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Ben Jebli M, Boussaidi R. Empirical evidence of emissions discourse related to food, beverage, and tobacco production in leading manufacturing nations. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:23968-23978. [PMID: 38438642 DOI: 10.1007/s11356-024-32690-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/24/2024] [Indexed: 03/06/2024]
Abstract
The proliferation of carbon dioxide (CO2) emissions has resulted in significant environmental challenges worldwide, particularly within industrialized nations. The present paper tries to investigate the role of food, beverages, and tobacco in mitigating CO2 emissions in the top industrial countries. Economic growth and renewable and non-renewable energy consumption are integrated as control variable in the empirical model. The study applied the pooled mean group-autoregressive distributed lag (PMG-ARDL) model proposed by (J Appl Econ, 16:289-326, 2001) and Granger causality test for causalities directions. The empirical outcomes suggest the presence of cross-sectional dependence, and variables are integrated of order one and cointegrated. Long-run estimates revealed the presence of inversed U curve proving the validity of the environmental Kuznets curve. Also, the results show that renewable energy (RE) consumption contribute in reducing emissions, while non-renewable energy (NRE) and food, beverages, and tobacco (FBT) led to increase emissions level in the long run. Granger shows bidirectional long-run relationship between CO2 emissions, non-renewable energy, and economic growth. Moreover, Granger recorded no causality between food, beverages, and tobacco and any other variable. We recommend that firms engaged in the production of food, beverages, and tobacco products are increasingly urged to make investments in clean technologies powered by renewable energy sources for their manufacturing processes. This is considered a necessary step to achieve a significant reduction in CO2 emissions over an extended period.
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Affiliation(s)
- Mehdi Ben Jebli
- FSJEG Jendouba, University of Jendouba, Jendouba, Tunisia.
- ESCT, QUARG UR17ES26, Campus University of Manouba, 2010, Manouba, Tunisia.
| | - Ramzi Boussaidi
- Department of Finance and Economics, College of Business, University of Jeddah, Jeddah, Saudi Arabia
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Annan RA, Agyapong NAF, Thow AM, Swart EC. Background commentary on the Researching the Obesogenic Food Environment (ROFE) project. Public Health Nutr 2024; 27:e56. [PMID: 38229559 PMCID: PMC10882530 DOI: 10.1017/s136898002300280x] [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: 01/18/2024]
Abstract
OBJECTIVE The objective of this commentary is to provide an overview of the rationale and objectives of the Researching the Obesogenic Food Environment (ROFE) project that was conducted in Ghana and South Africa. DESIGN Narration has been used to describe the main objectives, phases as well as the methods used for the conduct of this project. SETTING The project described in this commentary was conducted in Khayelitsha and Mount Frere in South Africa and Ahodwo and Ejuratia for Ghana. PARTICIPANT Participants of the study described here include households in South Africa and Ghana, stakeholders and policymakers, and various actors within the food chain in both countries. RESULTS The ROFE findings provide a good understanding of the extent of the impact of the food environment on consumption, characteristics of value chains of healthy and unhealthy foods, as well as the potential for improved governance and policy that is relevant to the region. The supplement provides the opportunity to share the extensive findings of the ROFE project. Nine papers that describe the process and findings of the three phases of the ROFE project have been presented. Some of the papers focus on phases of the ROFE, while others cut across different phases and explore the linkages between the phases. Briefly descriptions of key findings of some of the papers in the supplement are provided. CONCLUSION Together, the findings of the ROFE study presented in this supplement have increased understanding of how communities in SA and Ghana interact with their food supplies and have led to identification of specific opportunities to improve food supply policies, in ways that create incentives for the production and consumption of healthy, relative to unhealthy foods.
