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Duus KS, Tjørnhøj-Thomsen T, Krølner RF. Implementation of health-promoting retail initiatives in the Healthier Choices in Supermarkets Study-qualitative perspectives from a feasibility study. BMC Med 2024; 22:349. [PMID: 39218867 PMCID: PMC11367934 DOI: 10.1186/s12916-024-03561-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 08/14/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Improving food environments like supermarkets has the potential to affect customers' health positively. Scholars suggest researchers and retailers collaborate closely on implementing and testing such health-promoting interventions, but knowledge of the implementation of such interventions is limited. We explore the implementation of four health-promoting food retail initiatives selected and developed by a partnership between a research institution, a large retail group, and a non-governmental organisation. METHODS The four initiatives included downsizing of bags for pick'n' mix sweets and soda bottles at the check-out registers, shelf tags promoting healthier breakfast cereal options, and replacing a complimentary bun with a banana offered to children. The initiatives were implemented for 6 weeks (or longer if the store manager allowed it) in one store in Copenhagen, Denmark. Data were collected through observations, informal interviews with customers, and semi-structured interviews with retailers. We conducted a thematic analysis of transcripts and field notes inspired by process evaluation concepts and included quantitative summaries of selected data. RESULTS Two out of four initiatives were not implemented as intended. The implementation was delayed due to delivery issues, which also resulted in soda bottles not being downsized as intended. The maintenance of the shelf tags decreased over time. Retailers expressed different levels of acceptability towards the initiatives, with a preference for the complimentary banana for children. This was also the only initiative noticed by customers with both positive and negative responses. Barriers and facilitators of implementation fell into three themes: Health is not the number one priority, general capacity of retailers, and influence of customers and other stakeholders on store operation. CONCLUSIONS The retailers' interests, priorities, and general capacity influenced the initiative implementation. Retailers' acceptability of the initiatives was mixed despite their involvement in the pre-intervention phase. Our study also suggests that customer responses towards health-promoting initiatives, as well as cooperation with suppliers and manufacturers in the development phase, may be determining to successful implementation. Future studies should explore strategies to facilitate implementation, which can be applied prior to and during the intervention.
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Affiliation(s)
- Katrine Sidenius Duus
- The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
| | - Tine Tjørnhøj-Thomsen
- The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Oliffe JL, Kelly MT, Gao N, Velzeboer R, Sharp P, Li EPH. The Commercial Determinants of Men's Health Promotion: A Case Study of Gambling, Nonnies, and Athleisurewear. Am J Mens Health 2024; 18:15579883241277047. [PMID: 39254105 PMCID: PMC11402093 DOI: 10.1177/15579883241277047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2024] Open
Abstract
Although the social determinants of health have guided equity work with the tailoring of men's health promotion programs, the role of, and potential for, the commercial determinants of health in those interventions is rarely addressed and poorly understood. While four commercial products, tobacco, alcohol, ultra-processed food, and fossil fuels, account for more than a third of global deaths, there is a need to recognize that consumer goods industries can make both positive and negative contributions to health. This article begins much-needed discussions about what we might learn from, and strategically tap in the commercial sector to seed, scale, and sustain men's health promotion programs. Three case studies, online sports betting, beer and the rise of the nonny, and athleisurewear, are discussed. Connections between online sports betting and masculinities explain young men's disproportionate involvement and gambling addictions with recommendations to legislate an end to gambling advertisements and de-incentivize industry profiteering through penalties and higher taxes. Regarding beer and the rise of the nonny, brewers have innovated with non-alcoholic beer based on shifting consumption patterns and masculinities in their core market-men. The nonny reminds health promoters to know their end-user's values and behaviors to bolster program acceptability. Detailing Under Armour and Lululemon, two highly gendered but diversifying athleisurewear brands, the complexities of, and potential for, leveraging public health and industry collaborations are underscored. Taken together, the article findings suggest men's health promoters should rigorously explore tapping key commercial entities and tax revenues to advance the health of men and their communities.
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Affiliation(s)
- John L Oliffe
- School of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada
- Department of Nursing, The University of Melbourne, Melbourne, Victoria, Australia
| | - Mary T Kelly
- School of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Nina Gao
- School of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Rob Velzeboer
- School of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada
- Faculty of Management, The University of British Columbia, Kelowna, British Columbia, Canada
| | - Paul Sharp
- School of Health Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Eric P H Li
- Faculty of Management, The University of British Columbia, Kelowna, British Columbia, Canada
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Dun-Campbell K, Hartwell G, Maani N, Tompson A, van Schalkwyk MC, Petticrew M. Commercial determinants of mental ill health: An umbrella review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003605. [PMID: 39196874 DOI: 10.1371/journal.pgph.0003605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 07/24/2024] [Indexed: 08/30/2024]
Abstract
Mental ill health has complex and interrelated underlying causes, with wider determinants of health often overlooked as risk factors. The 'commercial determinants of health' are gradually receiving more attention and recognition but there is a relative lack of awareness of the commercial determinants of mental health. This aim of this umbrella review was to synthesise systematic review level evidence for the association between commercial determinants and mental health outcomes. This umbrella review included evidence from high, middle, and low-income countries. We included terms related to broader commercial activities and terms focused on six key unhealthy commodities (tobacco, alcohol, ultra-processed foods, gambling, social media, fossil fuels) and the impacts of fossil fuel consumption (climate change, air pollution, wider pollution). We included 65 reviews and found evidence from high quality reviews for associations between alcohol, tobacco, gambling, social media, ultra-processed foods and air pollution and depression; alcohol, tobacco, gambling, social media, climate change and air pollution with suicide; climate change and air pollution with anxiety; and social media with self-harm. There was a lack of evidence examining wider practices of commercial industries. Our umbrella review demonstrates that by broadening the focus on commercial determinants, the influence of commercial products and activities on mental ill health can be better understood. The lack of research examining broader commercial practices on mental ill health is an area that should be addressed. Our review highlights the existing base of high-quality evidence for many of these unhealthy commodities' impacts on mental ill health and indicates that commercial determinants is a valuable framework for understanding the drivers of mental ill health.
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Affiliation(s)
- Kate Dun-Campbell
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Greg Hartwell
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Nason Maani
- School of Social and Political Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Alice Tompson
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - May Ci van Schalkwyk
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mark Petticrew
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Guarnizo-Herreño CC, Celeste RK, Peres MA. The ongoing fight for population oral health. Lancet 2024; 404:635-638. [PMID: 38518794 DOI: 10.1016/s0140-6736(24)00536-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 03/13/2024] [Indexed: 03/24/2024]
Affiliation(s)
- Carol C Guarnizo-Herreño
- Departamento de Salud Colectiva, Facultad de Odontología, Universidad Nacional de Colombia, Bogotá, Colombia.
