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Anaf J, Baum F, Fisher M, Friel S. Civil society action against transnational corporations: implications for health promotion. Health Promot Int 2021; 35:877-887. [PMID: 31504470 DOI: 10.1093/heapro/daz088] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Transnational corporations (TNCs) shape population health both positively and negatively through their national and international social, political and economic power and influence; and are a vital commercial determinant of health. Individual and group advocacy and activism in response to corporate products, practices or policy influences can mediate negative health impacts. This paper discusses the unequal power relations existing between TNCs that promote their own financial interests, and activists and advocates who support population and environmental health by challenging corporate power. It draws on interview data from 19 respondents who informed 2 health impact assessments conducted on TNCs; 1 from the fast food industry, and 1 from the extractive industries sector. It reveals the types of strategies that civil society organizations (CSOs) have used to encourage TNCs to act in more health promoting ways. It discusses the extent to which these strategies have been effective, and how TNCs have used their power to respond to civil society action. The paper highlights the rewards, and the very real challenges faced by CSOs trying to change TNC practices related to health, within a neoliberal policy environment. It aims to provide evidence for socially oriented actors to inform their advocacy for changes in public policy or corporate practices that can contribute to improving population health and equity and tackling commercial determinants of health.
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Affiliation(s)
- Julia Anaf
- Southgate Institute for Health, Society and Equity, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, South Australia 5042, Australia
| | - Fran Baum
- Southgate Institute for Health, Society and Equity, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, South Australia 5042, Australia
| | - Matthew Fisher
- Southgate Institute for Health, Society and Equity, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, South Australia 5042, Australia
| | - Sharon Friel
- School of Regulation and Global Governance (RegNet), College of Asia and the Pacific, Menzies Centre for Health Policy, The Australian National University, Canberra, ACT 0200, Australia
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Madden M, McCambridge J. Alcohol marketing versus public health: David and Goliath? Global Health 2021; 17:45. [PMID: 33845851 PMCID: PMC8040366 DOI: 10.1186/s12992-021-00696-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/31/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Alcohol harms are rising globally, and alcohol policies, where they exist, are weak or under-developed. Limited progress has been made since the formulation of the World Health Organisation (WHO) Global Strategy in 2010. WHO is seeking to accelerate progress in implementing international efforts to reduce the harmful use of alcohol. The threat to global health posed by tobacco is well understood by policy communities and populations globally; by contrast alcohol is much less so, despite available evidence. THE COMPETITION FOR EPISTEMIC AUTHORITY Global alcohol corporations have sought to become trusted sources of advice for policy makers and consumers, while continuing to grow their markets. Evidence-informed public health messaging faces formidable competition from transnational corporations as the worlds of corporate and political communications, social and mainstream media become increasingly linked, presenting new opportunities for corporate actors to shape global health governance. Alcohol messaging that uses means of persuasion tied to industry agendas does not tell a clear story about commercial determinants of health, and does not contribute to health improvement. On the contrary, the basic tenets of an evidence-informed population-based approach are denied and the policy measures supported by high quality evidence are being opposed, because they are inimical to commercial interests. A David and Goliath metaphor for this state of affairs, which seems to fit at first glance, may unwittingly reinforce the status quo. CONCLUSION Public opinion on alcohol and policy issues varies across time and place and can be influenced by dedicated public health interventions. Alcohol marketing dominates people's thinking about alcohol because we currently allow this to happen. Greater ambition is needed in developing countermarketing and other interventions to promote evidence-informed ideas with the public. Alcohol policies need to be further developed, and implemented more widely, in order to arrest the growing burden of alcohol harms across the world.