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Affiliation(s)
- Reginald Adjetey Annan
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Nana Ama Frimpomaa Agyapong
- Department of Clinical Nutrition and Dietetics, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Anne Marie Thow
- Menzies Centre for Health Policy, University of Sydney, Sydney, NSW2006, 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: 117] [Impact Index Per Article: 117.0] [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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Erzse A, Karim SA, Foley L, Hofman KJ. A realist review of voluntary actions by the food and beverage industry and implications for public health and policy in low- and middle-income countries. NATURE FOOD 2022; 3:650-663. [PMID: 37118592 DOI: 10.1038/s43016-022-00552-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 06/14/2022] [Indexed: 04/30/2023]
Abstract
The increasing availability of unhealthy processed food products is linked to rising rates of non-communicable diseases and obesity in low- and middle-income countries. Voluntary actions (VAs) are often adopted in lieu of regulating the composition, production, marketing and sale of unhealthy commodities, but their effectiveness is unclear. This realist review examines VAs adopted by the food and beverage industry in low- and middle-income countries. We developed a conceptual framework and followed a three-stage search to identify literature and VAs and, adhering to the Realist and Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) guidelines, we produced a synthesized analysis of VAs. VAs, often initiated in response to governments' efforts to introduce regulations, were difficult to evaluate due to vague language and a lack of enforcement mechanisms. The review found no evidence indicating that VAs are effective in safeguarding public health. Yet their implementation has resulted in weaker responses and policy substitution, and so we suggest that VAs have the potential to negatively influence public health and policy. The United Nations should rescind their endorsement of industry involvement and mandatory measures should be favoured over VAs.
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Affiliation(s)
- Agnes Erzse
- SAMRC/Wits Centre for Health Economics and Decision Science - PRICELESS SA, University of Witwatersrand School of Public Health, Faculty of Health Sciences, Johannesburg, South Africa.
| | - Safura Abdool Karim
- SAMRC/Wits Centre for Health Economics and Decision Science - PRICELESS SA, University of Witwatersrand School of Public Health, Faculty of Health Sciences, Johannesburg, South Africa
| | - Louise Foley
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Karen Joanne Hofman
- SAMRC/Wits Centre for Health Economics and Decision Science - PRICELESS SA, University of Witwatersrand School of Public Health, Faculty of Health Sciences, Johannesburg, South Africa
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Loewenson R, Godt S, Chanda-Kapata P. Asserting public health interest in acting on commercial determinants of health in sub-Saharan Africa: insights from a discourse analysis. BMJ Glob Health 2022; 7:bmjgh-2022-009271. [PMID: 35817497 PMCID: PMC9274517 DOI: 10.1136/bmjgh-2022-009271] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/17/2022] [Indexed: 11/04/2022] Open
Abstract
The actors influencing the commercial determinants of health (CDOH) in sub-Saharan Africa (SSA) have different interests and lenses around the costs and benefits of market influences in health. We analysed the views and priorities on CDOH in the discourse of global and regional agencies, SSA governments, private investors and companies, civil society and academia through a desk review of online publications post-2010, validated by purposively selected key informant interviews. The most polarised views were between civil society and academia on one hand, focused more on harms, and private business/investors on the other, almost exclusively focused on benefits. Others had mixed messaging, encouraging partnerships with commercial actors for health benefits and also voicing cautions over negative health impacts. Views also differed between transnational and domestic business and investors. Three areas of discourse stood out, demonstrating also tensions between commercial and public health objectives. These were the role of human rights as fundamental for or obstacle to engaging commercial practice in health; the development paradigm and role of a neoliberal political economy generating harms or opportunities for health; and the implications of commercial activity in health services. COVID-19 has amplified debate, generating demand for public sectors to incentivise commercial activity to ‘modernise’ and digitise health services and meet funding gaps and generating new thinking and engagement on domestic production of key health inputs. Power plays a critical role in CDOH. Commercial actors in SSA increase their influence through discursive and agential forms of power and take advantage of the structural power gained from a dominant view of free markets and for-profit commerce as essential for well-being. As a counterfactual, we found and present options for using these same three forms of narrative, agential and structural power to proactively advance public health objectives and leadership on CDOH in SSA.