| | - Roger Keller Celeste
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Marco A Peres
- National Dental Research Institute, National Dental Centre and Oral Health Academic Clinical Programme and Health Services and Systems Research Program, Duke-NUS Medical School, Singapore
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Anaf J, Baum F. Health and equity impacts of global consultancy firms. Global Health 2024; 20:55. [PMID: 39054549 PMCID: PMC11271056 DOI: 10.1186/s12992-024-01061-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 07/17/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Concern is growing over the power, influence, and threats to health and equity from the operations of large global consultancy firms. Collectively, these firms support a neoliberal policy environment promoting business interests ahead of public health. Global consultancy firms act as commercial determinants of health, an evolving area of research over recent years. However, this research mainly focuses on specific corporations or industry sectors, especially those which produce harmful products, including ultra-processed food, alcohol, and fossil fuels. It is therefore important to expand the focus to include large global consultancy firms and place a public health and equity lens over their operations. MAIN BODY Global consultancy firms have wide-ranging conflicts of interest. These arise from the 'revolving door' employment strategies between their own staff and those from government and regulatory bodies. These firms also advise governments on taxation and other matters while concurrently advising corporate clients on ways to minimise taxation. They advise fossil fuel corporations while also advising governments on climate and health policies. These firms undermine the capabilities of the public sector through the outsourcing of traditional public sector roles to these private interests. Consultancy firms foster private interests through their engagement with the higher education sector, and thereby weaken the tradition of transparent management of university affairs by accountable university councils. While private consultancies cannot be blamed for all the negative consequences for health and equity caused by the problems associated with globalisation and advanced capitalism, they have played a role in amplifying them. CONCLUSION Addressing the negative impacts of global consultancy firms will require strengthening the public sector, enforcing greater transparency, accountability, and minimising conflicts of interest. It will also demand critical thought, counter discourses, and activism to reframe the narratives supporting neo-liberal ideas of governance that are promoted in both government and business arenas.
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Affiliation(s)
- Julia Anaf
- North Tce Campus, Stretton Health Equity, Stretton Institute, University of Adelaide, Adelaide, 5005, Australia.
| | - Fran Baum
- Health Equity, North Tce Campus, Stretton Institute, University of Adelaide, Adelaide, 5005, Australia
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Aravena-Rivas Y, Heilmann A, Watt RG, Broomhead T, Tsakos G. Analysis of public records of lobbying practices of the ultra-processed sugary food and drink industries in Chile: a qualitative study. LANCET REGIONAL HEALTH. AMERICAS 2024; 35:100794. [PMID: 39100991 PMCID: PMC11294830 DOI: 10.1016/j.lana.2024.100794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 05/03/2024] [Accepted: 05/15/2024] [Indexed: 08/06/2024]
Abstract
Background Given the role of commercial determinants on sugar consumption and health, this study aimed to describe lobbying practices of the ultra-processed sugary food and drinks industries in Chile between 2014 and 2022. Methods Official meetings between ultra-processed sugary food and drinks industries and related commercial actors and Chilean government officials were obtained from the Chilean Lobby Registry. Relevant commercial names were initially identified based on their market share and expanded iteratively based on information from relevant meetings. Qualitative analysis followed a deductive-inductive approach using the Corporate Political Activity Model to identify and classify objectives, framing and action strategies. Findings From 237 records identified, the Ministries of Health, Social Development, and Economy were the most frequently lobbied. Industry representatives sought to achieve their short- and long-term objectives by targeting a diverse range of authorities, including Ministers and Under-secretaries, using different strategies. Framing strategies focused on presenting sugary food and drinks industries as socially responsible and legitimate policy actors and criticised public health initiatives as 'bad solutions'. Action strategies aimed to influence policymaking and nurture corporate reputations. Interpretation Extensive lobbying took place by the sugary food and drinks industries between 2014 and 2022, a period when major public health policies were being discussed in Chile. Lobbying strategies varied to meet industry objectives and targeted a diverse range of government institutions including high-ranking officials. Tighter regulations to stop inappropriate industry influence in public health policymaking are urgently required. Funding Agencia Nacional de Investigación y Desarrollo (Chile)-PhD Scholarship. University College London-Open Access fees.
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Affiliation(s)
- Yanela Aravena-Rivas
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Anja Heilmann
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Richard G. Watt
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Tom Broomhead
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, 19 Claremont Crescent, Sheffield, S10 2TA, UK
| | - Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
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Lesch M, McCambridge J. Continuities and change in alcohol policy at the global level: a documentary analysis of the 2010 Global Strategy for Reducing the Harmful Use of Alcohol and the Global Alcohol Action Plan 2022-2030. Global Health 2024; 20:47. [PMID: 38877515 PMCID: PMC11179290 DOI: 10.1186/s12992-024-01034-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 03/23/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND There are only two major statements which define alcohol policy development at the global level. There has not been any comparative analysis of the details of these key texts, published in 2010 and 2022 respectively, including how far they constitute similar or evolving approaches to alcohol harm. METHODS Preparatory data collection involved examination of documents associated with the final policy statements. A thematic analysis across the two policy documents was performed to generate understanding of continuity and change based on comparative study. Study findings are interpreted in the contexts of the evolving conceptual and empirical literatures. RESULTS Both documents exhibit shared guiding principles and identify similar governance challenges, albeit with varying priority levels. There is more emphasis on the high-impact interventions on price, availability and marketing in 2022, and more stringent targets have been set for 2030 in declaring alcohol as a public health priority therein, reflecting the action-oriented nature of the Plan. The identified roles of policy actors have largely remained unchanged, albeit with greater specificity in the more recent statement, appropriately so because it is concerned with implementation. The major exception, and the key difference in the documents, regards the alcohol industry, which is perceived primarily as a threat to public health in 2022 due to commercial activities harmful to health and because policy interference has slowed progress. CONCLUSIONS The adoption of the Global Alcohol Action Plan 2022-30 potentially marks a pivotal moment in global alcohol policy development, though it is unclear how fully it may be implemented. Perhaps, the key advances lie in advancing the ambitions of alcohol policy and clearly identifying that the alcohol industry should not be seen as any kind of partner in public health policymaking, which will permit progress to the extent that this influences what actually happens in alcohol policy at the national level.
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Affiliation(s)
- Matthew Lesch
- Department of Politics and International Relations, Derwent College, University of York, D/N/126, Heslington, York, YO10 5DD, UK.
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Díaz LA, Villota-Rivas M, Barrera F, Lazarus JV, Arrese M. The burden of liver disease in Latin America. Ann Hepatol 2024; 29:101175. [PMID: 37922988 DOI: 10.1016/j.aohep.2023.101175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 10/08/2023] [Indexed: 11/07/2023]
Abstract
Liver disease poses a substantial burden in Latin America. This burden is primarily attributed to a high level of alcohol consumption and the increasing prevalence of risk factors associated with metabolic dysfunction-associated steatotic liver disease (MASLD), such as sedentary lifestyles, easy access to ultra-processed foods, obesity, and type 2 diabetes mellitus. These epidemiological trends are cause for concern, especially considering that there are significant challenges in addressing them due to disparities in access to liver disease screening and care. In this article, we aim to provide an overview of the current situation regarding liver disease in Latin America. We also discuss recent multinational proposals designed to address the growing MASLD burden via its integration into existing non-communicable diseases policies, at both local and global levels. Additionally, we emphasize the urgent need to establish effective public health policies that target both MASLD risk factors and excessive alcohol consumption. Furthermore, we discuss the development of liver transplantation programs, areas for improvement in medical education and research capabilities, and how the fostering of extensive collaboration among all stakeholders is crucial for addressing liver disease in the region.
