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Nyarko E, Bartelmeß T. Drivers of consumer food choices of multinational corporations' products over local foods in Ghana: a maximum difference scaling study. Global Health 2024; 20:22. [PMID: 38500144 PMCID: PMC10949566 DOI: 10.1186/s12992-024-01027-x] [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: 06/06/2023] [Accepted: 03/12/2024] [Indexed: 03/20/2024] Open
Abstract
INTRODUCTION The fundamental transformation of food systems and retail environments in low-income countries is influencing consumers' food choices and dietary habits in unfavourable directions through the consumption of highly processed, energy-dense foods, predominantly manufactured by multinational food corporations. This study aims to identify the principal factors driving consumers' preference for multinational foods over local foods in the urban Accra region of Ghana. METHOD This cross-sectional survey involving a random sample of 200 consumers conducted in March/April 2023 using interviewer-administered questionnaires employed a maximum difference scaling approach to investigate the drivers of urban Ghanaian consumer food choices for multinational food corporations' products over local foods. The maximum difference scaling modelling analysis utilized in this study identifies the primary drivers of multinational food corporations' product preferences and the associated trade-offs. RESULT The study discovered that food quality and safe packaging, perceived healthiness, taste and flavour, and nutritional value were the most significant factors driving consumer preference for multinational food corporations' products over local foods in Ghana. The criterion food quality and safe packaging had the significantly highest utility than all other attributes in terms of consumer preference for products/meals from multinational food corporations over local foods. CONCLUSION The results of this study provide significant contributions to the existing body of research, as previous studies have not identified these factors as primary drivers of multinational food products. Public health authorities and nutritionists can use the study's findings to implement targeted quality assurance measures in local markets and to address the drivers in health education campaigns.
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Affiliation(s)
- Eric Nyarko
- Department of Statistics and Actuarial Science, School of Physical and Mathematical Sciences, University of Ghana, Box LG 115, Accra, Legon, Ghana
| | - Tina Bartelmeß
- Faculty of Life Sciences: Food, Nutrition and Health, University of Bayreuth, Fritz-Hornschuch-Strasse 13, Kulmbach, Germany.
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Zwierczyk U, Kobryn M, Duplaga M. The Awareness of the Role of Commercial Determinants of Health and the Readiness to Accept Restrictions on Unhealthy Food Advertising in Polish Society. Nutrients 2023; 15:4743. [PMID: 38004137 PMCID: PMC10674888 DOI: 10.3390/nu15224743] [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: 09/23/2023] [Revised: 10/17/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
The negative consequences of commercial determinants of health (CDoH) have become a major challenge for public health systems, especially in terms of non-communicable diseases (NCDs). CDoH are defined as profit-driven factors that influence health. In this study, we assessed the awareness of CDoH and the attitudes toward potential restrictions on advertising, as well as fiscal interventions targeting food products with harmful effects on health in Polish society. Our analysis is based on data from a computer-based web interviewing (CAWI) survey performed in May 2022 among 2008 adult internet users from Poland. Multivariable logistic regression models were developed for variables derived from three items exploring the respondents' understanding of the relationship between CDoH and NCDs, as well as three items asking about their acceptance of a prohibition of advertising unhealthy products during sports events, a general ban on unhealthy food advertising, and their attitudes toward sugar-sweetened beverages (SSBs). Food (FL) and e-health literacy (eHL) levels were consistently positive predictors of both awareness of CDoH and acceptance of the proposed actions. Both higher FL and eHL were significantly associated with the opinion that advertising unhealthy food is associated with the prevalence of NCDs (OR, 95% CI: 1.03, 1.02-1.05, and 1.04, 1.02-1.06, respectively). Health literacy was less frequently a significant predictor of the dependent variables. Among sociodemographic factors, a respondent's level of education and age showed a significant relationship with their awareness and acceptance of countermeasures against CDoH. Respondents with a university master's level of education were more likely to agree with the statement on the relationship between big industry profits and harm to society's health (OR, 95% CI: 1.96, 1.42-2.69) and to support a ban on advertising unhealthy food similar to that for tobacco products (OR, 95% CI: 1.66, 1.21-2.27). Respondents suffering from chronic diseases were also consistently more likely to show a greater understanding of the harmful impact of CDoH and support proposed restrictions. For example, they were more likely to agree with restrictions on advertising harmful products during sports events (OR, 95% CI: 1.23, 1.02-1.50) and the introduction of a sugar tax (OR, 95% CI: 1.26, 1.03-1.54). Our study revealed that more than 50% of the Polish population is conscious of the problem of the harmful effects of big industries producing and selling processed food, sugar-sweetened beverages, and alcoholic beverages. Interestingly, slightly more than half of the respondents supported the introduction of restrictions on advertising such products. Still, only approximately 30% of them accepted a sugar tax to counter the obesity epidemic. The results of our study indicate that Polish society is open to the introduction of regulations aimed at limiting the impact of commercial determinants of health. To our knowledge, this is one of the first studies to assess the awareness of CDoH and the acceptance of restrictions to limit their impact.
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Affiliation(s)
| | | | - Mariusz Duplaga
- Department of Health Promotion and e-Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Skawińska Str. 8, 31-066 Krakow, Poland; (U.Z.); (M.K.)