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Affiliation(s)
- Mary Madden
- Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, YO10 5DD UK
| | - Jim McCambridge
- Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, YO10 5DD UK
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Wood B, Williams O, Baker P, Nagarajan V, Sacks G. The influence of corporate market power on health: exploring the structure-conduct-performance model from a public health perspective. Global Health 2021; 17:41. [PMID: 33823900 PMCID: PMC8025506 DOI: 10.1186/s12992-021-00688-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 03/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The detrimental impact of dominant corporations active in health-harming commodity industries is well recognised. However, to date, existing analyses of the ways in which corporations influence health have paid limited attention to corporate market power. Accordingly, the public health implications of concentrated market structures, the use of anti-competitive market strategies, and the ways in which market power mediates the allocation and distribution of resources via market systems, remain relatively unexplored. To address this gap, this paper aimed to identify and explore key literature that could inform a comprehensive framework to examine corporate market power from a public health perspective. The ultra-processed food (UPF) industry was used to provide illustrative examples. METHODS A scoping review of a diverse range of literature, including Industrial Organization, welfare economics, global political economy and antitrust policy, was conducted to identify important concepts and metrics that could be drawn upon within the field of public health to understand and explore market power. The Structure-Conduct-Performance (SCP) model, a guiding principle of antitrust policy and the regulation of market power, was used as an organising framework. RESULTS We described each of the components of the traditional SCP model and how they have historically been used to assess market power through examining the interrelations between the structure of industries and markets, the conduct of dominant firms, and the overall ability of markets and firms to efficiently allocate and distribute the scarce resources. CONCLUSION We argue that the SCP model is well-placed to broaden public health research into the ways in which corporations influence health. In addition, the development of a comprehensive framework based on the key findings of this paper could help the public health community to better engage with a set of policy and regulatory tools that have the potential to curb the concentration of corporate power for the betterment of population health.
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Affiliation(s)
- Benjamin Wood
- Global Obesity Centre, Deakin University, Geelong, Australia.
| | - Owain Williams
- School of Political Science and International Studies, University of Leeds, Leeds, UK
| | - Phil Baker
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | | | - Gary Sacks
- Global Obesity Centre, Deakin University, Geelong, Australia
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Maani N, VAN Schalkwyk MC, Petticrew M, Galea S. The Commercial Determinants of Three Contemporary National Crises: How Corporate Practices Intersect With the COVID-19 Pandemic, Economic Downturn, and Racial Inequity. Milbank Q 2021; 99:503-518. [PMID: 33783862 PMCID: PMC8241267 DOI: 10.1111/1468-0009.12510] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Policy Points The United States finds itself in the middle of an unprecedented combination of crises: a global pandemic, economic crisis, and unprecedented civic responses to structural racism. While public sector responses to these crises have faced much justified criticism, the commercial determinants of these crises have not been sufficiently examined. In this commentary we examine the nature of the contributions of such actors to the conditions that underpin these crises in the United States through their market and nonmarket activities. On the basis of this analysis, we make recommendations on the role of governance and civil society in relation to such commercial actors in a post-COVID-19 world.
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Affiliation(s)
- Nason Maani
- Boston University School of Public Health.,London School of Hygiene and Tropical Medicine.,SPECTRUM Consortium (Shaping Public Health Policies to Reduce Inequalities and Harm), Edinburgh University
| | | | - Mark Petticrew
- London School of Hygiene and Tropical Medicine.,SPECTRUM Consortium (Shaping Public Health Policies to Reduce Inequalities and Harm), Edinburgh University
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Wood B, Williams O, Nagarajan V, Sacks G. Market strategies used by processed food manufacturers to increase and consolidate their power: a systematic review and document analysis. Global Health 2021; 17:17. [PMID: 33499883 PMCID: PMC7836045 DOI: 10.1186/s12992-021-00667-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/18/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The public health community has become increasingly critical of the role that powerful corporations play in driving unhealthy diets, one of the leading contributors to the global burden of disease. While a substantial amount of work has examined the political strategies used by dominant processed food manufacturers that undermine public health, less attention has been paid to their use of market strategies to build and consolidate power. In this light, this paper aimed to systematically review and synthesise the market strategies deployed by dominant processed food manufacturers to increase and consolidate their power. METHODS A systematic review and document analysis of public health, business, legal and media content databases (Scopus, Medline, ABI Inform, Business Source Complete, Thomas Reuters Westlaw, Lexis Advance, Factiva, NewsBank), and grey literature were conducted. Data extracted were analysed thematically using an approach informed by Porter's 'Five Forces' framework. RESULTS 213 documents met inclusion criteria. The market strategies (n=21) and related practices of dominant processed food manufacturers identified in the documents were categorised into a typological framework consisting of six interconnected strategic objectives: i) reduce intense competition with equivalent sized rivals and maintaining dominance over smaller rivals; ii) raise barriers to market entry by new competitors; iii) counter the threat of market disruptors and drive dietary displacement in favour of their products; iv) increase firm buyer power over suppliers; v) increase firm seller power over retailers and distributors; and vi) leverage informational power asymmetries in relations with consumers. CONCLUSIONS The typological framework is well-placed to inform general and jurisdiction-specific market strategy analyses of dominant processed food manufacturers, and has the potential to assist in identifying countervailing public policies, such as those related to merger control, unfair trading practices, and public procurement, that could be used to address market-power imbalances as part of efforts to improve population diets.