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Affiliation(s)
| | - Sue Godt
- Consultant, Ottawa, Ontario, Canada
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Development and Field-Testing of Proposed Food-Based Dietary Guideline Messages and Images amongst Consumers in Tanzania. Nutrients 2022; 14:nu14132705. [PMID: 35807884 PMCID: PMC9268523 DOI: 10.3390/nu14132705] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/17/2022] [Accepted: 06/20/2022] [Indexed: 02/01/2023] Open
Abstract
In this paper we report on the development and field-testing of proposed food-based dietary guideline (FBDG) messages among Tanzanian consumers. The messages were tested for cultural appropriateness, consumer understanding, acceptability, and feasibility. In addition, comprehension of the messages was assessed using culturally representative images for low literacy audiences. Focus group discussions were used as method for data collection. Results indicate that the core meaning of the proposed FBDG messages and images were understood and acceptable to the general population. However, participants felt that nutrition education would be required for improved comprehension. Feasibility was affected by some cultural differences, lack of nutrition knowledge, time constraints, and poverty. Suggestions were made for some rewording of certain messages and editing of certain images. It is recommended that the field-tested messages and images, incorporating the suggested changes, should be adopted. Once adopted, the FBDGs can be used to inform and engage various stakeholders, including parents, caregivers, healthcare providers and educators on appropriate nutritional practices for children and adults. They can also be used to guide implementation of relevant policies and programmes to contribute towards the achievement of sustainable healthy diets and healthy dietary patterns.
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Chavez‐Ugalde Y, Jago R, Toumpakari Z, Egan M, Cummins S, White M, Hulls P, De Vocht F. Conceptualizing the commercial determinants of dietary behaviors associated with obesity: A systematic review using principles from critical interpretative synthesis. Obes Sci Pract 2021; 7:473-486. [PMID: 34401205 PMCID: PMC8346378 DOI: 10.1002/osp4.507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 03/04/2021] [Accepted: 03/12/2021] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Unhealthy diet is an important preventable risk factor for overweight and obesity. Identifying the key drivers of an unhealthy diet is an important public health aim. "Big Food" has been identified as an influential factor shaping dietary behavior and obesity, and their practices have broadly been labeled as the "commercial determinants of obesity," but there is a lack of definitions and conceptualizations for these terms. This review aimed to synthesize literature on the commercial determinants of dietary behavior associated with obesity. It presents the development of an integrative definition and a conceptual framework involving potential influences on dietary behavior, and it examines the prevalence of certain narratives within papers that focus on children and adolescents. METHODS Four electronic databases (Ovid MEDLINE, PubMed, Web of Science, and Scopus) were searched up to December 2020. Eighty-one articles met the inclusion criteria: they were published in a peer-reviewed academic journal, described a practice from the food/beverage industry in relation to dietary behavior or obesity. Data were integrated using critical interpretative synthesis. RESULTS The commercial determinants of dietary behavior are conceptualized in terms of three corporate spheres of action-political and legal; production, processing and design; and marketing and preference shaping-which enable powerful food industry to successfully pursue their business, market, and political objectives. The most frequently reported sphere of action targeting children and adolescents was marketing and preference shaping. CONCLUSIONS In the included literature, the commercial determinants of dietary behavior associated with obesity have been conceptualized as being part of a complex system where corporate practices are enabled by power structures. The proposed framework can facilitate a structured identification and systematic study of the impact of specific aspects of food industry's strategies and increase opportunities for primary prevention by anticipating industry responses and by discouraging corporate practices that harm health.