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Crocetti AC, Cubillo Larrakia B, Walker Yorta Yorta T, Mitchell Mununjali F, Paradies Wakaya Y, Backholer K, Browne J. 'A recipe for cultural disaster!'- a case study of Woolworths Group's proposal to build an alcohol megastore in Darwin, Northern Territory. Global Health 2023; 19:38. [PMID: 37301864 DOI: 10.1186/s12992-023-00938-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND The health and wellbeing impacts of commercial activity on Indigenous populations is an emerging field of research. The alcohol industry is a key driver of health and social harms within Australia. In 2016 Woolworths, the largest food and beverage retailer in Australia, proposed to build a Dan Murphy's alcohol megastore in Darwin, near three 'dry' Aboriginal communities. This study examines the tactics used by Woolworths to advance the Dan Murphy's proposal and understand how civil society action can overcome powerful commercial interests to protect Aboriginal and Torres Strait Islander health and wellbeing. METHODS Data from 11 interviews with Aboriginal and non-Aboriginal informants were combined with data extracted from media articles and government, non-government and industry documents. Thematic analysis was informed by an adapted corporate health impact assessment framework. RESULTS Woolworths employed several strategies including lobbying, political pressure, litigation, and divisive public rhetoric, while ignoring the evidence suggesting the store would increase alcohol-related harm. The advocacy campaign against the proposal highlighted the importance of Aboriginal and non-Aboriginal groups working together to counter commercial interests and the need to champion Aboriginal leadership. Advocacy strategies included elevating the voices of community Elders in the media and corporate activism via Woolworths' investors. CONCLUSIONS The strategies used by the coalition of Aboriginal and non-Aboriginal groups may be useful in future advocacy campaigns to safeguard Aboriginal and Torres Strait Islander health and wellbeing from commercial interests.
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Affiliation(s)
- Alessandro Connor Crocetti
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, VIC, Australia.
| | - Beau Cubillo Larrakia
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Troy Walker Yorta Yorta
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | | | - Yin Paradies Wakaya
- Deakin University, Alfred Deakin Institute for Citizenship and Globalisation, Burwood, VIC, Australia
| | - Kathryn Backholer
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Jennifer Browne
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, VIC, Australia
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Lacy-Nichols J, Williams O. Political Economy and Research Silos: A Response to the Recent Commentaries. Int J Health Policy Manag 2023; 12:7995. [PMID: 37579411 PMCID: PMC10461845 DOI: 10.34172/ijhpm.2023.7995] [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: 02/19/2023] [Accepted: 03/01/2023] [Indexed: 08/16/2023] Open
Affiliation(s)
- Jennifer Lacy-Nichols
- Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Owain Williams
- School of Politics and International Studies, University of Leeds, Leeds, UK
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Lacy-Nichols J, Nandi S, Mialon M, McCambridge J, Lee K, Jones A, Gilmore AB, Galea S, de Lacy-Vawdon C, de Carvalho CMP, Baum F, Moodie R. Conceptualising commercial entities in public health: beyond unhealthy commodities and transnational corporations. Lancet 2023; 401:1214-1228. [PMID: 36966783 DOI: 10.1016/s0140-6736(23)00012-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 09/25/2022] [Accepted: 12/23/2022] [Indexed: 04/07/2023]
Abstract
Most public health research on the commercial determinants of health (CDOH) to date has focused on a narrow segment of commercial actors. These actors are generally the transnational corporations producing so-called unhealthy commodities such as tobacco, alcohol, and ultra-processed foods. Furthermore, as public health researchers, we often discuss the CDOH using sweeping terms such as private sector, industry, or business that lump together diverse entities whose only shared characteristic is their engagement in commerce. The absence of clear frameworks for differentiating among commercial entities, and for understanding how they might promote or harm health, hinders the governance of commercial interests in public health. Moving forward, it is necessary to develop a nuanced understanding of commercial entities that goes beyond this narrow focus, enabling the consideration of a fuller range of commercial entities and the features that characterise and distinguish them. In this paper, which is the second of three papers in a Series on commercial determinants of health, we develop a framework that enables meaningful distinctions among diverse commercial entities through consideration of their practices, portfolios, resources, organisation, and transparency. The framework that we develop permits fuller consideration of whether, how, and to what extent a commercial actor might influence health outcomes. We discuss possible applications for decision making about engagement; managing and mitigating conflicts of interest; investment and divestment; monitoring; and further research on the CDOH. Improved differentiation among commercial actors strengthens the capacity of practitioners, advocates, academics, regulators, and policy makers to make decisions about, to better understand, and to respond to the CDOH through research, engagement, disengagement, regulation, and strategic opposition.
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Affiliation(s)
- Jennifer Lacy-Nichols
- Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, VIC, Australia.
| | - Sulakshana Nandi
- Public Health Resource Network, Chhattisgarh, India; People's Health Movement, New Delhi, India
| | - Melissa Mialon
- Trinity Business School, Trinity College Dublin, Dublin, Ireland
| | | | - Kelley Lee
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Alexandra Jones
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Anna B Gilmore
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Sandro Galea
- School of Public Health, Boston University, Boston, MA, USA
| | | | | | - Fran Baum
- Stretton Institute, University of Adelaide, Adelaide, SA, Australia
| | - Rob Moodie
- Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, VIC, 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: 105] [Impact Index Per Article: 105.0] [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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FREUDENBERG NICHOLAS. Framing Commercial Determinants of Health: An Assessment of Potential for Guiding More Effective Responses to the Public Health Crises of the 21 st Century. Milbank Q 2023; 101:83-98. [PMID: 37096607 PMCID: PMC10126974 DOI: 10.1111/1468-0009.12639] [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: 04/21/2022] [Revised: 09/27/2022] [Accepted: 01/06/2023] [Indexed: 04/26/2023] Open
Abstract
Policy Points The commercial determinants of health (CDH) framework can inform public health policy, practice, and research in ways that contribute to overcoming the world's most serious public health challenges. By documenting the pathways by which commercial actors shape health, the CDH framework can provide a unifying focus for collective action to prevent and ameliorate global health crises. To realize these opportunities, CDH proponents need to find synergies in the multiple emerging streams of research, practice, and advocacy and create a body of scientific evidence, methodologies, and ideas that can inform a public health practice for the 21st century.