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Affiliation(s)
- Luis Antonio Díaz
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Observatorio Multicéntrico de Enfermedades Gastrointestinales (OMEGA), Santiago, Chile
| | - Marcela Villota-Rivas
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Francisco Barrera
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Observatorio Multicéntrico de Enfermedades Gastrointestinales (OMEGA), Santiago, Chile
| | - Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain; CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, NY, United States; Global NASH Council, Washington DC, United States
| | - Marco Arrese
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Observatorio Multicéntrico de Enfermedades Gastrointestinales (OMEGA), Santiago, Chile; Global NASH Council, Washington DC, United States.
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Dumbili EW. Alcohol industry-sponsored music festivals, alcohol marketing and drinking practices among young Nigerians: Implications for policy. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 127:104384. [PMID: 38492330 DOI: 10.1016/j.drugpo.2024.104384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/17/2024] [Accepted: 03/03/2024] [Indexed: 03/18/2024]
Abstract
INTRODUCTION The global alcohol industry sponsors social/music events targeting young people; however, existing literature focuses on Westernised contexts. Given the decline in young people's drinking in many Western countries, it appears that multinational alcohol companies are importing the strategies they have used in high-income countries to the Global South countries like Nigeria to recoup profits. This study aims to examine the Guinness Show- a free one-month annual music festival, alcohol marketing at the festival and the extent to which the event encourages diverse drinking practices among its attendees. METHODS We observed the music festival before collecting data through 53 interviews and 3 focus groups (N = 26). Data were analysed to generate themes with the aid of NVivo 12 software. FINDINGS Over 6000 participants attend the Guinness Show daily, and participants gave detailed descriptions of the music festival, alcohol marketing activities that occur in it and the drinking practices of attendees, indicating that they were highly knowledgeable of the event. The Guinness Show attracts famous music artistes and other entertainers. Therefore, young people attend to see them perform free of charge. However, diverse alcohol promotions (e.g., quantity deals, low prices, giveaways) that happen daily, the strategic use of young women as 'beer promoters', and the pleasure the event induces by fusing music/entertainment into alcogenic environments, encourage drinking and drunkenness. All the attendees drank alcohol, and some engaged in impulse buying, while many consumed excessively due to promotions (e.g., buy-two-get-one free), which facilitated intoxication and the loss of control. CONCLUSIONS Guinness Nigeria organises the event for strategic brand communication, generating brand capital, and encouraging alcohol purchases and consumption among young people. Policymakers should reconsider self-regulation and implement national alcohol control policies and other public health interventions to restrain the alcohol industry from sponsoring such events.
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Affiliation(s)
- Emeka W Dumbili
- School of Sociology, College of Social Sciences and Law, University College Dublin, Belfield, Dublin 4, Ireland.
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Burgess RC, Nyhan K, Dharia N, Freudenberg N, Ransome Y. Characteristics of commercial determinants of health research on corporate activities: A scoping review. PLoS One 2024; 19:e0300699. [PMID: 38669229 PMCID: PMC11051660 DOI: 10.1371/journal.pone.0300699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 03/04/2024] [Indexed: 04/28/2024] Open
Abstract
INTRODUCTION Business practices have influenced human health for centuries, yet an overarching concept to study these activities across nations, time periods, and industries (called 'the commercial determinants of health' (CDH)) has emerged only recently. The purpose of this review was to assess the descriptive characteristics of CDH research and to identify remaining research gaps. METHODS We systematically searched four databases (Scopus, OVID Medline, Ovid Embase, and Ovid Global Health) on Sept 13, 2022 for literature using CDH terms that described corporate activities that have the potential to influence population health and/or health equity (n = 116). We evaluated the following characteristics of the literature: methods employed, industries studied, regions investigated, funders, reported conflicts of interest, and publication in open-access formats. RESULTS The characteristics of the articles included that many were conceptual (50/116 articles; 43%) or used qualitative methods (37; 32%). Only eight articles (7%) used quantitative or mixed methods. The articles most often discussed corporate activities in relation to the food and beverage (51/116; 44%), tobacco (20; 17%), and alcohol industries (19; 16%), with limited research on activities occurring in other industries. Most articles (42/58 articles reporting a regional focus; 72%) focused on corporate activities occurring in high-income regions of the world. CONCLUSIONS Our findings indicate that literature that has used CDH terms and described corporate practices that influence human health has primarily focused on three major industries in higher-income regions of the world. Qualitative methods were the most common empirical method for investigating these activities. CDH-focused investigations of corporate practices conducted by less-studied industries (e.g., social media) and in lower-income regions are recommended. Longitudinal quantitative studies assessing the associations between corporate practices and a range of health outcomes is also a necessary next step for this field.
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Affiliation(s)
- Raquel C. Burgess
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Kate Nyhan
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, Connecticut, United States of America
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Naisha Dharia
- Bachelor of Health Sciences Program, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Nicholas Freudenberg
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health & Health Policy, New York City, New York, United States of America
| | - Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, United States of America
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Crocetti AC, Walker T, Mitchell F, Sherriff S, Hill K, Paradies Y, Backholer K, Browne J. Making Big Business Everybody's Business: Aboriginal leaders' perspectives on commercial activities influencing aboriginal health in Victoria, Australia. Global Health 2024; 20:33. [PMID: 38637867 PMCID: PMC11025162 DOI: 10.1186/s12992-024-01038-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 04/02/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND The commercial determinants of health is a rapidly expanding field of research; however Indigenous perspectives remain notably underrepresented. For Indigenous peoples the intersection of globalisation, colonialism and capitalism may amplify commercially-driven health inequities. This study aimed to explore the perspectives of Aboriginal leaders regarding the influence of commercial activities on Aboriginal health and wellbeing in Victoria, Australia. METHODS Semi-structured interviews with 23 Aboriginal leaders from across five sectors (n = 15 urban, n = 8 rural/regional) were analysed through reflexive thematic analysis. RESULTS Three overarching themes were identified encompassing (i) harmful commercial practices and processes, (ii) improving corporate engagement and (iii) opportunities for self-determination through business. Participants expressed concern over aggressive marketing by the gambling industry, commercial exploitation of Aboriginal culture, the privatisation of public services, and lack of oversignt of corporate social responsibility strategies. Simultaneously, Aboriginal-led businesses were viewed as opportunities for cultural connection, and financial empowerment and self-determination. CONCLUSION Numerous commercial entities and activities are perceived to influence Aboriginal health and wellbeing. This study highlights the need for stronger policy and regulation to mitigate harmful industry practices while incentivising the potential positive impacts of the commercial activities on Aboriginal health and wellbeing.
