Table 1

Luke’s three faces of power and the CDoH

Three ‘faces’ of powerMechanismsExample
InstrumentalExerts direct influence on decision makers, for example, via lobbying, campaign contributions, revolving door; highlights relationships commercial actors have with other stakeholders involved in policy makingIn 2013, the American soft drink industry (Coca-Cola, PepsiCo and the American Beverage Association) spent $10.9 million dollars lobbying the US government.82
StructuralInfluences the agenda-setting process that precedes decision making (‘non-decision-making power’) and can limit the range of choices available to policy makers; can also involve the acquisition of decision-making power via self-regulationThe political and economic importance of Mexico and Brazil’s sugar cane industries influenced government’s unwillingness to regulate the food industry.83
DiscursiveInfluences norms and ideas that underpin and precede agenda setting and political decision-making; shapes public opinion of issues and non-issuesThe European Union lobby group FoodDrinkTax portrayed a sugar tax as a ‘nanny state’ intervention that limits ‘personal freedom’.84