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Bennett E, Topp SM, Moodie AR. National Public Health Surveillance of Corporations in Key Unhealthy Commodity Industries - A Scoping Review and Framework Synthesis. Int J Health Policy Manag 2023; 12:6876. [PMID: 37579395 PMCID: PMC10425693 DOI: 10.34172/ijhpm.2023.6876] [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: 10/20/2021] [Accepted: 01/02/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Corporations in unhealthy commodity industries (UCIs) have growing influence on the health of national populations through practices that lead to increased consumption of unhealthy products. The use of government-led public health surveillance is best practice to better understand any emerging public health threat. However, there is minimal systematic evidence, generated and monitored by national governments, regarding the scope of UCI corporate practices and their impacts. This study aims to synthesise current frameworks that exist to identify and monitor UCI influence on health to highlight the range of practices deployed by corporations and inform future surveillance efforts in key UCIs. METHODS Seven biomedical, business and scientific databases were searched to identify literature focused on corporate practices that impact human health and frameworks for monitoring or assessment of the way UCIs impact health. Content analysis occurred in three phases, involving (1) the identification of framework documents in the literature and extraction of all corporate practices from the frameworks; (2) initial inductive grouping and synthesis followed by deductive synthesis using Lima and Galea's 'vehicles of power' as a heuristic; and (3) scoping for potential indicators linked to each corporate practice and development of an integrated framework. RESULTS Fourteen frameworks were identified with 37 individual corporate practices which were coded into five different themes according the Lima and Galea 'Corporate Practices and Health' framework. We proposed a summary framework to inform the public health surveillance of UCIs which outlines key actors, corporate practices and outcomes that should be considered. The proposed framework draws from the health policy triangle framework and synthesises key features of existing frameworks. CONCLUSION Systematic monitoring of the practices of UCIs is likely to enable governments to mitigate the negative health impacts of corporate practices. The proposed synthesised framework highlights the range of practices deployed by corporations for public health surveillance at a national government level. We argue there is significant precedent and great need for monitoring of these practices and the operationalisation of a UCI monitoring system should be the object of future research.
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Affiliation(s)
- Elizabeth Bennett
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, VIC, Australia
| | - Stephanie M. Topp
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, VIC, Australia
| | - Alan Rob Moodie
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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Allen LN. Trust, but Verify Comment on "'Part of the Solution': Food Corporation Strategies for Regulatory Capture and Legitimacy". Int J Health Policy Manag 2022; 11:2727-2731. [PMID: 35247935 PMCID: PMC9818090 DOI: 10.34172/ijhpm.2022.7008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/06/2022] [Indexed: 01/21/2023] Open
Abstract
According to Lacy-Nichols and Williams, the food industry is increasingly forestalling regulation with incremental concessions and co-option of policy-making discourses and processes; bolstering their legitimacy via partnerships with credible stakeholders; and disarming critics by amending their product portfolios whilst maintaining high sales volumes and profits. Their assessment raises a number of fundamental philosophical questions that we must address in order to form an appropriate public health response: is it appropriate to treat every act of corporate citizenship with cynicism? If voluntary action leads to better health outcomes, does it matter whether profits are preserved? How should we balance any short-term benefits from industry-led reforms against the longer-term risk stemming from corporate capture of policy-making networks? I argue for a nuanced approach, focused on carefully defined health outcomes; allowing corporations the benefit of the doubt, but implementing robust binding measures the moment voluntary actions fail to meet independently set objectives.
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Affiliation(s)
- Luke N. Allen
- London School of Hygiene and Tropical Medicine, London, UK
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Zaltz DA, Bisi LE, Ruskin G, Hoe C. How independent is the international food information council from the food and beverage industry? A content analysis of internal industry documents. Global Health 2022; 18:91. [PMID: 36309701 PMCID: PMC9618198 DOI: 10.1186/s12992-022-00884-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 10/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background The International Food Information Council (IFIC) and its partner foundation (IFIC Foundation) widely disseminate nutrition information and participate in relevant policymaking processes. Prior research has established a connection between IFIC and large food and beverage companies, representing a potential conflict of interest. The authors reviewed public records documents to investigate the connection between IFIC and industry, and to describe how IFIC communicates policy-relevant information about nutrition science to the public. Methods The research team collected communications between IFIC and members of the research and policymaking communities by using state and federal transparency laws. The team analyzed the content of these documents with a commercial determinants of health framework while allowing for new themes to emerge, guided by the broad analytic questions of how and why does IFIC communicate nutrition information to policymakers and the broader public? Results IFIC employs self-designed research and media outreach to disseminate nutrition information. Communications from IFIC and its affiliates related to nutrition information fell within major themes of manufacturing doubt and preference shaping. Conclusions IFIC uses media outlets to preemptively counter information about the negative health impacts of added sugars and ultra-processed foods, and promotes a personal-responsibility narrative about dietary intake and health. IFIC and its affiliates disseminate a narrow subset of nutrition and health information consistent with corporate interests and in opposition to public health policies associated with improved population health. Supplementary Information The online version contains supplementary material available at 10.1186/s12992-022-00884-8.
