to improve nutrition have not been well studied.
Aim: To explore internal and external drivers of food company actions to address population nutrition issues.
Methods: The REFORM study was a cluster randomised controlled trial to test the impact of a 12-month intervention consisting of direct engagement with food companies to improve their nutrition policies and practices via training, technical support and performance benchmarking. Eligible companies included the largest Australian and New Zealand packaged food and non-alcoholic beverage companies and chained fast-food companies. Post-intervention, semi-structured interviews with intervention company representatives from nutrition, marketing, and research and development roles investigated perceptions of factors which supported or inhibited company action to improve nutrition policies and practices. Deductive analysis derived themes against the ADKAR change model domains (Awareness, Desire, Knowledge, Ability, Reinforcement) and Consolidated Framework for Implementation Research.
Results: 15 Australian and 4 New Zealand company representatives were interviewed. Few companies reported substantive nutrition policy or practice changes in response to the REFORM intervention. Key drivers supporting healthy practices included: A) external influences that increased company desire for nutrition action, particularly comparisons to competitors; B) empowering internal nutrition advocates to engage senior company decision-makers; C) internal governance structures and resourcing that support change; D) absence of external shocks to company operations; and E) the need to manage (the threat of) consumer demand and public perceptions.
Conclusions: Voluntary food company initiatives are unlikely to be effective in supporting healthy food company policies and practices given internal and external drivers. Government regulation is likely required to improve population nutrition.

Background: There is significant public health concern about the excessive promotion of gambling in sport. Attempts to regulate gambling advertising in sport have failed to address the influence of sponsorship, focusing mainly on traditional television ads during broadcasts of elite sport. Community sporting organisations have been left to navigate the ethical landscape of gambling sponsorship independently. Little is known about how these organisations assess the risks involved. Therefore, this study aimed to understand the factors that shape their decisions around accepting gambling sponsorship.

Methods: In-depth interviews were held with 24 representatives from sporting organisations across Victoria and NSW. Participants were asked questions relating to decisions about gambling sponsorship within their clubs and how they assess the risks and benefits of gambling sponsors. Data was analysed using reflexive thematic analysis.

Results: This study found that perceptions of risk of gambling sponsorship were shaped by sporting organisations’ ethical standards and community-centric values. However, while many sporting organisations viewed that gambling sponsorships misaligned with their community-centric values, some participants perceived that there were significant benefits that could outweigh the risks. The study also revealed that some sporting organisations perceived that there were ethical ways to engage with gambling sponsors while minimising the promotion of gambling products, particularly by shielding children from exposure to gambling promotional materials. Lastly, this study found that community attitudes and social norms played an important role in shaping perceptions of risks of gambling sponsorship.

Conclusion: The findings from this study highlight significant concerns regarding the complex motivations driving community sporting clubs to accept gambling sponsorships. With sporting organisations navigating ethical dilemmas, weighing up values, reputation, and financial viability, policy action is needed to support community sport and protect those involved from harmful industry marketing.

Front-of-pack nutrition labelling (FOPNL) on packaged foods is recommended as one of the most effective policies to promote healthier diets and prevent noncommunicable disease. Australia’s Health Star Rating (HSR) FOPNL displays the healthiness of foods across ten half-star increments, ranging from 0.5 (less healthy) to 5.0 (more healthy) to guide consumers towards healthier choices. Since voluntary implementation commenced in 2014, uptake has been slow and remains low overall, with the HSR label appearing on only around one third of all products for which it is intended in 2023. The aim of this work was to examine the distribution of HSR uptake for each HSR increment. We obtained the HSR for products available for sale in 2023 at four large food retailers in Australia. For each HSR increment (0.5 to 5.0), we calculated products displaying the HSR label as a percentage of products intended to display that HSR increment. Uptake of the HSR label varied widely, with the lowest uptake on products with a HSR of 0.5 (16.4%) and highest on products that scored a HSR of 5.0 (61.2%). Low HSR uptake on unhealthy products reiterates that most food manufacturers will only voluntarily display the HSR on higher scoring products where the rating has marketing value. Limited uptake on low scoring products denies consumers the benefit of this information on unhealthy products and limits their ability to use the label as a comparative tool. Despite efforts from Food Ministers to establish uptake targets, the public health potential of the HSR system is threatened if the program remains voluntary. Urgent government action to make the system mandatory is crucial to ensure the HSR system achieves maximum public health impact.

The private sector can influence the social, physical and cultural environments in society through business actions. Alternate leisure businesses (ALBs) have been recognised as an under-utilised and new opportunity for prevention of non-communicable diseases, as they provide fun and social physical activity options for families, children and young adults. Examples of these businesses include dance and aerial studios, children’s play centres, and theme parks among others. Therefore, the aim of this research project was to explore the suitability of ALBs as a place for health promotion action.
A design-thinking methodology was used to co-design a pilot project with 43 community members and 5 ALBs through a survey and focus group with the aims of improving the physical and socioeconomic environments of ALBs in three local government areas in south-east Melbourne. Surveys of 42 local community members identified inclusivity and accessibility, a lack of healthy food options, and high entry fees were limiting the communities’ access to ALB services. Consequently, two priority health areas were identified for targeted action healthy eating and inclusion.
Four ALBs were engaged in the pilot including: a dance studio, an aerial studio, a children’s farm and a play centre. These businesses were supported to create action plans to either improve their healthy eating environment or increase their inclusivity and accessibility. Engaged businesses also had access to an incentive voucher program funded by VicHealth which aimed to determine whether lower entry fees led to an increase in visitation and sustained retention from community members. Three hundred visits to the ALBs were supported using the incentive voucher program over a 10 month period.
Evaluation of the pilot project including interviews, surveys and focus groups are currently occurring and the findings will be presented, along with recommendations on the suitability of ALBs for health promotion action will be discussed.