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Affiliation(s)
- Alessandro Connor Crocetti
- Deakin University, Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia.
| | - Troy Walker
- Deakin University, Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia
| | - Fiona Mitchell
- Deakin Rural Health, Faculty of Health, Deakin University, Warrnambool, VIC, Australia
| | - Simone Sherriff
- Deakin University, Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia
- The Poche Centre for Indigenous Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Karen Hill
- Deakin University, Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia
| | - Yin Paradies
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Burwood, VIC, Australia
| | - Kathryn Backholer
- Deakin University, Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia
| | - Jennifer Browne
- Deakin University, Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia
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CHUNG HOLLY, CULLERTON KATHERINE, LACY‐NICHOLS JENNIFER. Mapping the Lobbying Footprint of Harmful Industries: 23 Years of Data From OpenSecrets. Milbank Q 2024; 102:212-232. [PMID: 38219274 PMCID: PMC10938928 DOI: 10.1111/1468-0009.12686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 12/05/2023] [Accepted: 12/08/2023] [Indexed: 01/16/2024] Open
Abstract
Policy Points Our research reveals the similarities and differences among the lobbying activities of tobacco, alcohol, gambling, and ultraprocessed food industries, which are often a barrier to the implementation of public health policies. Over 23 years, we found that just six organizations dominated lobbying expenses in the tobacco and alcohol sectors, whereas the gambling sector outsourced most of their lobbying to professional firms. Databases like OpenSecrets are a useful resource to monitor the commercial determinants of health. CONTEXT Commercial lobbying is often a barrier to the development and implementation of public health policies. Yet, little is known about the similarities and differences in the lobbying practices of different industry sectors or types of commercial actors. This study compares the lobbying practices of four industry sectors that have been the focus of much public health research and advocacy: tobacco, alcohol, gambling, and ultraprocessed foods. METHODS Data on lobbying expenditures and lobbyist backgrounds were sourced from the OpenSecrets database, which monitors lobbying in the United States. Lobbying expenditure data were analyzed for the 1998-2020 period. We classified commercial actors as companies or trade associations. We used Power BI software to link, analyze, and visualize data sets. FINDINGS We found that the ultraprocessed food industry spent the most on lobbying ($1.15 billion), followed by gambling ($817 million), tobacco ($755 million), and alcohol ($541 million). Overall, companies were more active than trade associations, with associations being least active in the tobacco industry. Spending was often highly concentrated, with two organizations accounting for almost 60% of tobacco spending and four organizations accounting for more than half of alcohol spending. Lobbyists that had formerly worked in government were mainly employed by third-party lobby firms. CONCLUSIONS Our study shows how comparing the lobbying practices of different industry sectors offers a deeper appreciation of the diversity and similarities of commercial actors. Understanding these patterns can help public health actors to develop effective counterstrategies.
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Affiliation(s)
- HOLLY CHUNG
- Centre for Health Policy, Melbourne School of Population and Global HealthThe University of Melbourne
| | | | - JENNIFER LACY‐NICHOLS
- Centre for Health Policy, Melbourne School of Population and Global HealthThe University of Melbourne
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Vandenbroucke F. Working together to advance resilient health systems across the OECD. Lancet 2024; 403:415-416. [PMID: 38278168 DOI: 10.1016/s0140-6736(24)00129-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 01/19/2024] [Indexed: 01/28/2024]
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Hagenaars LL, Maani N, Schmidt LA. Is the commercial determinants conversation confined to the health sciences? Potentially, and that's a problem. Global Health 2024; 20:3. [PMID: 38167207 PMCID: PMC10759639 DOI: 10.1186/s12992-023-00989-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 11/06/2023] [Indexed: 01/05/2024] Open
Abstract
The commercial determinants of health (CDoH) are attracting increased interest and are of great importance when discussing how trade affects health. Through a citation analysis of recent foundational CDoH documents (a Lancet paper series and an Oxford University textbook), we find that fully 71% of all citations reference the health sciences. The health sciences may be well suited to documenting the specific pathways of how commercial (by)products and practices harm human health. However, to operationalize upstream solutions for mitigating these harms, our citation analysis suggests that the field can engage political scientists, economists, sociologists, the trade law and business, as well as advocates in civil society and journalism, more so than it currently does. With CDoH explicitly referring to the interaction between commerce and health, CDoH researchers might be uniquely positioned to get health on the agenda of others, which requires that CDoH methods, datasets, evidence reviews, and proposed interventions are drawn from the widest possible range of sources.
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Affiliation(s)
- Luc Louis Hagenaars
- University of California San Francisco School of Medicine, Philip R. Lee Institute for Health Policy Studies, Campus Box 0936, 490 Illinois Street, Floor 7, San Francisco, CA, 94158, USA.
- Department of Public Health, Amsterdam UMC Location AMC, Meibergdreef 9, Amsterdam, 1105 AZ, the Netherlands.
| | - Nason Maani
- Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, 15a George Square, Edinburgh, UK
| | - Laura Anne Schmidt
- University of California San Francisco School of Medicine, Philip R. Lee Institute for Health Policy Studies, Campus Box 0936, 490 Illinois Street, Floor 7, San Francisco, CA, 94158, USA
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15
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Torres I, Villalba JJ, López-Cevallos DF, Galea S. Governmental institutionalization of corporate influence on national nutrition policy and health: a case study of Ecuador. LANCET REGIONAL HEALTH. AMERICAS 2024; 29:100645. [PMID: 38298501 PMCID: PMC10829353 DOI: 10.1016/j.lana.2023.100645] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 02/02/2024]
Abstract
Corporate influence in policy and decision-making is an important public health concern. This Health Policy paper reviews Ecuador's child malnutrition strategy instruments, approved between 2020 and 2023, to identify how private interests are becoming legally integrated into the public sector. Evidence indicates that recent changes are enabling corporations to promote their brands, gain tax deductions, oversee public policy and set priorities, allocate resources, and decide on implementation of the country's child malnutrition strategy. Further, corporate representatives are active members of an advisory council, free from scrutiny or accountability, while being privy to undisclosed government information. Moreover, a UN agency (the World Food Program) engaged in corporate promotion of highly processed foods, illustrating the breadth of Ecuador's corporate influence scheme. Improved regulations should set clear limits to the influence of food and beverage industries in national nutrition policy, while following transparency laws in the composition and operation of Ecuador's child malnutrition strategy and related efforts.
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Affiliation(s)
- Irene Torres
- Fundacion Octaedro, El Zurriago E8-28 y Ave. De los Shyris, Quito, Ecuador
| | - José Julio Villalba
- School of Nursing, Pontifical Catholic University of Ecuador, Ave. 12 de Octubre 1076, Quito 170143, Ecuador
| | - Daniel F. López-Cevallos
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA 01003, United States
| | - Sandro Galea
- Boston University School of Public Health, Boston, MA 02118, United States
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16
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Fazzino TL, Jun D, Chollet-Hinton L, Bjorlie K. US tobacco companies selectively disseminated hyper-palatable foods into the US food system: Empirical evidence and current implications. Addiction 2024; 119:62-71. [PMID: 37682074 DOI: 10.1111/add.16332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/13/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND AND AIMS US tobacco companies owned leading US food companies from 1980 to 2001. We measured whether hyper-palatable foods (HPF) were disproportionately developed in tobacco-owned food companies, resulting in substantial tobacco-related influence on the US food system. DESIGN The study involved a review of primary industry documents to identify food brands that were tobacco company-owned. Data sets from the US Department of Agriculture were integrated to facilitate longitudinal analyses estimating the degree to which foods were formulated to be hyper-palatable, based on tobacco ownership. SETTING AND CASES United States Department of Agriculture data sets were used to identify HPF foods that were (n = 105) and were not (n = 587) owned by US tobacco companies from 1988 to 2001. MEASUREMENTS A standardized definition from Fazzino et al. (2019) was used to identify HPF. HPF items were identified overall and by HPF group: fat and sodium HPF, fat and sugar HPF and carbohydrates and sodium HPF. FINDINGS Tobacco-owned foods were 29% more likely to be classified as fat and sodium HPF and 80% more likely to be classified as carbohydrate and sodium HPF than foods that were not tobacco-owned between 1988 and 2001 (P-values = 0.005-0.009). The availability of fat and sodium HPF (> 57%) and carbohydrate and sodium HPF (> 17%) was high in 2018 regardless of prior tobacco-ownership status, suggesting widespread saturation into the food system. CONCLUSIONS Tobacco companies appear to have selectively disseminated hyper-palatable foods into the US food system between 1988 and 2001.