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Anaf J, Baum F, Fisher M, Haigh F, Miller E, Gesesew H, Freudenberg N. Assessing the health impacts of transnational corporations: a case study of Carlton and United Breweries in Australia. Global Health 2022; 18:80. [PMID: 36085238 PMCID: PMC9462641 DOI: 10.1186/s12992-022-00870-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 08/02/2022] [Indexed: 11/10/2022] Open
Abstract
Background The practices of transnational corporations (TNCs) affect population health through unhealthy products, shaping social determinants of health, or influencing the regulatory structures governing their activities. There has been limited research on community exposures to TNC policies and practices. The aim of this paper was to adapt existing Health Impact Assessment methods that were previously used for both a fast food and an extractives industry corporation in order to assess Carlton and United Breweries (CUB) operations within Australia. CUB is an Australian alcohol company owned by a large transnational corporation Asahi Group Holdings. Data identifying potential impacts were sourced through document analysis, including corporate literature; media analysis, and 12 semi-structured interviews. The data were mapped against a corporate health impact assessment framework which included CUB’s political and business practices; products and marketing; workforce, social, environmental and economic conditions; and consumers’ adverse health impacts. We also conducted an ecological study for estimating alcohol attributable fractions and burdens of death due to congestive heart disease, diabetes mellitus, stroke, breast cancer, bowel cancer and injury in Australia. Beer attributable fractions and deaths and CUB’s share were also estimated. Results We found both positive and adverse findings of the corporation’s operations across all domains. CUB engage in a range of business practices which benefit the community, including sustainability goals and corporate philanthropy, but also negative aspects including from taxation arrangements, marketing practices, and political donations and lobbying which are enabled by a neoliberal regulatory environment. We found adverse health impacts including from fetal alcohol spectrum disorder and violence and aggression which disproportionately affect Indigenous and other disadvantaged populations. Conclusion Our research indicates that studying a TNC in a rapidly changing global financialised capitalist economy in a world which is increasingly being managed by TNCs poses methodological and conceptual challenges. It highlights the need and opportunity for future research. The different methods revealed sufficient information to recognise that strong regulatory frameworks are needed to help to avoid or to mediate negative health impacts. Supplementary Information The online version contains supplementary material available at 10.1186/s12992-022-00870-0.
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Affiliation(s)
- Julia Anaf
- Stretton Health Equity, Stretton Institute, North Tce Campus, University of Adelaide, Adelaide, 5005, Australia.
| | - Fran Baum
- Stretton Health Equity, Stretton Institute, North Tce Campus, University of Adelaide, Adelaide, 5005, Australia
| | - Matt Fisher
- Stretton Health Equity, Stretton Institute, North Tce Campus, University of Adelaide, Adelaide, 5005, Australia
| | - Fiona Haigh
- Health Equity Research Development Unit *HERDU, UNSW Centre for Primary Health Care and Equity (CPHCE), University of New South Wales, Sydney, 2052, Australia.,Clinical Services Integration and Population Health, Sydney Local Health District, Sydney, Australia
| | - Emma Miller
- College of Medicine and Public Health, Flinders University of South Australia, GPO Box 2100, Adelaide, South Australia, 5001
| | - Hailay Gesesew
- Torrens University Australia, 88 Wakefield St, Adelaide, South Australia, 5000
| | - Nicholas Freudenberg
- Graduate School of Public Health and Health Policy, City University of New York, New York, USA
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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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Wood B, Baker P, Sacks G. Conceptualising the Commercial Determinants of Health Using a Power Lens: A Review and Synthesis of Existing Frameworks. Int J Health Policy Manag 2022; 11:1251-1261. [PMID: 33619932 PMCID: PMC9808328 DOI: 10.34172/ijhpm.2021.05] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 01/16/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND There is increasing recognition that power imbalances that favour corporations, especially those active in unhealthy commodity industries, over other actors are central to the ways in which corporations influence population health. However, existing frameworks for analysing corporate strategies and practices that impact on health do not incorporate concepts of power in consistent ways. This paper aimed to review the ways in which corporate power has been incorporated into such frameworks, and to propose a revised framing of the commercial determinants of health (CDoH) that makes concepts of power explicit. METHODS We conducted a narrative review of frameworks that identify corporate strategies and practices and explain how these influence population health. Content analysis was conducted to identify explicit references to different qualities of power - its origins, nature, and manifestations. RESULTS Twenty-two frameworks were identified, five of which used theories of power. A wide range of contexts that shape, and are shaped by corporate power were discussed, as were a diversity of corporate, social and ecological outcomes. A variety of material and ideational sources of power was also covered. We proposed an integrated 'Corporate Power and Health' framework to inform analysis of the CDoH, organised around key questions on power set out by Foucault. The proposed framework draws from a number of well-established corporate power theories and synthesises key features of existing CDoH frameworks. CONCLUSION Public health advocates, researchers and policy-makers would likely be better placed to understand and address the CDoH by engaging with theories of power to a greater extent, and by explicitly incorporating concepts of corporate power in analyses of how the deployment of corporate strategies and practices influence population health.
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Affiliation(s)
- Benjamin Wood
- Global Obesity Centre, Deakin University, Geelong, VIC, Australia
| | - Phillip Baker
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Gary Sacks
- Global Obesity Centre, Deakin University, Geelong, VIC, Australia
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14
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Montiel I, Park J, Husted BW, Velez-Calle A. Tracing the connections between international business and communicable diseases. JOURNAL OF INTERNATIONAL BUSINESS STUDIES 2022; 53:1785-1804. [PMID: 35345569 PMCID: PMC8942389 DOI: 10.1057/s41267-022-00512-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 06/14/2023]
Abstract
We posit that international business and the emergence and spread of communicable diseases are intrinsically connected. To support our arguments, we first start with a historical timeline that traces the connections between international business and communicable diseases back to the sixth century. Second, following the epidemiology of communicable diseases, we identify two crucial transitions related to international business: the emergence of epidemics within a host country and the shift from epidemics to global pandemics. Third, we highlight international business contextual factors (host country regulatory quality, urbanization, trade barriers, global migration) and multinationals' activities (foreign direct investment, corporate political activity, global supply chain management, international travel) that could accelerate each transition. Finally, building on public health insights, we suggest research implications for business scholars on how to integrate human health challenges into their studies and practical implications for global managers on how to help prevent the emergence and spread of communicable diseases.