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Affiliation(s)
- Benjamin Wood
- Global Obesity Centre, Deakin University, Melbourne, Australia.
| | - Owain Williams
- School of Political Science and International Studies, University of Leeds, Leeds, UK
| | | | - Gary Sacks
- Global Obesity Centre, Deakin University, Melbourne, Australia
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Lee JGL, Cristello JV, Buckton CH, Carey RN, Trucco EM, Schenk PM, Ikegwuonu T, Hilton S, Golden SD, Conway DI. Message framing to inform cancer prevention pricing interventions in the UK and USA: a factorial experiment, 2019. BMJ Open 2021; 11:e041324. [PMID: 33495253 PMCID: PMC7839858 DOI: 10.1136/bmjopen-2020-041324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 12/10/2020] [Accepted: 12/18/2020] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To advance understanding of how message framing can be used to maximise public support across different pricing policies for alcohol, tobacco and sugary drinks/foods that prevent consumption of cancer-causing products. DESIGN We designed a 3×4×3 randomised factorial experiment to test responses to messages with three pricing policies, four message frames and three products. SETTING Online survey panel (Qualtrics) in 2019. PARTICIPANTS Adults (N=1850) from the UK and USA. INTERVENTIONS Participants randomly viewed one of 36 separate messages that varied by pricing policy (increasing taxes, getting rid of price discounts, getting rid of low-cost products), four frames and product (alcohol, tobacco, sugary drinks/foods). PRIMARY AND SECONDARY OUTCOME MEASURES We assessed the relationship between the message characteristics and four dependent variables. Three were related to policy support: (1) increasing taxes on the product mentioned in the message, (2) getting rid of price discounts and special offers on the product mentioned in the message and (3) getting rid of low-cost versions of the product mentioned in the message. One was related to reactance, a psychological response to having one's freedom limited. RESULTS We found no effect for pricing policy in the message. Frames regarding children and reducing cancer risk moderated some outcomes, showing promise for real-world use. We found differences in support by product and reactance with greatest support and least reactance for tobacco policies, less support and more reactance for alcohol policies, and the least support and most reactance for sugary drinks/foods policies. CONCLUSIONS Cancer prevention efforts using policy interventions can be informed by the message framing literature. Our results offer insights for cancer prevention advocacy efforts across the UK and USA and highlight that tax versus non-tax approaches to increasing the cost of cancer-causing products result in similar responses from consumers.
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Affiliation(s)
- Joseph G L Lee
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA
- Cancer Prevention and Control, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
| | - Julie V Cristello
- Department of Psychology, Florida International University, Miami, Florida, USA
| | - Christina H Buckton
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Rachel N Carey
- Department of Clinical, Educational & Health Psychology, University College London, London, UK
| | - Elisa M Trucco
- Department of Psychology and Center for Children and Families, Florida International University, Miami, Florida, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Paulina M Schenk
- Department of Clinical, Educational & Health Psychology, University College London, London, UK
| | - Theresa Ikegwuonu
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Shona Hilton
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Shelley D Golden
- Cancer Prevention and Control, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - David I Conway
- School of Medicine, Dentistry, and Nursing, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Abstract
Policy Points Explanations for the troubling trend in US life expectancy since the 1980s should be grounded in the dynamic changes in policies and political landscapes. Efforts to reverse this trend and put US life expectancy on par with other high-income countries must address those factors. Of prime importance are the shifts in the balance of policymaking power in the United States, the polarization of state policy contexts, and the forces behind those changes.