Women and girls are disproportionally impacted by the Commercial Determinants of Health (CDoH). The CDoH critically shape health outcomes, with substantial impacts on women, contributing to global health disparities. CDoH extend beyond traditional harmful industries like tobacco and alcohol, encompassing broad economic interests that often undermine public health. Commercial actors use a range of sophisticated strategies designed to protect and promote their commercial interests. These include a range of production, consumption, and public relations processes. Women, particularly in low and middle-income countries, bear a disproportionate burden due to gendered inequities in production sectors such as fashion and mining, as well as through targeted marketing of harmful products like alcohol and gambling.

Researchers have highlighted the ways in which corporations capture gender equity framing in Corporate Social Responsibility (CSR) initiatives to portray themselves as socially progressive while simultaneously undermining women’s health. For instance, tobacco and alcohol companies sponsor health campaigns while marketing aggressively to vulnerable populations, including women. Despite significant research on marketing tactics, the role of CSR in influencing women’s consumer behaviour remains underexplored. Gendered CSR initiatives, supposedly promoting gender equality, frequently serve corporate interests by deflecting criticism and leveraging the appearance of social responsibility. Therefore, it is important that the public health community must pay greater attention to CSR initiatives by industries known to cause harm.

This presentation aims to consider the impact gendered CSR initiatives from corporations. It seeks to discuss how Australian women conceptualise the use of CSR strategies and their perception of the impact of CSR initiatives in shaping women’s attitudes and behaviours, and their recommendations for addressing the impact of CSR on gender inequity. Understanding these dynamics is crucial for the public health community to develop effective policies and interventions addressing the intersection of the CDoH and gender. The presentation will be based on recent research findings from a study that explores women's perceptions of CSR.

There is widespread evidence linking poor physical and mental health to ‘energy hardship’, where individuals are unable to obtain energy services to meet basic living standards. Between 2−14 per cent of Australian households may experience energy hardship, and those experiencing the greatest health inequities are most at risk, such as individuals in public housing or relying on government pensions.

Numerous drivers for energy hardship have been identified, including household income, energy pricing, and consumer literacy in navigating energy markets. Energy retail prices have been systematically increasing in Australia since 2010, and while energy expenditure has declined at a population-wide level, inequities remain. Low-income households spend more of their income on energy compared to high-income households. Health concerns may arise when households sacrifice energy use due to cost concerns and restrict the use of appliances at the expense of their general health and wellbeing. These challenges may be exacerbated by poor housing conditions (e.g. poor insulation or heating systems), which drive higher energy consumption to adequately maintain warm homes. Privatised electricity and gas markets with competitive pricing schemes may also leave consumers feeling ill-equipped to navigate its complexity, leading to confusion and lack of trust.

In this presentation, we summarise findings from a literature review on international responses to energy hardship and the roles health systems can play. We highlight the need for cooperation between public and private sectors to recognise and mitigate energy hardship. Energy hardship must be framed as a public health issue. Formal definitions and indicators for energy hardship must be agreed upon to help identify and respond to households at risk. Capacity building within and coordinated action by the health, housing and energy sectors is critical for addressing this key commercial determinant of health.

This paper presents empirical evidence of the nature and characteristics of unhealthy food advertising online in Australia to inform policy development designed to promote a healthy digital food environment. International bodies, such as the World Health Organization, and public health experts are calling for urgent restrictions on the online marketing of unhealthy food. The harmful effects of incessant unhealthy food advertising, particularly to children, has prompted a proposed policy action in Australia to restrict childrens’ exposure to the marketing of unhealthy foods, including a strong, broad prohibition on all unhealthy food marketing online. We used a novel data donation infrastructure, the Australian Ad Observatory, to create a dataset of thousands of unhealthy food ads, from individual Australians’ Facebook feeds in order to investigate unhealthy food advertising on social media; identify any harmful targeting and marketing practices; and demonstrate how online advertising may be made observable and accountable. We find that there is evidence that young people, especially young men, are being targeted by unhealthy food, especially fast food, ads, and that unhealthy food ads use numerous potentially harmful marketing strategies to appeal to children, young people and the broader community, including cartoon characters, associations with popular sports and greenwashing. The policy implications of our findings are that a strong, broad prohibition on unhealthy food advertising that is not age-restricted and that prohibits all forms of unhealthy food advertising is needed to protect children, young people and the broader community, to address the digital determinants of health.

Background
Gambling is a global public health issue with significant impacts on health and wellbeing. Research has found that young people are concerned about the tactics of the gambling industry particularly the impact of marketing. They are supportive of public health responses such as policies that aim to restrict or ban gambling marketing. However, there is limited evidence that has documented what young people think about gambling policies, and ways to engage young people in public health responses.

Methods
Online focus groups with n= 64 young people aged 12-17 years from New South Wales and Victoria were conducted. Participants were asked to consider different public health responses to gambling, if and how they should be involved in policy discussions, and what they thought needs to be done. Reflexive thematic analysis was used to construct themes from the data.

Results
Many young people thought that they should be included in discussions and decisions relating to gambling. This was because they thought they provided unique perspectives and experiences that could be different to adults. Young people wanted to see more effective gambling marketing regulations, which addresses the frequency and content of marketing materials, as well as education that countered the positive depictions that they saw about gambling. Young people were asked if they had a message for the Australian Prime Minister, in which some responded that they thought there needed to be greater accountability and more action was needed.

Conclusion
Young people are not confident in the government’s ability to protect young people from gambling industry tactics. This study highlights young people’s capacity and desire to engage in meaningful discussions around policy responses to harmful industries. The public health community needs to ensure that there are mechanisms that facilitate young people’s participation and engagement in public health policies and responses.