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Affiliation(s)
- Ivan Montiel
- Baruch College, Zicklin School of Business, The City University of New York, 55 Lexington Ave at 24th Street, New York, NY 10010 USA
| | - Junghoon Park
- Baruch College, Zicklin School of Business, The City University of New York, 55 Lexington Ave at 24th Street, New York, NY 10010 USA
| | - Bryan W. Husted
- Tecnológico de Monterrey, EGADE Business School, Eugenio Garza Lagüera & Rufino Tamayo, Valle Oriente, 66269 San Pedro Garza García, Nuevo León Mexico
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15
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Grundy Q, Parker L, Wong A, Fusire T, Dimancesco D, Tisocki K, Walkowiak H, Vian T, Kohler J. Disclosure, transparency, and accountability: a qualitative survey of public sector pharmaceutical committee conflict of interest policies in the World Health Organization South-East Asia Region. Global Health 2022; 18:33. [PMID: 35303902 PMCID: PMC8931570 DOI: 10.1186/s12992-022-00822-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Weak governance over public sector pharmaceutical policy and practice limits access to essential medicines, inflates pharmaceutical prices, and wastes scarce health system resources. Pharmaceutical systems are technically complex and involve extensive interactions between the private and public sectors. For members of public sector pharmaceutical committees, relationships with the private sector can result in conflicts of interest, which may introduce commercial biases into decision-making, potentially compromising public health objectives and health system sustainability. We conducted a descriptive, qualitative study of conflict of interest policies and practices in the public pharmaceutical sector in ten countries in the World Health Organization (WHO) South-East Asia Region (SEAR) (Bangladesh, Bhutan, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, and Timor-Leste) between September 2020 and March 2021. RESULTS We identified 45 policy and regulatory documents and triangulated documentary data with 21 expert interviews. Key informants articulated very different governance priorities and conflict of interest concerns depending on the features of their country's pharmaceutical industry, market size, and national economic objectives related to the domestic pharmaceutical industry. Public sector pharmaceutical policies and regulations consistently contained provisions for pharmaceutical committee members to disclose relevant interests, but contained little detail about what should be declared, when, and how often, nor whether disclosures are evaluated and by whom. Processes for preventing or managing conflicts of interest were less well developed than those for disclosure except for a few key procurement processes. Where processes for managing conflicts of interest were specified, the dominant strategy was to recuse committee members with a conflict of interest from relevant work. Policies rarely specified that committee members should divest or otherwise be free from conflicts of interest. CONCLUSIONS Robust processes for conflict of interest prevention and management could ensure the integrity of decision-making and build public trust in pharmaceutical processes to achieve public health objectives. Upstream approaches including supportive legislative frameworks, the creation of oversight bodies, and strengthening regulatory institutions can also contribute to building cultures of transparency, accountability, and trust.
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Affiliation(s)
- Quinn Grundy
- University of Toronto, Suite 130, 155 College Street, Toronto, M5T 1P8, Canada.
| | | | - Anna Wong
- University of Toronto, Suite 130, 155 College Street, Toronto, M5T 1P8, Canada
| | - Terence Fusire
- World Health Organization, South East Asia Region Office, New Delhi, India
| | | | | | - Helena Walkowiak
- USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Arlington, USA
| | - Taryn Vian
- University of San Francisco, San Francisco, USA
| | - Jillian Kohler
- University of Toronto, Suite 130, 155 College Street, Toronto, M5T 1P8, Canada
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16
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Abstract
WHO has a pivotal role in reducing health inequities but faces five fundamental constraints to progress, argue Unni Gopinathan and Kent Buse
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Affiliation(s)
- Unni Gopinathan
- Cluster for Global Health, Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Kent Buse
- Healthier Societies Programme, George Institute for Global Health, Imperial College London, London, UK
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17
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Lee K, Freudenberg N, Zenone M, Smith J, Mialon M, Marten R, Lima JM, Friel S, Klein DE, Crosbie E, Buse K. Measuring the Commercial Determinants of Health and Disease: A Proposed Framework. INTERNATIONAL JOURNAL OF HEALTH SERVICES : PLANNING, ADMINISTRATION, EVALUATION 2022; 52:115-128. [PMID: 34723675 PMCID: PMC8592108 DOI: 10.1177/00207314211044992] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 07/27/2021] [Indexed: 01/03/2023]
Abstract
The commercial determinants of health (CDoH) describe the adverse health effects associated with for-profit actors and their actions. Despite efforts to advance the definition, conceptualization, and empirical analyses of CDoH, the term's practical application to mitigate these effects requires the capacity to measure the influences of specific components of CDoH and the cumulative impacts of CDoH on the health and well-being of specific populations. Building on the Global Burden of Disease Study, we begin by conceptualizing CDoH as risk factor exposures that span agency and structural influences. We identify 6 components of these influences and propose an initial set of indicators and datasets to rank exposures as high, medium, or low. These are combined into a commercial determinants of health index (CDoHi) and illustrated by 3 countries. Although now a proof of concept, comparative analysis of CDoH exposures by population, over time and space, and their associated health outcomes will become possible with further development of indicators and datasets. Expansion of the CDoHi and application to varied populations groups will enable finer targeting of interventions to reduce health harms. The measurement of improvements to health and wellness from such interventions will, in turn, inform overall efforts to address the CDoH.