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Ultraprocessed Food: Addictive, Toxic, and Ready for Regulation. Nutrients 2020; 12:nu12113401. [PMID: 33167515 PMCID: PMC7694501 DOI: 10.3390/nu12113401] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/19/2020] [Accepted: 10/23/2020] [Indexed: 12/15/2022] Open
Abstract
Past public health crises (e.g., tobacco, alcohol, opioids, cholera, human immunodeficiency virus (HIV), lead, pollution, venereal disease, even coronavirus (COVID-19) have been met with interventions targeted both at the individual and all of society. While the healthcare community is very aware that the global pandemic of non-communicable diseases (NCDs) has its origins in our Western ultraprocessed food diet, society has been slow to initiate any interventions other than public education, which has been ineffective, in part due to food industry interference. This article provides the rationale for such public health interventions, by compiling the evidence that added sugar, and by proxy the ultraprocessed food category, meets the four criteria set by the public health community as necessary and sufficient for regulation—abuse, toxicity, ubiquity, and externalities (How does your consumption affect me?). To their credit, some countries have recently heeded this science and have instituted sugar taxation policies to help ameliorate NCDs within their borders. This article also supplies scientific counters to food industry talking points, and sample intervention strategies, in order to guide both scientists and policy makers in instituting further appropriate public health measures to quell this pandemic.
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Ndebele P, Shaikh H, Paichadze N, Bari I, Michaels D, Santos Burgoa C, Hyder AA. Commercial determinants of health: an ethical exploration. Int J Public Health 2020; 65:1123-1132. [PMID: 32840631 DOI: 10.1007/s00038-020-01427-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 06/27/2020] [Accepted: 07/06/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES This paper seeks to contribute toward a better understanding of commercial determinants of health by proposing a set of ethical principles that can be used by researchers and other health actors in understanding and addressing Commercial Determinants of Health (CDoH). METHODS The paper is mainly based on a systematic review and qualitative analysis of the existing literature on CDoH and public health ethics frameworks. We conducted searches using selected search engines (Google Scholar and Pubmed). For ethical challenges relating to CDOH, our searches in Google Scholar yielded 17 papers that discussed ethical challenges that affect CDoH. For ethical frameworks relevant for CDOH, our searches in Google Scholar and Pubmed yielded 15 papers that clearly described bioethical models including relevant ethical principles. Additionally, we consulted eight experts working on CDoH. Through these two methods, we were able to identify ethical challenges as well as norms and values related to CDoH that we offer as candidates to comprise a foundational ethics framework for CDoH. RESULTS Discussing risk factors associated with CDH frequently brings public health into conflict with the interests of industry actors in the food, automobile, beverage, alcohol, ammunition, gaming and tobacco industries including conflict between profit-making and public health. We propose the following candidate ethical principles that can be used in addressing CDoH: moral responsibility, nonmaleficence, social justice and equity, consumer sovereignty, evidence-informed actions, responsiveness, accountability, appropriateness, transparency, beneficence and holism. CONCLUSIONS We hope that this set of guiding principles will generate wider global debate on CDoH and help inform ethical analyses of corporate actions that contribute to ill health and policies aimed at addressing CDoH. These candidate principles can guide researchers and health actors including corporations in addressing CDoH.
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Affiliation(s)
- Paul Ndebele
- Center for Commercial Determinants of Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, Suite 722, Washington, DC, 20037, USA.
| | - Hina Shaikh
- Center for Commercial Determinants of Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, Suite 722, Washington, DC, 20037, USA
| | - Nino Paichadze
- Center for Commercial Determinants of Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, Suite 722, Washington, DC, 20037, USA
| | - Imran Bari
- Center for Commercial Determinants of Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, Suite 722, Washington, DC, 20037, USA
| | - David Michaels
- Center for Commercial Determinants of Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, Suite 722, Washington, DC, 20037, USA
| | - Carlos Santos Burgoa
- Center for Commercial Determinants of Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, Suite 722, Washington, DC, 20037, USA
| | - Adnan A Hyder
- Center for Commercial Determinants of Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, Suite 722, Washington, DC, 20037, USA
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Mialon M. An overview of the commercial determinants of health. Global Health 2020; 16:74. [PMID: 32807183 PMCID: PMC7433173 DOI: 10.1186/s12992-020-00607-x] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 08/05/2020] [Indexed: 12/20/2022] Open
Abstract
Background Different terms are described in the literature that refer to commercial determinants as drivers of ill-health. The aim of the present review was to provide an overview of the commercial determinants of health, through a review of the literature on this subject. The review was conducted in December 2019 and updated in February 2020. Searches were conducted from peer-reviewed scientific articles, commentaries, books, and books chapters, with no restriction in their publication dates and languages. Main body The commercial determinants of health cover three areas. First, they relate to unhealthy commodities that are contributing to ill-health. Secondly, they include business, market and political practices that are harmful to health and used to sell these commodities and secure a favourable policy environment. Finally, they include the global drivers of ill-health, such as market-driven economies and globalisation, that have facilitated the use of such harmful practices. Short conclusion The discussion on the commercial determinants of health offers a unique opportunity to shift the dominant paradigm in public health, where individual behaviours are considered to be driven by inadequate environments. Ill-health, damages to the environment, and health and social inequalities, might be better understood through a commercial determinant lens.