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Affiliation(s)
- Yanaina Chavez‐Ugalde
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Russell Jago
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Centre for Exercise, Nutrition & Health Sciences, School for Policy StudiesUniversity of BristolBristolUK
- National Institute for Health Research Collaboration for Leadership, Applied Health Research and Care West (NIHR CLAHRC West)BristolUK
| | - Zoi Toumpakari
- Centre for Exercise, Nutrition & Health Sciences, School for Policy StudiesUniversity of BristolBristolUK
| | - Matt Egan
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Department of Public Health, Environments and SocietyLondon School of Hygiene and Tropical MedicineLondonUK
| | - Steven Cummins
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Department of Public Health, Environments and SocietyLondon School of Hygiene and Tropical MedicineLondonUK
| | - Martin White
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Centre for Diet and Activity Research (CEDAR) MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | - Paige Hulls
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Frank De Vocht
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
- National Institute for Health Research Collaboration for Leadership, Applied Health Research and Care West (NIHR CLAHRC West)BristolUK
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Mapping of food industry strategies to influence public health policy, research and practice in South Africa. Int J Public Health 2020; 65:1027-1036. [PMID: 32728853 DOI: 10.1007/s00038-020-01407-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 04/29/2020] [Accepted: 06/07/2020] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES To identify the corporate political activity (CPA) of food industry actors in South Africa. METHODS We studied the CPA of ten different food actors for the period Jan 2018-April 2019. We used a systematic approach and existing framework to collect and analyse information available in the public domain, including material from the industry, government, academia and civil society. RESULTS Food industry actors in South Africa established multiple relationships with various parties in and outside the South African government. These included interactions between large food companies and the Department of Basic Education, the Department of Sport & Recreation, the Department of Health, and the Department of Agriculture. In addition, the food industry-sponsored community programs, with a focus on poverty alleviation and undernutrition. Moreover, food industry actors influenced science were directly involved in policy-making and helped frame the debate on diet and public health in South Africa. CONCLUSIONS It is crucial that there is increased transparency, disclosure, and awareness of industry strategies, and that mechanisms to address and manage industry influence are strengthened in the country.
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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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Rother HA. Controlling and preventing climate-sensitive noncommunicable diseases in urban sub-Saharan Africa. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 722:137772. [PMID: 32199361 DOI: 10.1016/j.scitotenv.2020.137772] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 02/12/2020] [Accepted: 03/05/2020] [Indexed: 06/10/2023]
Abstract
Research continues to highlight the link between climate change and health outcomes. There is, however, limited evidence in research, policies and in the Sustainable Development Goals (SDGs) about the impact of environmental factors on noncommunicable diseases (NCDs) for people living in urban areas of sub-Saharan Africa (SSA). Important is that 80% of NCDs are taking place in low- and middle-income countries (LMICs) and linked to a third of the deaths in SSA. The question is, what would these statistics look like if environmental risk factors (e.g., pollution, chemicals) for NCDs, linked to climate change, were prevented and controlled. This article presents a framework for understanding climatic pathways' impacts on climate-sensitive NCDs and achieving the SDGs. It further explains how current global mitigation interventions in high income urban settings, with implied health co-benefits for NCD reduction (i.e., promoting use of less polluting vehicles, bicycles, walking, public transport, green spaces), experience major implementation challenges in SSA cities (i.e., too costly, lack of availability, poor road conditions, gender and cultural norms, security problems). Recommendations are made for applying this framework to control climate change impacts on NCDs and achieving the SDGs in SSA cities. These include, support for more research on the climate - NCD nexus, ensuring health professional training includes sustainable health education, and including a focus on climate change and health in primary and secondary school curricula. Further recommendations for addressing climate-sensitive NCDs and urban environmental health towards achieving and sustaining the SDGs, are linked to promoting climate-sensitive and health policies and governance, as well as controlling the influence of advertising. Lastly, improving communication of research findings for policy makers and the public in a manner for informed policy making, and how to comprehend this information to promote the reduction and prevention of NCDs in urban SSA, is key.
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Affiliation(s)
- Hanna-Andrea Rother
- Division of Environmental Health, and Centre for Environmental and Occupational Health, School of Public Health and Family Medicine, University of Cape Town, Anzio Rd., Observatory 7925, South Africa.
