Governing Noncommunicable Diseases Through Political Rationality and Technologies of Government: A Discourse Analysis

Joshua S. Yang, Hadii M. Mamudu and Timothy K. Mackey
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Joshua S. Yang: Department of Public Health, California State University, Fullerton, KHS 161 A, 800 N. State College Blvd, Fullerton, CA 92831, USA
Hadii M. Mamudu: Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
Timothy K. Mackey: Department of Anesthesiology and Division of Global Public Health, San Diego School of Medicine, University of California, San Diego, CA 92037, USA

IJERPH, 2020, vol. 17, issue 12, 1-16

Abstract: In the last two decades, global action to address noncommunicable diseases (NCDs) has accelerated, but policy adoption and implementation at the national level has been inadequate. This analysis examines the role of rationalities of governing, or governmentality , in national-level adoption of global recommendations. Critical discourse analysis was conducted using 49 formal institutional and organizational documents obtained through snowball sampling methodology. Text were coded using a framework of five forms of governmentality and analyzed to describe the order of discourse which has emerged within the global NCD policy domain. The dominant political rationality used to frame NCDs is rooted in risk governmentality. Recommendations for tobacco control and prevention of harmful alcohol use rely on a governmentality of police mixed with discipline. The promotion of physical activity relies heavily on disciplinary governmentality, and the prevention of unhealthy diet mixed disciplinary measures, discipline, and neoliberal governmentalities. To translate global NCD prevention and control strategies to national action, acceptability for the political rationalities embodied in policy options must be nurtured as new norms, procedures, and institutions appropriate to the political rationalities of specific interventions are developed.

Keywords: noncommunicable diseases; global governance; governmentality; discourse analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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