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Affiliation(s)
- Melissa Mialon
- School of Public Health, University of São Paulo, São Paulo, Brazil.
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Maani N, McKee M, Petticrew M, Galea S. Corporate practices and the health of populations: a research and translational agenda. LANCET PUBLIC HEALTH 2020; 5:e80-e81. [PMID: 32032560 DOI: 10.1016/s2468-2667(19)30270-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Nason Maani
- School of Public Health, Boston University, Boston, MA 02118, USA; Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Martin McKee
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Mark Petticrew
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Sandro Galea
- School of Public Health, Boston University, Boston, MA 02118, USA.
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Maani N, Collin J, Friel S, Gilmore AB, McCambridge J, Robertson L, Petticrew MP. Bringing the commercial determinants of health out of the shadows: a review of how the commercial determinants are represented in conceptual frameworks. Eur J Public Health 2020; 30:660-664. [PMID: 31953933 PMCID: PMC7445044 DOI: 10.1093/eurpub/ckz197] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The term 'commercial determinants of health' (CDOH) is increasingly focussing attention upon the role of tobacco, alcohol and food and beverage companies and others-as important drivers of non-communicable diseases (NCDs). However, the CDOH do not seem to be clearly represented in the most common social determinants of health (SDOH) frameworks. We review a wide range of existing frameworks of the determinants of health to determine whether and how commercial determinants are incorporated into current SDOH thinking. METHODS We searched for papers and non-academic reports published in English since 2000 describing influences on population health outcomes. We included documents with a formal conceptual framework or diagram, showing the integration of the different determinants. RESULTS Forty-eight framework documents were identified. Only one explicitly included the CDOH in a conceptual diagram. Ten papers discussed the commercial determinants in some form in the text only and fourteen described negative impacts of commercial determinants in the text. Twelve discussed positive roles for the private sector in producing harmful commodities. Overall, descriptions of commercial determinants are frequently understated, not made explicit, or simply missing. The role of commercial actors as vectors of NCDs is largely absent or invisible in many of the most influential conceptual diagrams. CONCLUSIONS Our current public health models may risk framing public health problems and solutions in ways that obscure the role that the private sector, in particular large transnational companies, play in shaping the broader environment and individual behaviours, and thus population health outcomes.
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Affiliation(s)
- Nason Maani
- London School of Hygiene and Tropical Medicine, London, UK
- School of Public Health, Boston University, Boston, MA, USA
| | - Jeff Collin
- Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, Edinburgh, UK
- SPECTRUM Consortium, UK
| | - Sharon Friel
- SPECTRUM Consortium, UK
- School of Regulation and Global Governance (RegNet), College of Asia and the Pacific, The Australian National University, Canberra, ACT, Australia
| | - Anna B Gilmore
- SPECTRUM Consortium, UK
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Jim McCambridge
- Department of Health Sciences, University of York, Heslington, York, UK
| | - Lindsay Robertson
- SPECTRUM Consortium, UK
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Mark P Petticrew
- London School of Hygiene and Tropical Medicine, London, UK
- SPECTRUM Consortium, UK
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The influence of the sugar-sweetened beverage industry on public policies in Mexico. Int J Public Health 2020; 65:1037-1044. [PMID: 32712688 DOI: 10.1007/s00038-020-01414-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The objective of this study was to map and describe the different corporate political activity (CPA) strategies used by the sugar-sweetened beverage (SSB) industry to influence public health policymaking geared toward decreasing the consumption of SSB in Mexico. METHODS We applied an existing approach to identify and monitor the CPA of the SSB industry. A documentary analysis was conducted for two main actors in the SSB industry, for the period 2017-2019, and was triangulated with eleven semi-structured interviews with key informants in public health nutrition and from the SSB industry. The information was analyzed using an existing framework for categorizing the CPA. RESULTS Although data were found for six CPA strategies, the SSB industry mainly highlighted its economic importance and spoke openly against the 2014 SSB tax. We documented the industry's relationships with governmental bodies and civil society actors to promote corporate social responsibility and gain public support. CONCLUSIONS The SSB industry in Mexico uses a variety of strategies, directly or through third parties, to influence public policies related to the prevention and control of obesity and non-communicable diseases.