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Delobelle P. Big Tobacco, Alcohol, and Food and NCDs in LMICs: An Inconvenient Truth and Call to Action Comment on "Addressing NCDs: Challenges From Industry Market Promotion and Interferences". Int J Health Policy Manag 2019; 8:727-731. [PMID: 31779301 PMCID: PMC6885859 DOI: 10.15171/ijhpm.2019.74] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 09/04/2019] [Indexed: 12/24/2022] Open
Abstract
In their editorial, Tangcharoensathien et al1 describe the challenges of industry market promotion and policy interference from Big Tobacco, Alcohol, and Food in addressing non-communicable diseases (NCDs). They provide an overview of the increasing influence of corporate interest in emerging economies and government attempts to implement the World Health Organization (WHO) 'best buy' interventions. The authors largely draw on examples from Asia and a few selected countries, but provide little detail as to how aggressive marketing and policy interference plays out in a context of poor legislation and regulation in many low- and middleincome countries (LMICs), where the burden of NCDs is increasing at an alarming rate and governments face a high burden of disease with a limited budget for countering industry interference. This commentary provides some poignant examples of the influence of Big Tobacco, Alcohol, and Food on market regulation and policy interference in LMICs and argues for more policy coherence and accountability in terms of multisectoral action and civil society activism. Securing funds for health promotion and establishing health promotion foundations could help achieve that goal.
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Affiliation(s)
- Peter Delobelle
- University of Western Cape, Cape Town, South Africa
- Chronic Disease Initiative for Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Bekele TH, de Vries JJ, Trijsburg L, Feskens E, Covic N, Kennedy G, Brouwer ID. Methodology for developing and evaluating food-based dietary guidelines and a Healthy Eating Index for Ethiopia: a study protocol. BMJ Open 2019; 9:e027846. [PMID: 31315863 PMCID: PMC6661676 DOI: 10.1136/bmjopen-2018-027846] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Food-based dietary guidelines (FBDGs) are used to promote and maintain healthy eating in a population, by providing country-specific guidance. However, many African countries like Ethiopia do not have FBDGs. This paper describes the methodology for the development of Ethiopian FBDGs and for creating and evaluating a Healthy Eating Index and a scoring tool that can be used to monitor the adherence of the population to FBDGs. METHODS AND ANALYSIS A multidisciplinary technical working group will be tasked to develop FBDGs for the general population above 2 years of age based on identification of priority diet-related public health problems and risk factors, and a systematic review of dietary patterns in relation to the identified priority health outcomes, following a multistep process. FBDGs will be translated into daily food choices for specific subpopulations by applying linear programming using data from the National Food Consumption Survey (NFCS) of 2011. FBDGs will be evaluated for cultural appropriateness, acceptability, consumer understanding and practicality. A dietary gap assessment will be conducted by comparing the national food supply with the country's food demand. In addition an Ethiopian Healthy Eating Index (EHEI) will be developed based on the FBDGs using the NFCS data. The EHEI will be evaluated by comparing the EHEI Score based on 24 hours diet recall with that of the EHEI Score based on a Food Frequency Questionnaire, by analysing the association of the EHEI Score with population characteristics and micronutrient intake with or without additional adjustment for energy intake. Finally, a brief Food Quality Screening tool scoring for the important EHEI components will be developed to enable evaluation for counselling. ETHICS AND DISSEMINATION Ethical approval is received from the Scientific and Ethical Review Office of the Ethiopian Public Health Institute. The findings will be disseminated through peer-reviewed publications.A dissemination workshop will be organised with key implementing sectors of the food system for a healthier diet (http://a4nh.cgiar.org/our-research/research-flagships/) and with key public and private partners. The findings from this study will be translated into FBDGs and shared through conferences, reports and the mass media (TV and radio). TRIAL REGISTRATION NUMBER NCT03394963; Pre-results.