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Affiliation(s)
- Kelley Lee
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | | | - Marco Zenone
- London School of Hygiene & Tropical Medicine, London, UK
| | - Julia Smith
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Melissa Mialon
- Trinity Business School, Trinity College Dublin, Dublin, Ireland
| | - Robert Marten
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
| | | | - Sharon Friel
- School of Regulation and Global Governance, Australian National University, Canberra, Australia
| | | | - Eric Crosbie
- School of Public Health, University of Nevada Reno, Reno, USA
| | - Kent Buse
- George Institute for Global Health UK, Imperial College London, London, UK
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18
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Jabot F. L’évaluation d’impact sur la santé pour scruter et sculpter les politiques. SANTE PUBLIQUE 2021; Vol. 33:7-16. [PMID: 34372643 DOI: 10.3917/spub.211.0007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Health impact assessment (HIA) is a prospective approach that consists of identifying the potential consequences, both negative and positive, of an intervention on the health of populations with the aim of improving it. Identified as a specific practice in 1999, it rapidly gained in popularity and was progressively deployed on all continents with variations in terms of implementation strategies, area of application, scales of implementation, modes of governance, institutions and actors involved. It is currently booming in France and Quebec, where it is generating real expectations with regard to the issues of health inequalities, democracy and the coordination of sectoral policies. This article, based on our research, provides a brief portrait of HIA in France and introduces questions on the strengths, limitations and added-value of the approach. This special issue sheds light on the practice through applications in different fields and contexts, emphasizes the methodological, political and social issues related to the process as well as the challenges to be met in order to strengthen the potential of HIA to improve decision-making and develop policies and projects that promote health.
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19
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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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20
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Legg T, Hatchard J, Gilmore AB. The Science for Profit Model-How and why corporations influence science and the use of science in policy and practice. PLoS One 2021; 16:e0253272. [PMID: 34161371 PMCID: PMC8221522 DOI: 10.1371/journal.pone.0253272] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 06/01/2021] [Indexed: 12/15/2022] Open
Abstract
Science has been at the centre of attempts by major industries, including tobacco, chemical, and pharmaceutical, to delay progress in tackling threats to human and planetary health by, inter alia, obscuring industry harms, and opposing regulation. Some aspects of this influence are well documented, others remain poorly understood, and similarities between industries remain underexplored. This study, therefore, aims to synthesise the literature to develop an evidence-based typology and model of corporate influence on science in order to provide an overview of this multi-faceted phenomenon. We obtained literature examining corporate attempts to influence science and the use of science in policy and practice from: database searches, bibliographies, expert recommendations, and web alerts; using a modified scoping review methodology (n = 68). Through interpretive analysis we developed the Science for Profit Typology and Model. We identified eight corporate sectors repeatedly engaging in activities to influence science, including: manipulation of scientific methods; reshaping of criteria for establishing scientific "proof"; threats against scientists; and clandestine promotion of policy reforms that increase reliance on industry evidence. The typology identifies five macro-level strategies used consistently across the eight industries, comprising 19 meso-level strategies. The model shows how these strategies work to maximise the volume, credibility, reach, and use of industry-favourable science, while minimising these same aspects of industry-unfavourable science. This creates doubt about harms of industry products/practices or efficacy of policies affecting industry; promotes industry-favoured policy responses and industry products as solutions; and legitimises industry's role as scientific stakeholder. These efforts ultimately serve to weaken policy, prevent litigation, and maximise use of industry products/practices-maximising corporate profitability. We provide an accessible way to understand how and why corporations influence science, demonstrate the need for collective solutions, and discuss changes needed to ensure science works in the public interest.
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Affiliation(s)
- Tess Legg
- Department for Health, Tobacco Control Research Group, University of Bath, Bath, United Kingdom
| | - Jenny Hatchard
- Department for Health, Tobacco Control Research Group, University of Bath, Bath, United Kingdom
| | - Anna B. Gilmore
- Department for Health, Tobacco Control Research Group, University of Bath, Bath, United Kingdom
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21
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Van Dam I, Wood B, Sacks G, Allais O, Vandevijvere S. A detailed mapping of the food industry in the European single market: similarities and differences in market structure across countries and sectors. Int J Behav Nutr Phys Act 2021; 18:54. [PMID: 33902639 PMCID: PMC8074488 DOI: 10.1186/s12966-021-01117-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 03/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Food environments are influenced by food industries (packaged food and non-alcoholic beverage manufacturers; supermarkets and quick service restaurants). An important source of this influence is the significant market power held by a limited number of food companies. Market structure analysis, as part of a broader market power research agenda, has received limited attention from the public health community. The aim of this study was to analyse similarities and differences in market structure across countries and industries in the European Single Market. METHODS The companies with the largest market share at the national level for each industry were identified from Euromonitor sales data in 2017/18. The market structure was assessed by the following metrics: the number of global brand owners with ≥1% market share per country, the number of companies unique for one European Single Market member state, the most sold packaged food and non-alcoholic beverage categories, the number of quick-service restaurants and supermarkets per 1000 inhabitants and market concentration by means of the Herfindahl-Hirschman Index (HHI) and the four firm concentration ratio (CR4). CR4-values > 40% and HHI-values > 2000 indicate concentrated markets with limited competition. RESULTS The leading packaged food and non-alcoholic beverage manufacturers and the most sold food and beverage product categories were similar across countries in Europe. The observed levels of concentration were however different. Average CR4-values ranged from 21 to 72% among packaged food product markets and 60 to 76% for non-alcoholic beverage product markets. Average CR4-values for quick service restaurants and supermarkets were 50 and 60%, respectively. Across European countries the same leading quick-service restaurants were identified, while this was not the case for supermarkets. CONCLUSIONS This study forms an important basis to understand key aspects of market structure of the European food industry, observing clear differences between food industries and European Single Market member states. This has potential implications for the implementation of food environment policies at different levels of jurisdiction.