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Affiliation(s)
- Trevor A Sheldon
- Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University, London, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford
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de Lacy-Vawdon C, Livingstone C. Defining the commercial determinants of health: a systematic review. BMC Public Health 2020; 20:1022. [PMID: 32600398 PMCID: PMC7325018 DOI: 10.1186/s12889-020-09126-1] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 06/16/2020] [Indexed: 12/14/2022] Open
Abstract
Background Despite increasing attention to the social determinants of health in recent decades, globally there is an unprecedented burden from non-communicable diseases (NCDs). Recently, the corporate and commercial conditions associated with these, commercial determinants of health (CDoH), have also begun to receive attention. This research aims to articulate the CDoH as described in the literature, summarize substantive findings, and assess strengths and limitations of current literature. Methods Systematic review of formal (Medline, EMBASE, Scopus, Global Health) and grey literature (database, Google Advanced, targeted website, citation searching). Searching identified 125 texts for full-text review, with 33 included for final review. Data extracted were analyzed thematically. Results The dynamics constituting CDoH include broad facilitators such as globalization of trade, corporate structures, and regulatory systems, articulation of social and economic power, neoliberal and capitalist ideologies; additional elements include corporate activities such as marketing, corporate political activities, corporate social responsibility, extensive supply chains, harmful products and production, and issues of accessibility. These contribute significantly to worsened global health outcomes. Conclusions Literature describing effects of macro conditions and corporate activities on health could usefully utilize CDoH terminology. Facilitation via revised, consistent and operational definition of CDoH would assist. Social, political, commercial and economic structures and relations of CDoH are under-theorized. Systematic approaches to identifying, describing, and disrupting these are required to improve global health.
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Affiliation(s)
| | - Charles Livingstone
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
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McCambridge J, Kypri K, Sheldon TA, Madden M, Babor TF. Advancing public health policy making through research on the political strategies of alcohol industry actors. J Public Health (Oxf) 2020; 42:262-269. [PMID: 31220307 PMCID: PMC7297281 DOI: 10.1093/pubmed/fdz031] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 02/04/2019] [Indexed: 12/16/2022] Open
Abstract
Development and implementation of evidence-based policies is needed in order to ameliorate the rising toll of non-communicable diseases (NCDs). Alcohol is a key cause of the mortality burden and alcohol policies are under-developed. This is due in part to the global influence of the alcohol industry. We propose that a better understanding of the methods and the effectiveness of alcohol industry influence on public health policies will support efforts to combat such influence, and advance global health. Many of the issues on the research agenda we propose will inform, and be informed by, research into the political influence of other commercial actors.
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Affiliation(s)
- Jim McCambridge
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK
| | - Kypros Kypri
- School of Medicine & Public Health, University of Newcastle, Australia
| | - Trevor A Sheldon
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK
| | - Mary Madden
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK
| | - Thomas F Babor
- Department of Community Medicine and Health Care, UConn Health, Farmington, Connecticut
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67
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Magnusson R, Patterson D. Global action, but national results: strengthening pathways towards better health outcomes for non-communicable diseases. CRITICAL PUBLIC HEALTH 2019. [DOI: 10.1080/09581596.2019.1693029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Roger Magnusson
- Sydney Law School, The University of Sydney, Sydney, Australia
| | - David Patterson
- Global Health Law Groningen Research Centre, Faculty of Law, University of Groningen, Groningen, Netherlands
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Patterson D, Buse K, Magnusson R, Toebes B. Identifying a human rights-based approach to obesity for States and civil society. Obes Rev 2019; 20 Suppl 2:45-56. [PMID: 31297936 DOI: 10.1111/obr.12873] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 02/28/2019] [Accepted: 03/29/2019] [Indexed: 11/27/2022]
Abstract
Obesity and its comorbidities pose daunting challenges to global health and development in the 21st century. This paper reviews some commonalities between obesity and another global health challenge, the pandemic of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). International human rights law was an important catalyst for civil society movements that helped to overcome inertia and generate political will for State action in response to HIV and AIDS. Drawing on the HIV experience, the authors propose a conceptual model for a human rights-based response to obesity founded on the twin pillars of State obligations and civil society engagement. Framing States' obligations to address the global obesity pandemic as a matter of international law, informed by the examples of the United Nations "International Guidelines on HIV/AIDS and Human Rights" and the General Comments of the United Nations human rights treaty bodies on HIV and AIDS, provides a normative framework to guide State actions and opportunities to engage the extensive accountability mechanisms of the United Nations international human rights system. In addition, it provides civil society organizations with the language and tools to demand State action on obesity. The authors call for similar authoritative guidance for States on the application of international human rights law to obesity.