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Affiliation(s)
- Tesfaye Hailu Bekele
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Jeanne Jhm de Vries
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Laura Trijsburg
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Edith Feskens
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Namukolo Covic
- Poverty, Health and Nutrition Division, International Food Policy Research Institute, Addis Ababa, Ethiopia
| | - Gina Kennedy
- Diet Diversity for Nutrition and Health, Bioversity International, Maccarese, Italy
| | - Inge D Brouwer
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
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Reeve B, Gostin LO. "Big" Food, Tobacco, and Alcohol: Reducing Industry Influence on Noncommunicable Disease Prevention Laws and Policies Comment on "Addressing NCDs: Challenges From Industry Market Promotion and Interferences". Int J Health Policy Manag 2019; 8:450-454. [PMID: 31441282 PMCID: PMC6706978 DOI: 10.15171/ijhpm.2019.30] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 05/11/2019] [Indexed: 01/08/2023] Open
Abstract
The food, tobacco and alcohol industries have penetrated markets in low- and middle-income countries (LMICs), with a significant impact on these countries' burden of noncommunicable diseases (NCDs). Tangcharoensathien and colleagues describe the aggressive marketing of unhealthy food, alcohol and tobacco in LMICs, as well as key tactics used by these industries to resist laws and policies designed to reduce behavioural risk factors for NCDs. This commentary expands on the recommendations made by Tangcharoensathien and colleagues for preventing or managing conflicts of interest and reducing undue industry influence on NCD prevention policies and laws, focusing on the needs of LMICs. A growing body of research proposes ways to design voluntary industry initiatives to make them more effective, transparent and accountable, but governments should also consider whether collaboration with health-harming industries is ever appropriate. More fundamentally, mechanisms for identifying, managing and mitigating conflicts of interest and reducing industry influence must be woven into - and supported by - broader governance and regulatory structures at both national and international levels.
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Affiliation(s)
- Belinda Reeve
- The University of Sydney Law School, Sydney, NSW, Australia
| | - Lawrence O. Gostin
- O’Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC, USA
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Aldakhil AM, Nassani AA, Abro MMQ, Zaman K. Food-beverage-tobacco consumption, smoking prevalence, and high-technology exports influenced healthcare sustainability agenda across the globe. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:33249-33263. [PMID: 30255272 DOI: 10.1007/s11356-018-3277-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 09/18/2018] [Indexed: 06/08/2023]
Abstract
The objective of the study is to analyze the long-run, causal, and inter-temporal relationships between food-beverage-tobacco consumption, smoking prevalence in male and females, and high-technology exports and their resulting impact on global healthcare sustainability agenda in a panel of 19 European, North American, and Asian countries during a period of 1990-2016. The results show that the sample countries are largely affected by high mass consumption of food, beverages, and tobacco, due to which the health spending is very high in their economies that increase healthcare costs and mortality rates accordingly. The relationship between death rate and per capita income is found negative in a panel of selected countries, where high death rates substantially decrease country's per capita income. The Granger causality estimates confirm the unidirectional causality running from (i) high-technology exports to CO2 emissions, (ii) smoking prevalence of male and female to health expenditures, (iii) industrial value added to mortality, (iv) health expenditures to per capita income, (v) per capita income to death rates, and (vi) food, beverages, and tobacco consumption to mortality indicators, whereas, the inter-temporal causation confirmed that lifetime risk of maternal death will largely influence health expenditures in a panel of selected countries for the next 10-year time period.
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Affiliation(s)
- Abdullah Mohammed Aldakhil
- Department of Management, College of Business Administration, King Saud University, Riyadh, Saudi Arabia
| | - Abdelmohsen A Nassani
- Department of Management, College of Business Administration, King Saud University, Riyadh, Saudi Arabia
| | | | - Khalid Zaman
- Department of Economics, University of Wah, Quaid Avenue, Wah Cantonment, Pakistan.
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15
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Chigumete TG, Townsend N, Srinivas SC. Facilitating and limiting factors of workplace health promotion at Rhodes University, South Africa. Work 2018; 59:599-606. [PMID: 29733050 DOI: 10.3233/wor-182707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Workplace health promotion programs, when well designed and implemented are beneficial to both employees and their employers. OBJECTIVE To investigate the factors that affect workplace health promotion initiatives intended for support staff at Rhodes University. To explore ways in which future initiatives that aim to reduce the prevalence of non-communicable diseases in the workplace may be improved. METHODS A qualitative study, using semi-structured interviews and focus group discussions with key stakeholders and support staff. All interviews and focus group discussions were voice recorded and then transcribed verbatim. Transcripts were uploaded into NVivo® 10 for coding and thematic analysis. RESULTS Key stakeholders reported that health promotion initiatives have been attempted and were advertised, however the turnout was poor. The support staff in turn, stated that past initiatives were not tailored to their health needs and they lacked context-specificity and cultural sensitivity. They also suggested improvements for future initiatives such as convenient venues and using films and short plays as a means of delivering health information. CONCLUSIONS Based on inputs from key stakeholders and support staff, there are several factors that affect the success of health promotion initiatives in the workplace. Employees, who are the recipients of the planned initiatives, need to be involved in all stages of the planning and implementation.