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Affiliation(s)
- Tera L Fazzino
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, Kansas, USA
| | - Daiil Jun
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, Kansas, USA
| | - Lynn Chollet-Hinton
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Kayla Bjorlie
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, Kansas, USA
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Madden M, Bartlett A, McCambridge J. Constructing public-private partnerships to undermine the public interest: critical discourse analysis of Working Together published by the International Alliance for Responsible Drinking. Global Health 2023; 19:103. [PMID: 38104100 PMCID: PMC10725627 DOI: 10.1186/s12992-023-01000-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 11/28/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND The global burden of alcohol harm has increased and is forecast to grow further without effective policy implementation. Public-private partnerships aiming to address global health, and other societal challenges, are a burgeoning feature of neoliberal governance. Rhetorically distancing themselves from tobacco, the major alcohol companies are committed to tackling 'harmful drinking' and have created a distinct type of public relations organization for this purpose. The activities of such organizations are increasingly recognized as an impediment to the implementation of policies to reduce alcohol harm, including in low- and middle-income countries where markets are expanding. METHODS The approach of critical discourse analysis is used to examine the discursive tactics and strategies used in Working Together; a 'toolkit' published by the key global level alcohol industry public relations organization, the International Alliance for Responsible Drinking (IARD). This study considers how it works discursively to set the terms of, and overcome skepticism about partnerships, to define aims and position various actors by constructing their roles. The construction of prospective partners provides insights into the alcohol industry itself. RESULTS The toolkit operates as an ideological resource for forming public-private partnerships across the world based on the accumulated know-how of the major companies through IARD. This allows the largest alcohol companies to exercise leadership of the industry, while remaining off-stage. The toolkit relies on a form of rhetorical work which creates distance from obvious corporate interests and the harms caused to population health and society. This is accomplished by working against evidence-informed population level approaches, and thus avoiding policies that will make any significant difference to overall alcohol harm. Unspecific "complexity" affords opportunity for preferred types of "actions", and "partnership" provides opportunity to gain credibility by association, further minimizing the likelihood of any material harm being reduced. CONCLUSIONS The toolkit is designed to not only legitimate the inclusion of alcohol industry actors as initiating 'partners', but also assigns them roles as managers of a set of carefully constructed relationships. This vision of public-private partnership reproduces the hegemonic narrative that has successfully blocked policy advances for decades and led to growing alcohol harm globally.
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Affiliation(s)
- Mary Madden
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, England.
| | - Andrew Bartlett
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, England
| | - Jim McCambridge
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, England
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Ralston R, Carlini G, Johns P, Lencucha R, Radvany R, Shah D, Collin J. Corporate interests and the UN treaty on plastic pollution: neglecting lessons from the WHO Framework Convention on Tobacco Control. Lancet 2023; 402:2272-2274. [PMID: 37804860 DOI: 10.1016/s0140-6736(23)02040-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/19/2023] [Indexed: 10/09/2023]
Affiliation(s)
- Rob Ralston
- UKPRP SPECTRUM Consortium and School of Social and Political Science, University of Edinburgh, Edinburgh EH8 9LD, UK.
| | - Giulia Carlini
- Center for International Environmental Law, Washington, DC, USA; Center for International Environmental Law, Geneva, Switzerland
| | | | - Raphael Lencucha
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Rachel Radvany
- Center for International Environmental Law, Washington, DC, USA; Center for International Environmental Law, Geneva, Switzerland
| | - Dharmesh Shah
- Center for International Environmental Law, Washington, DC, USA; Center for International Environmental Law, Geneva, Switzerland
| | - Jeff Collin
- UKPRP SPECTRUM Consortium and School of Social and Political Science, University of Edinburgh, Edinburgh EH8 9LD, UK
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19
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Leavy JE, Crawford G, Scarr JP, Meddings DR. Drowning prevention: A global health promotion imperative, now more than ever. Health Promot J Austr 2023. [PMID: 38009891 DOI: 10.1002/hpja.830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023] Open
Affiliation(s)
- Justine E Leavy
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Gemma Crawford
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Justin P Scarr
- Royal Life Saving Society, Sydney, New South Wales, Australia
- Faculty of Medicine, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - David R Meddings
- Department of the Social Determinants of HealthDivision of UHC/Healthier Populations, World Health Organization (WHO), Geneva, Switzerland
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20
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Lacy-Nichols J, Jones A, Buse K. Corrigendum: Taking on the Commercial Determinants of Health at the level of actors, practices and systems. Front Public Health 2023; 11:1305512. [PMID: 38045971 PMCID: PMC10690595 DOI: 10.3389/fpubh.2023.1305512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 10/13/2023] [Indexed: 12/05/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fpubh.2022.981039.].
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Affiliation(s)
- Jennifer Lacy-Nichols
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Alexandra Jones
- The George Institute for Global Health, Sydney, NSW, Australia
| | - Kent Buse
- The George Institute for Global Health, Imperial College, London, United Kingdom
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21
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Buse K, Bestman A, Srivastava S, Marten R, Yangchen S, Nambiar D. What Are Healthy Societies? A Thematic Analysis of Relevant Conceptual Frameworks. Int J Health Policy Manag 2023; 12:7450. [PMID: 38618792 PMCID: PMC10699824 DOI: 10.34172/ijhpm.2023.7450] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 10/16/2023] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND While support for the idea of fostering healthy societies is longstanding, there is a gap in the literature on what they are, how to beget them, and how experience might inform future efforts. This paper explores developments since Alma Ata (1978) to understand how a range of related concepts and fields inform approaches to healthy societies and to develop a model to help conceptualize future research and policy initiatives. METHODS Drawing on 68 purposively selected documents, including political declarations, commission and agency reports, peer-reviewed papers and guidance notes, we undertook qualitative thematic analysis. Three independent researchers compiled and categorised themes describing the domains of a potential healthy societies approach. RESULTS The literature provides numerous frameworks. Some of these frameworks promote alternative endpoints to development, eschewing short-term economic growth in favour of health, equity, well-being and sustainability. They also identify values, such as gender equality, collaboration, human rights and empowerment that provide the pathways to, or underpin, such endpoints. We categorize the literature into four "components": people; places; products; and planet. People refers to social positions, interactions and networks creating well-being. Places are physical environments-built and natural-and the interests and policies shaping them. Products are commodities and commercial practices impacting population health. Planet places human health in the context of the 'Anthropocene.' These components interact in complex ways across global, regional, country and community levels as outlined in our heuristic. CONCLUSION The literature offers little critical reflection on why greater progress has not been made, or on the need to organise and resist the prevailing systems which perpetuate ill-health.