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Affiliation(s)
- David Patterson
- Global Health Law Groningen Research Centre, Faculty of Law, University of Groningen, Netherlands
| | | | - Roger Magnusson
- Sydney Law School, University of Sydney, Camperdown, NSW, Australia
| | - Brigit Toebes
- Faculty of Law, University of Groningen, Groningen, Netherlands
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69
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Akl EA, Khamis AM. The intersections of industry with the health research enterprise. Health Res Policy Syst 2019; 17:53. [PMID: 31142343 PMCID: PMC6542139 DOI: 10.1186/s12961-019-0457-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 04/30/2019] [Indexed: 01/05/2023] Open
Abstract
There is increased awareness of the negative impact of large multinational corporations - the 'industry' - on public health. These corporations have established different types of relationships with a number of actors in the field of health research. This Commentary explores the different types of relationships between the industry and the actors of health research, how they intersect with the different research steps, and how these relationships allow the industry to exert influence. The types of relationships discussed consist of funding of research, direct relationships with the actors of research (namely advocacy groups, funding agencies, experts, professional organisations, regulatory agencies and health practitioners), and the influencing research standards. The potentially influenced research steps either precede the research (i.e. the prioritisation of research question), relate to it directly (i.e. its planning, conduct, reporting, dissemination and evaluation), or build on it (i.e. regulatory approval, integration into guidelines and adoption into practice). In conclusion, the industry has successfully fostered relationships with almost every actor of the health research enterprise and is using these relationships to influence the different steps of health research. The degree of influence the industry is having on health research calls for more work on managing the relationships discussed herein.
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Affiliation(s)
- Elie A. Akl
- Department of Internal Medicine, American University of Beirut Medical Center, P.O. Box: 11-0236, Riad-El-Solh Beirut, Beirut, 1107 2020 Lebanon
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario Canada
| | - Assem M. Khamis
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
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70
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van Schalkwyk MCI, Cassidy R, McKee M, Petticrew M. Gambling control: in support of a public health response to gambling. Lancet 2019; 393:1680-1681. [PMID: 31034361 DOI: 10.1016/s0140-6736(19)30704-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 03/12/2019] [Indexed: 01/19/2023]
Affiliation(s)
- May C I van Schalkwyk
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK; Department of Primary Care and Public Health, Imperial College London, London W6 6RP, UK.
| | - Rebecca Cassidy
- Anthropology, Goldsmiths, University of London New Cross, London, UK
| | - Martin McKee
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Mark Petticrew
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
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71
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Policy options for reducing antibiotics and antibiotic-resistant genes in the environment. J Public Health Policy 2019; 39:389-406. [PMID: 30297918 DOI: 10.1057/s41271-018-0144-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Responses to the threat posed by antimicrobial resistance have been inadequate. Most attention has focused on the emergence of resistant organisms in human medicine and in agriculture. Much less attention has been given to antibiotic contamination of the environment. To assist health advocates to engage with this issue, we review the evidence on the role of agriculture, aquaculture, domestic waste and pharmaceutical manufacturing in the spread of antibiotic resistance, concluding that all of these activities pose a potentially serious threat. We then examine ways that this threat might be mitigated by specific measures, such as improved wastewater treatment processes, reduction of manufacturing emissions, consideration of environmental impacts in procurement and drug approval decisions, and better manure management. We conclude by placing this problem within the growing literature on commercial determinants of health, stressing the need for effective legislation and regulation developed independent of vested interests.