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Parra DC, de Sá TH, Monteiro CA, Freudenberg N. Automobile, construction and entertainment business sector influences on sedentary lifestyles. Health Promot Int 2018; 33:239-249. [PMID: 27561906 DOI: 10.1093/heapro/daw073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Sedentary lifestyles contribute to premature death and health inequalities. Researchers have studied personal and community-level determinants of inactivity but few have analyzed corporate influences. To reframe the public health debate on inactivity and open new doors for public sector intervention, we conducted a scoping review of evidence from several disciplines to describe how the business and political practices of the automobile, construction, and entertainment sectors have encouraged sedentary lifestyles. In the last 50 years, these industries have found it profitable to produce motor vehicles, housing, and entertainment, which intentionally or unintentionally discourage physical activity. Ceding primary authority for policy decisions in these sectors to the market-based economy has enabled the growth of powerful lobbies that encourage and maintain sedentary lifestyles. To counteract these influences, public health and civil society need to confront more upstream economic and social determinants of sedentary lifestyles. Building on evidence from efforts to change harmful tobacco, alcohol and food industry practices, we propose the creation of research and policy agendas that contribute to public health practice that can modify corporate practices that contribute to physical, social and political environments that discourage physical activity.
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Affiliation(s)
- Diana C Parra
- Physical Therapy, Washington University, St Louis, Missouri, USA
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17
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Maani Hessari N, Petticrew M. What does the alcohol industry mean by ‘Responsible drinking’? A comparative analysis. J Public Health (Oxf) 2017; 40:90-97. [DOI: 10.1093/pubmed/fdx040] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 03/22/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
- N Maani Hessari
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - M Petticrew
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
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18
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Lee K, Eckhardt J, Holden C. Tobacco industry globalization and global health governance: towards an interdisciplinary research agenda. PALGRAVE COMMUNICATIONS 2016; 2:16037. [PMID: 28458910 PMCID: PMC5409523 DOI: 10.1057/palcomms.2016.37] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 05/17/2016] [Indexed: 05/02/2023]
Abstract
Shifting patterns of tobacco production and consumption, and the resultant disease burden worldwide since the late twentieth century, prompted efforts to strengthen global health governance through adoption of the Framework Convention on Tobacco Control. While the treaty is rightfully considered an important achievement, to address a neglected public health issue through collective action, evidence suggests that tobacco industry globalization continues apace. In this article, we provide a systematic review of the public health literature and reveal definitional and measurement imprecision, ahistorical timeframes, transnational tobacco companies and the state as the primary units and levels of analysis, and a strong emphasis on agency as opposed to structural power. Drawing on the study of globalization in international political economy and business studies, we identify opportunities to expand analysis along each of these dimensions. We conclude that this expanded and interdisciplinary research agenda provides the potential for fuller understanding of the dual and dynamic relationship between the tobacco industry and globalization. Deeper analysis of how the industry has adapted to globalization over time, as well as how the industry has influenced the nature and trajectory of globalization, is essential for building effective global governance responses. This article is published as part of a thematic collection dedicated to global governance.
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Affiliation(s)
- Kelley Lee
- Simon Fraser University, Burnaby, Canada
| | | | - Chris Holden
- Department of Social Policy and Social Work, University of York, York, UK
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Airhihenbuwa CO, Ogedegbe G. Noncommunicable Diseases in Africa and the Global South. HEALTH EDUCATION & BEHAVIOR 2016; 43:5S-6S. [PMID: 27037148 DOI: 10.1177/1090198116630529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Gbenga Ogedegbe
- New York University Langone Medical Center, New York, NY, USA
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