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Affiliation(s)
- Kent Buse
- The George Institute for Global Health, Imperial College London, London, UK
| | - Amy Bestman
- Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | | | - Robert Marten
- The Alliance for Health Policy and Systems Research, World Health Organization (WHO), Geneva, Switzerland
| | - Sonam Yangchen
- The Alliance for Health Policy and Systems Research, World Health Organization (WHO), Geneva, Switzerland
| | - Devaki Nambiar
- Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- The George Institute for Global Health, New Delhi, India
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
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22
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Foo D, Spanos S, Dammery G, Ellis LA, Willcock SM, Braithwaite J. The rise of direct-to-consumer telemedicine services in Australia: implications for primary care and future research. Med J Aust 2023; 219:344-347. [PMID: 37666506 DOI: 10.5694/mja2.52097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/15/2023] [Accepted: 08/21/2023] [Indexed: 09/06/2023]
Affiliation(s)
- Darran Foo
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW
- MQ Health General Practice Macquarie University, Sydney, NSW
| | - Samantha Spanos
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW
| | - Genevieve Dammery
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW
| | - Louise A Ellis
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW
| | | | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW
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23
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Shaw C, Macmillan A. Overcoming resistance and rebalancing power: shifting gears for cross sectoral collaboration on transport and climate change. BMJ 2023; 383:2215. [PMID: 37793683 DOI: 10.1136/bmj.p2215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Affiliation(s)
- Caroline Shaw
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Alex Macmillan
- Department of Preventive and Social Medicine, University of Otago, New Zealand
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Baum F, Friel S, Liberman J, de Leeuw E, Smith JA, Herriot M, Williams C. Why action on the commercial determinants of health is vital. Health Promot J Austr 2023; 34:725-727. [PMID: 37130652 DOI: 10.1002/hpja.737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2023] [Indexed: 05/04/2023] Open
Affiliation(s)
- Fran Baum
- The Stretton Institute, The University of Adelaide, Adelaide, Australia
| | - Sharon Friel
- School of Regulation and Global Governance, The Australian National University, Canberra, Australia
| | - Jonathan Liberman
- Law and Global Health, The University of Melbourne, Melbourne, Australia
| | - Evelyne de Leeuw
- HUE (Healthy Urban Environments) Collaboratory, Maridulu Budyari Gumal, Sydney, Australia
| | - James A Smith
- Rural and Remote Health, College of Public Health and Medicine, Flinders University, Darwin, Australia
| | | | - Carmel Williams
- Centre for Health in All Policies Research Translation, SAHMRI and University of Adelaide, Adelaide, Australia
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25
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Wood B, Lacy-Nichols J, Sacks G. Taking on the Corporate Determinants of Ill-health and Health Inequity: A Scoping Review of Actions to Address Excessive Corporate Power to Protect and Promote the Public's Health. Int J Health Policy Manag 2023; 12:7304. [PMID: 38618808 PMCID: PMC10590241 DOI: 10.34172/ijhpm.2023.7304] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 08/18/2023] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND In many sectors of the economy, for-profit business corporations hold excessive power relative to some governments and civil society. These power imbalances have been recognised as important contributors to many pressing and complex societal challenges, including unhealthy diets, climate change, and widening socio-economic inequalities, and thus pose a major barrier to efforts to improve public health and health equity. In this paper, we reviewed potential actions for addressing excessive corporate power. METHODS We conducted a scoping review of diverse literature (using Scopus, Web of Science, HeinOnline, and EBSCO databases), along with expanded searches, to identify state and collective actions with the potential to address excessive corporate power. Actions were thematically classified into overarching strategic objectives, guided by Meagher's '3Ds' heuristic, which classifies actions to curb corporate power into three groups: dispersion, democratisation, and dissolution. Based on the actions identified, we proposed two additional strategic objectives: reform and democratise the global governance of corporations, and strengthen countervailing power structures. RESULTS We identified 178 documents that collectively cover a broad range of actions to address excessive corporate power. In total, 18 interrelated strategies were identified, along with several examples in which aspects of these strategies have been implemented. CONCLUSION The proposed framework sheds light on how a diverse set of strategies and actions that seek to address excessive corporate power can work synergistically to change the regulatory context in which corporations operate, so that broader societal goals, including health and equity, are given much greater prominence and consideration vis-à-vis powerful corporate interests.
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Affiliation(s)
- Benjamin Wood
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Jennifer Lacy-Nichols
- Centre for Health Policy, The University of Melbourne School of Population and Global Health, Melbourne, VIC, Australia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia
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O'Brien P, Dwyer R, Gleeson D, Cook M, Room R. Influencing the global governance of alcohol: Alcohol industry views in submissions to the WHO consultation for the Alcohol Action Plan 2022-2030. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 119:104115. [PMID: 37549594 DOI: 10.1016/j.drugpo.2023.104115] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 06/22/2023] [Accepted: 06/24/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND In 2020, the Secretariat of the World Health Organization (WHO) conducted an open consultation, with public submissions, for the purpose of developing an Alcohol Action Plan to "strengthen implementation" of the WHO's 2010 Global Strategy to Reduce the Harmful Use of Alcohol. The consultation process and public submissions provided an opportunity to critically examine alcohol industry perspectives and arguments in relation to the global governance of alcohol. METHODS 48 alcohol industry submissions to the WHO's 2020 consultation were included for analysis. Directed content analysis was used to examine the policy positions and arguments made by industry actors. Thematic analysis was employed to further explore the framing of industry arguments. RESULTS In framing their arguments, alcohol industry actors positioned themselves as important stakeholders in policy debates; differentiated "normal" drinking from consumption that merits intervention; argued that alcohol policy should be made at the national, rather than global, level; and supported industry self-regulation or co-regulation rather than cost-effective public health measures to prevent harms from alcohol. CONCLUSION The alcohol industry's submissions to the WHO's 2020 consultation could be seen as efforts to stymie improvements in the global governance of alcohol, and repeats several framing strategies that the industry has used in other forums, both national and global. However, their arguments appear to have had little traction in the creation of the Alcohol Action Plan. Changes from the Working Document to the adopted Action Plan show little acceptance by WHO of industry arguments.
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Affiliation(s)
- Paula O'Brien
- Melbourne Law School, University of Melbourne, Parkville, Victoria, 3010, Australia.