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Affiliation(s)
- Iris Van Dam
- Sciensano, Service of Lifestyle and chronic diseases, Brussels, Belgium
- Université Paris-Saclay, INRAE, UR ALISS, 94205 Ivry-sur-Seine, France
| | - Benjamin Wood
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC 3220 Australia
| | - Gary Sacks
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC 3220 Australia
| | - Olivier Allais
- Université Paris-Saclay, INRAE, UR ALISS, 94205 Ivry-sur-Seine, France
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22
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Anaf J, Baum F, Fisher M, Friel S. Civil society action against transnational corporations: implications for health promotion. Health Promot Int 2021; 35:877-887. [PMID: 31504470 DOI: 10.1093/heapro/daz088] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Transnational corporations (TNCs) shape population health both positively and negatively through their national and international social, political and economic power and influence; and are a vital commercial determinant of health. Individual and group advocacy and activism in response to corporate products, practices or policy influences can mediate negative health impacts. This paper discusses the unequal power relations existing between TNCs that promote their own financial interests, and activists and advocates who support population and environmental health by challenging corporate power. It draws on interview data from 19 respondents who informed 2 health impact assessments conducted on TNCs; 1 from the fast food industry, and 1 from the extractive industries sector. It reveals the types of strategies that civil society organizations (CSOs) have used to encourage TNCs to act in more health promoting ways. It discusses the extent to which these strategies have been effective, and how TNCs have used their power to respond to civil society action. The paper highlights the rewards, and the very real challenges faced by CSOs trying to change TNC practices related to health, within a neoliberal policy environment. It aims to provide evidence for socially oriented actors to inform their advocacy for changes in public policy or corporate practices that can contribute to improving population health and equity and tackling commercial determinants of health.
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Affiliation(s)
- Julia Anaf
- Southgate Institute for Health, Society and Equity, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, South Australia 5042, Australia
| | - Fran Baum
- Southgate Institute for Health, Society and Equity, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, South Australia 5042, Australia
| | - Matthew Fisher
- Southgate Institute for Health, Society and Equity, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, South Australia 5042, Australia
| | - Sharon Friel
- School of Regulation and Global Governance (RegNet), College of Asia and the Pacific, Menzies Centre for Health Policy, The Australian National University, Canberra, ACT 0200, Australia
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23
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Nikogosian H. The interface of multisectoral and multilateral dimensions of public health policy: what's new in the 21st century? J Public Health (Oxf) 2021; 44:349-355. [PMID: 33512497 DOI: 10.1093/pubmed/fdaa274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 12/18/2020] [Accepted: 12/26/2020] [Indexed: 11/14/2022] Open
Abstract
The article examines key developments unfolding in the 21st century in the intersection of multisectoral and multilateral dimensions of public health policy. Several processes and mechanisms, relatively new or rapidly evolving, are fuelling this dynamic interface. They include, in particular, expansion of the spectrum of sectors involved in the health domain, the upsurge of trans-border and commercial determinants of health, growing presence of health issues in multilateral instruments and processes that are outside of the health sector, and strengthening the legal base of intersectoral relations and responsibilities for health. They also encompass and reflect important transformations in health diplomacy and governance for health, some of the fundamentals of contemporary public and global health. The article argues that overall, multisectoral and multilateral dimensions tend to interact, inform and reinforce each other, and that such interaction would be one of important drivers of 21st century intersectoral policy-and international cooperation-for health.
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Affiliation(s)
- Haik Nikogosian
- Graduate Institute of International and Development Studies - Global Health Centre, Geneva 1211, Switzerland
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24
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Wood B, Williams O, Nagarajan V, Sacks G. Market strategies used by processed food manufacturers to increase and consolidate their power: a systematic review and document analysis. Global Health 2021; 17:17. [PMID: 33499883 PMCID: PMC7836045 DOI: 10.1186/s12992-021-00667-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/18/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The public health community has become increasingly critical of the role that powerful corporations play in driving unhealthy diets, one of the leading contributors to the global burden of disease. While a substantial amount of work has examined the political strategies used by dominant processed food manufacturers that undermine public health, less attention has been paid to their use of market strategies to build and consolidate power. In this light, this paper aimed to systematically review and synthesise the market strategies deployed by dominant processed food manufacturers to increase and consolidate their power. METHODS A systematic review and document analysis of public health, business, legal and media content databases (Scopus, Medline, ABI Inform, Business Source Complete, Thomas Reuters Westlaw, Lexis Advance, Factiva, NewsBank), and grey literature were conducted. Data extracted were analysed thematically using an approach informed by Porter's 'Five Forces' framework. RESULTS 213 documents met inclusion criteria. The market strategies (n=21) and related practices of dominant processed food manufacturers identified in the documents were categorised into a typological framework consisting of six interconnected strategic objectives: i) reduce intense competition with equivalent sized rivals and maintaining dominance over smaller rivals; ii) raise barriers to market entry by new competitors; iii) counter the threat of market disruptors and drive dietary displacement in favour of their products; iv) increase firm buyer power over suppliers; v) increase firm seller power over retailers and distributors; and vi) leverage informational power asymmetries in relations with consumers. CONCLUSIONS The typological framework is well-placed to inform general and jurisdiction-specific market strategy analyses of dominant processed food manufacturers, and has the potential to assist in identifying countervailing public policies, such as those related to merger control, unfair trading practices, and public procurement, that could be used to address market-power imbalances as part of efforts to improve population diets.