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72
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Madureira Lima J, Galea S. The Corporate Permeation Index - A tool to study the macrosocial determinants of Non-Communicable Disease. SSM Popul Health 2019; 7:100361. [PMID: 30906842 PMCID: PMC6411497 DOI: 10.1016/j.ssmph.2019.100361] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 01/15/2019] [Accepted: 01/18/2019] [Indexed: 01/24/2023] Open
Abstract
Commercial interests have long been identified as a macrosocial determinant of health. We present a composite indicator of corporate permeation- the Corporate Permeation Index (CPI) -, a novel tool for explaining variations in the consumption of products such as alcohol or tobacco and in the comprehensiveness of health policy regarding these products. Using a published framework for the analysis of commercial influences on health as a theoretical basis, we collected 25 indicators of corporate permeation comparable across 148 countries in five continents for six years 2010–2015. Two alternative approaches were used in each of the steps taken to build the measure – imputation of missing data, multivariate analysis, and weighing and aggregation of the subcomponents. We assessed the Index’s criterion-related validity by calculating the strength of the association among the different formulations of the Index. Alternative formulations of the CPI are highly correlated. Whilst High Income Countries are generally overrepresented among the lowest scores, some High Income Countries have high permeation scores. There is no clear regional pattern, with scores showing as much intra-regional as inter-regional variability. The CPI appears to be a robust measure of corporate permeation at the national level, suggesting tremendous variability in permeation worldwide. There are limitations to the CPI, the most notable of which is the lack of large scale cross-country comparable data on some important mechanisms of corporate permeation (e.g., lobbying expenditures by large corporations). Further work will target proxy measures for these phenomena to be incorporated in the Index calculation.
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Affiliation(s)
| | - Sandro Galea
- School of Public Health, Boston University, United States
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73
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Magnusson RS, McGrady B, Gostin L, Patterson D, Abou Taleb H. Legal capacities required for prevention and control of noncommunicable diseases. Bull World Health Organ 2019; 97:108-117. [PMID: 30728617 PMCID: PMC6357565 DOI: 10.2471/blt.18.213777] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 10/14/2018] [Accepted: 10/23/2018] [Indexed: 12/14/2022] Open
Abstract
Law lies at the centre of successful national strategies for prevention and control of noncommunicable diseases. By law we mean international agreements, national and subnational legislation, regulations and other executive instruments, and decisions of courts and tribunals. However, the vital role of law in global health development is often poorly understood, and eclipsed by other disciplines such as medicine, public health and economics. This paper identifies key areas of intersection between law and noncommunicable diseases, beginning with the role of law as a tool for implementing policies for prevention and control of leading risk factors. We identify actions that the World Health Organization and its partners could take to mobilize the legal workforce, strengthen legal capacity and support effective use of law at the national level. Legal and regulatory actions must move to the centre of national noncommunicable disease action plans. This requires high-level leadership from global and national leaders, enacting evidence-based legislation and building legal capacities.
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Affiliation(s)
- Roger S Magnusson
- Sydney Law School, University of Sydney, New South Wales, 2006, Australia
| | - Benn McGrady
- Prevention of Noncommunicable Diseases Department, World Health Organization, Geneva, Switzerland
| | - Lawrence Gostin
- WHO Collaborating Center for National & Global Health Law, Georgetown University, Washington, United States of America
| | - David Patterson
- Health, Law and Development Consultants (HLDC), The Hague, Netherlands
| | - Hala Abou Taleb
- Health Systems Development Department, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
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74
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Di Ruggiero E, Leung Z, Mwatsama M, Hallen G. Sustainable partnerships for NCD prevention: implications for public health. Int J Public Health 2018; 63:553-554. [PMID: 29766206 DOI: 10.1007/s00038-018-1112-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 04/10/2018] [Indexed: 11/26/2022] Open
Affiliation(s)
- Erica Di Ruggiero
- Dalla Lana School of Public Health, University of Toronto, Toronto, M5T 3M7, Canada.
| | - Zee Leung
- International Development Research Centre, Ottawa, Canada
| | | | - Greg Hallen
- International Development Research Centre, Ottawa, Canada
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