| | - Robyn Dwyer
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Victoria, 3083, Australia
| | - Deborah Gleeson
- School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, 3083, Australia
| | - Megan Cook
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Victoria, 3083, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Victoria, 3083, Australia; Centre for Social Research on Alcohol & Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
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Khatri RB, Erku D, Endalamaw A, Wolka E, Nigatu F, Zewdie A, Assefa Y. Multisectoral actions in primary health care: A realist synthesis of scoping review. PLoS One 2023; 18:e0289816. [PMID: 37561811 PMCID: PMC10414560 DOI: 10.1371/journal.pone.0289816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/27/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Multisectoral actions (MSAs) on health are key to implementation of primary health care (PHC) and achieving the targets of the Sustainable Development Goal 3. However, there is limited understanding and interpretation of how MSAs on health articulate and mediate health outcomes. This realist review explored how MSAs influence on implementing PHC towards universal health coverage (UHC) in the context of multilevel health systems. METHODS We reviewed published evidence that reported the MSAs, PHC and UHC. The keywords used in the search strategy were built on these three key concepts. We employed Pawson and Tilley's realist review approach to synthesize data following Realist and Meta-narrative Evidence Syntheses: Evolving Standards publication standards for realist synthesis. We explained findings using a multilevel lens: MSAs at the strategic level (macro-level), coordination and partnerships at the operational level (meso-level) and MSAs employing to modify behaviours and provide services at the local level (micro-level). RESULTS A total of 40 studies were included in the final review. The analysis identified six themes of MSAs contributing to the implementation of PHC towards UHC. At the macro-level, themes included influence on the policy rules and regulations for governance, and health in all policies for collaborative decision makings. The meso-level themes were spillover effects of the non-health sector, and the role of community health organizations on health. Finally, the micro-level themes were community engagement for health services/activities of health promotion and addressing individuals' social determinants of health. CONCLUSION Multisectoral actions enable policy and actions of other sectors in health involving multiple stakeholders and processes. Multisectoral actions at the macro-level provide strategic policy directions; and operationalise non-health sector policies to mitigate their spillover effects on health at the meso-level. At micro-level, MSAs support service provision and utilisation, and lifestyle and behaviour modification of people leading to equity and universality of health outcomes. Proper functional institutional mechanisms are warranted at all levels of health systems to implement MSAs on health.
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Affiliation(s)
- Resham B. Khatri
- School of Public Health, the University of Queensland, Brisbane, Australia
- Health Social Science and Development Research Institute, Kathmandu, Nepal
| | - Daniel Erku
- Centre for Applied Health Economics, School of Medicine, Griffith University, Nathan, Australia
- Menzies Health Institute Queensland, Griffith University, Nathan, Australia
| | - Aklilu Endalamaw
- School of Public Health, the University of Queensland, Brisbane, Australia
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Eskinder Wolka
- International Institute for Primary Health Care-Ethiopia, Addis Ababa, Ethiopia
| | - Frehiwot Nigatu
- International Institute for Primary Health Care-Ethiopia, Addis Ababa, Ethiopia
| | - Anteneh Zewdie
- International Institute for Primary Health Care-Ethiopia, Addis Ababa, Ethiopia
| | - Yibeltal Assefa
- School of Public Health, the University of Queensland, Brisbane, Australia
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28
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Lacy-Nichols J, Johnson M, Cullerton K. Commercial lobbying and political contributions: an Australian scoping review. Aust N Z J Public Health 2023; 47:100073. [PMID: 37478519 DOI: 10.1016/j.anzjph.2023.100073] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 05/21/2023] [Accepted: 05/31/2023] [Indexed: 07/23/2023] Open
Abstract
OBJECTIVE Many of the most effective and equitable policies to reduce the burden of non-communicable diseases threaten the interests of powerful corporations. A first step for public health advocates seeking to challenge powerful corporate interests is to understand the nature and extent of corporate political practices. This scoping review explored public health research on two political practices in Australia: lobbying and political donations. METHODS We searched six databases, two Google Advanced searches and 11 Australian public health websites. We screened 2866 documents in total, and extracted information about political practices, industry actors and datasets. RESULTS 62 studies published between 1980 and 2021 were identified, analysing public health advocacy, policy submissions, direct engagement with government representatives and political donations. We extracted data from 14 studies that focused on direct engagement and/or political donations. Most focused on 'unhealthy commodity industries.' CONCLUSIONS Analysis of lobbying and political contributions in Australia is a nascent but expanding area of public health research. We discuss opportunities for future research to strengthen the evidence base and support public health advocacy to counter harmful corporate practices and promote and protect population health. IMPLICATIONS FOR PUBLIC HEALTH Countering powerful commercial interests requires greater investment in understanding corporate political activities.
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Affiliation(s)
- Jennifer Lacy-Nichols
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, 3010 VIC Australia.
| | - Maggie Johnson
- School of Public Health and Preventive Medicine, Monash University, Australia
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Prescott SL, D’Adamo CR, Holton KF, Ortiz S, Overby N, Logan AC. Beyond Plants: The Ultra-Processing of Global Diets Is Harming the Health of People, Places, and Planet. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6461. [PMID: 37569002 PMCID: PMC10419141 DOI: 10.3390/ijerph20156461] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023]
Abstract
Global food systems are a central issue for personal and planetary health in the Anthropocene. One aspect of major concern is the dramatic global spread of ultra-processed convenience foods in the last 75 years, which is linked with the rising human burden of disease and growing sustainability and environmental health challenges. However, there are also calls to radically transform global food systems, from animal to plant-derived protein sources, which may have unintended consequences. Commercial entities have moved toward this "great plant transition" with vigor. Whether motivated by profit or genuine environmental concern, this effort has facilitated the emergence of novel ultra-processed "plant-based" commercial products devoid of nutrients and fiber, and sometimes inclusive of high sugar, industrial fats, and synthetic additives. These and other ingredients combined into "plant-based" foods are often assumed to be healthy and lower in calorie content. However, the available evidence indicates that many of these products can potentially compromise health at all scales-of people, places, and planet. In this viewpoint, we summarize and reflect on the evidence and discussions presented at the Nova Network planetary health meeting on the "Future of Food", which had a particular focus on the encroachment of ultra-processed foods into the global food supply, including the plant-sourced animal protein alternatives (and the collective of ingredients therein) that are finding their way into global fast-food chains. We contend that while there has been much uncritical media attention given to the environmental impact of protein and macronutrient sources-meat vs. novel soy/pea protein burgers, etc.-the impact of the heavy industrial processing on both human and environmental health is significant but often overlooked, including effects on cognition and mental health. This calls for a more nuanced discourse that considers these complexities and refocuses priorities and value systems towards mutualistic solutions, with co-benefits for individuals, local communities, and global ecology.
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Affiliation(s)
- Susan L. Prescott
- Nova Institute for Health, Baltimore, MD 21231, USA; (C.R.D.); (A.C.L.)
- Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Medical School, University of Western Australia, Nedlands, WA 6009, Australia
- The ORIGINS Project, Telethon Kids Institute, Nedlands, WA 6009, Australia
| | - Christopher R. D’Adamo
- Nova Institute for Health, Baltimore, MD 21231, USA; (C.R.D.); (A.C.L.)
- Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Kathleen F. Holton
- Departments of Health Studies and Neuroscience, Center for Neuroscience and Behavior, American University, Washington, DC 20016, USA;
| | - Selena Ortiz
- Department of Health Policy and Administration, The Pennsylvania State University, State College, PA 16802, USA;
| | - Nina Overby
- Department of Nutrition and Public Health, Centre for Lifecourse Nutrition, University of Agder, 4630 Kristiansand, Norway;
| | - Alan C. Logan
- Nova Institute for Health, Baltimore, MD 21231, USA; (C.R.D.); (A.C.L.)
