Environment and health in the twenty-first century

The manufacture of lifestyle: the role of corporations in unhealthy living

Recently, researchers have debated two views on the connection between lifestyle and health. In the first, health-related lifestyles including tobacco and alcohol use, diet, and physical activity are seen as primary influences on health. In the second, social stratification is the dominant influence with lifestyles simply markers of social status. Neither approach leads to interventions that can reverse the world's most serious health problems. This article proposes that corporate practices are a dominant influence on the lifestyles that shape patterns of health and disease. Modifying business practices that promote unhealthy lifestyles is a promising strategy for improving population health. Corporations shape lifestyles by producing and promoting healthy or unhealthy products, creating psychological desires and fears, providing health information, influencing social and physical environments, and advancing policies that favor their business goals. Public officials and health professionals can promote health by advocating policies to modify these corporate practices.

Ethical issues in measuring biomarkers in children's environmental health

BACKGROUND

Studying the impact of environmental exposures is important in children because they are more vulnerable to adverse effects on growth, development, and health. Assessing exposure in children is difficult, and measuring biomarkers is potentially useful. Research measuring biomarkers in children raises a number of ethical issues, some of which relate to children as research subjects and some of which are specific to biomarker research.

OBJECTIVE

As an international group with experience in pediatric research, biomarkers, and the ethics of research in children, we highlight the ethical issues of undertaking biomarker research in children in these environments.

DISCUSSION

Significant issues include undertaking research in vulnerable communities, especially in developing countries; managing community expectations; obtaining appropriate consent to conduct the research; the potential conflicts of obtaining permission from an ethics review board in an economically developed country to perform research in a community that may have different cultural values; returning research results to participants and communities when the researchers are uncertain of how to interpret the results; and the conflicting ethical obligations of maintaining participant confidentiality when information about harm or illegal activities mandate reporting to authorities.

CONCLUSION

None of these challenges are insurmountable and all deserve discussion. Pediatric biomarker research is necessary for advancing child health.