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30
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Arnot G, Thomas S, Pitt H, Warner E. Australian young people's perceptions of the commercial determinants of the climate crisis. Health Promot Int 2023; 38:daad058. [PMID: 37326409 DOI: 10.1093/heapro/daad058] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Abstract
There is increasing public health focus on how corporate practices impact population health and well-being. While the commercial determinants of the climate crisis pose serious threats to human and planetary health, governments largely seek to balance climate action with economic imperatives. Global stakeholders recognize that young people have important voices in influencing climate responses. However, few studies have investigated young people's perceptions of the commercial determinants of the climate crisis. A qualitatively led online survey of n = 500 young Australians (15-24 years) investigated their understanding of corporate responses to the climate crisis, factors that influenced these responses and strategies to respond. A reflexive approach to thematic analysis was used. Three themes were constructed from the data. First, young people perceived that corporate responses to the climate crisis focussed on soft options and lacked meaningful action. Second, they stated that these responses were largely influenced by economic imperatives rather than planetary health, with policy levers needed to implement environmentally responsible corporate practices. Third, young people perceived that systems needed change to create demand for a cleaner environment, leading to improved practices. Young people have a clear understanding of the commercial determinants of the climate crisis and associated threats to population health. They recognize that corporate practices (and consumer demand) will not change without significant policy and structural change. Public health and health promotion stakeholders should work alongside young people to influence decision-makers to address harmful corporate behaviours.
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Affiliation(s)
- Grace Arnot
- Institute for Health Transformation, Faculty of Health, Deakin University, 1 Geringhap St, Geelong, Victoria, 3220, Australia
| | - Samantha Thomas
- Institute for Health Transformation, Faculty of Health, Deakin University, 1 Geringhap St, Geelong, Victoria, 3220, Australia
| | - Hannah Pitt
- Institute for Health Transformation, Faculty of Health, Deakin University, 1 Geringhap St, Geelong, Victoria, 3220, Australia
| | - Elyse Warner
- Institute for Health Transformation, Faculty of Health, Deakin University, 1 Geringhap St, Geelong, Victoria, 3220, Australia
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Gilmore AB, Fabbri A, Baum F, Bertscher A, Bondy K, Chang HJ, Demaio S, Erzse A, Freudenberg N, Friel S, Hofman KJ, Johns P, Abdool Karim S, Lacy-Nichols J, de Carvalho CMP, Marten R, McKee M, Petticrew M, Robertson L, Tangcharoensathien V, Thow AM. Defining and conceptualising the commercial determinants of health. Lancet 2023; 401:1194-1213. [PMID: 36966782 DOI: 10.1016/s0140-6736(23)00013-2] [Citation(s) in RCA: 129] [Impact Index Per Article: 129.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 10/13/2022] [Accepted: 12/23/2022] [Indexed: 04/07/2023]
Abstract
Although commercial entities can contribute positively to health and society there is growing evidence that the products and practices of some commercial actors-notably the largest transnational corporations-are responsible for escalating rates of avoidable ill health, planetary damage, and social and health inequity; these problems are increasingly referred to as the commercial determinants of health. The climate emergency, the non-communicable disease epidemic, and that just four industry sectors (ie, tobacco, ultra-processed food, fossil fuel, and alcohol) already account for at least a third of global deaths illustrate the scale and huge economic cost of the problem. This paper, the first in a Series on the commercial determinants of health, explains how the shift towards market fundamentalism and increasingly powerful transnational corporations has created a pathological system in which commercial actors are increasingly enabled to cause harm and externalise the costs of doing so. Consequently, as harms to human and planetary health increase, commercial sector wealth and power increase, whereas the countervailing forces having to meet these costs (notably individuals, governments, and civil society organisations) become correspondingly impoverished and disempowered or captured by commercial interests. This power imbalance leads to policy inertia; although many policy solutions are available, they are not being implemented. Health harms are escalating, leaving health-care systems increasingly unable to cope. Governments can and must act to improve, rather than continue to threaten, the wellbeing of future generations, development, and economic growth.
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Affiliation(s)
| | - Alice Fabbri
- Department for Health, University of Bath, Bath, UK
| | - Fran Baum
- Stretton Health Institute, University of Adelaide, Adelaide, SA, Australia
| | | | - Krista Bondy
- Stirling Management School, University of Stirling, Stirling, UK
| | - Ha-Joon Chang
- Department of Economics, School of Oriental and African Studies University of London, London, UK
| | - Sandro Demaio
- Victorian Health Promotion Foundation, Melbourne, VIC, Australia
| | - Agnes Erzse
- South African Medical Research Council/Wits Centre for Health Economics and Decision Science, Wits School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Nicholas Freudenberg
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Sharon Friel
- Menzies Centre for Health Governance, School of Regulation and Global Governance, The Australian National University, Acton, ACT, Australia
| | - Karen J Hofman
- South African Medical Research Council/Wits Centre for Health Economics and Decision Science, Wits School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Paula Johns
- ACT Health Promotion, Rio de Janeiro, Brazil
| | - Safura Abdool Karim
- South African Medical Research Council/Wits Centre for Health Economics and Decision Science, Wits School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Jennifer Lacy-Nichols
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, VIC, Australia
| | | | - Robert Marten
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
| | - Martin McKee
- Department of Health Services Research 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
| | - Lindsay Robertson
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | | | - Anne Marie Thow
- Menzies Centre for Health Policy and Economics, University of Sydney, NSW, Australia
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32
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Friel S, Collin J, Daube M, Depoux A, Freudenberg N, Gilmore AB, Johns P, Laar A, Marten R, McKee M, Mialon M. Commercial determinants of health: future directions. Lancet 2023; 401:1229-1240. [PMID: 36966784 DOI: 10.1016/s0140-6736(23)00011-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 09/06/2022] [Accepted: 12/23/2022] [Indexed: 04/07/2023]
Abstract
This paper is about the future role of the commercial sector in global health and health equity. The discussion is not about the overthrow of capitalism nor a full-throated embrace of corporate partnerships. No single solution can eradicate the harms from the commercial determinants of health-the business models, practices, and products of market actors that damage health equity and human and planetary health and wellbeing. But evidence shows that progressive economic models, international frameworks, government regulation, compliance mechanisms for commercial entities, regenerative business types and models that incorporate health, social, and environmental goals, and strategic civil society mobilisation together offer possibilities of systemic, transformative change, reduce those harms arising from commercial forces, and foster human and planetary wellbeing. In our view, the most basic public health question is not whether the world has the resources or will to take such actions, but whether humanity can survive if society fails to make this effort.
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Affiliation(s)
- Sharon Friel
- Menzies Centre for Health Governance, School of Regulation and Global Governance, The Australian National University, Acton, ACT, Australia.
| | - Jeff Collin
- School of Political and Social Science, University of Edinburgh, Edinburgh, UK
| | - Mike Daube
- Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Anneliese Depoux
- Virchow-Villermé Public Health Centre, University of Paris, Paris, France
| | - Nicholas Freudenberg
- School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Anna B Gilmore
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Paula Johns
- ACT Health Promotion, Rio de Janeiro, Brazil
| | - Amos Laar
- School of Public Health, University of Ghana, Legon, Ghana
| | - Robert Marten
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
| | - Martin McKee
- London School of Hygiene & Tropical Medicine, London, UK
| | - Melissa Mialon
- Trinity Business School, Trinity College Dublin, Dublin, Ireland
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33
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Ghebreyesus TA. Achieving health for all requires action on the economic and commercial determinants of health. Lancet 2023; 401:1137-1139. [PMID: 36966778 DOI: 10.1016/s0140-6736(23)00574-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 03/14/2023] [Indexed: 04/07/2023]
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