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Affiliation(s)
- Benjamin Wood
- Global Obesity Centre, Deakin University, Melbourne, Australia.
| | - Owain Williams
- School of Political Science and International Studies, University of Leeds, Leeds, UK
| | | | - Gary Sacks
- Global Obesity Centre, Deakin University, Melbourne, Australia
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25
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Hawkes S, Buse K. COVID-19 and the gendered markets of people and products: explaining inequalities in infections and deaths. REVUE CANADIENNE D'ETUDES DU DEVELOPPEMENT = CANADIAN JOURNAL OF DEVELOPMENT STUDIES 2020; 42:37-54. [PMID: 35475122 PMCID: PMC7612661 DOI: 10.1080/02255189.2020.1824894] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 09/02/2020] [Indexed: 06/01/2023]
Abstract
COVID-19 has exposed and exploited existing inequalities in gender to drive inequities in health outcomes. Evidence illustrates the relationship between occupation, ethnicity and gender to increase risk of infection in some places. Higher death rates are seen among people also suffering from non-communicable diseases - e.g. heart disease and lung disease driven by exposure to harmful patterns of exposure to corporate products (tobacco, alcohol, ultra-processed foods), corporate by-products (e.g. outdoor air pollution) or gendered corporate processes (e.g. gendered occupational risk). The paper argues that institutional gender blindness in the health system means that underlying gender inequalities have not been taken into consideration in policies and programmatic responses to COVID-19.
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Affiliation(s)
- Sarah Hawkes
- Institute for Global Health, University College London, London, UK
| | - Kent Buse
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
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26
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Mialon M. An overview of the commercial determinants of health. Global Health 2020; 16:74. [PMID: 32807183 PMCID: PMC7433173 DOI: 10.1186/s12992-020-00607-x] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 08/05/2020] [Indexed: 12/20/2022] Open
Abstract
Background Different terms are described in the literature that refer to commercial determinants as drivers of ill-health. The aim of the present review was to provide an overview of the commercial determinants of health, through a review of the literature on this subject. The review was conducted in December 2019 and updated in February 2020. Searches were conducted from peer-reviewed scientific articles, commentaries, books, and books chapters, with no restriction in their publication dates and languages. Main body The commercial determinants of health cover three areas. First, they relate to unhealthy commodities that are contributing to ill-health. Secondly, they include business, market and political practices that are harmful to health and used to sell these commodities and secure a favourable policy environment. Finally, they include the global drivers of ill-health, such as market-driven economies and globalisation, that have facilitated the use of such harmful practices. Short conclusion The discussion on the commercial determinants of health offers a unique opportunity to shift the dominant paradigm in public health, where individual behaviours are considered to be driven by inadequate environments. Ill-health, damages to the environment, and health and social inequalities, might be better understood through a commercial determinant lens.
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Affiliation(s)
- Melissa Mialon
- School of Public Health, University of São Paulo, São Paulo, Brazil.
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Maani N, Collin J, Friel S, Gilmore AB, McCambridge J, Robertson L, Petticrew MP. Bringing the commercial determinants of health out of the shadows: a review of how the commercial determinants are represented in conceptual frameworks. Eur J Public Health 2020; 30:660-664. [PMID: 31953933 PMCID: PMC7445044 DOI: 10.1093/eurpub/ckz197] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The term 'commercial determinants of health' (CDOH) is increasingly focussing attention upon the role of tobacco, alcohol and food and beverage companies and others-as important drivers of non-communicable diseases (NCDs). However, the CDOH do not seem to be clearly represented in the most common social determinants of health (SDOH) frameworks. We review a wide range of existing frameworks of the determinants of health to determine whether and how commercial determinants are incorporated into current SDOH thinking. METHODS We searched for papers and non-academic reports published in English since 2000 describing influences on population health outcomes. We included documents with a formal conceptual framework or diagram, showing the integration of the different determinants. RESULTS Forty-eight framework documents were identified. Only one explicitly included the CDOH in a conceptual diagram. Ten papers discussed the commercial determinants in some form in the text only and fourteen described negative impacts of commercial determinants in the text. Twelve discussed positive roles for the private sector in producing harmful commodities. Overall, descriptions of commercial determinants are frequently understated, not made explicit, or simply missing. The role of commercial actors as vectors of NCDs is largely absent or invisible in many of the most influential conceptual diagrams. CONCLUSIONS Our current public health models may risk framing public health problems and solutions in ways that obscure the role that the private sector, in particular large transnational companies, play in shaping the broader environment and individual behaviours, and thus population health outcomes.
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Affiliation(s)
- Nason Maani
- London School of Hygiene and Tropical Medicine, London, UK
- School of Public Health, Boston University, Boston, MA, USA
| | - Jeff Collin
- Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, Edinburgh, UK
- SPECTRUM Consortium, UK
| | - Sharon Friel
- SPECTRUM Consortium, UK
- School of Regulation and Global Governance (RegNet), College of Asia and the Pacific, The Australian National University, Canberra, ACT, Australia
| | - Anna B Gilmore
- SPECTRUM Consortium, UK
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Jim McCambridge
- Department of Health Sciences, University of York, Heslington, York, UK
| | - Lindsay Robertson
- SPECTRUM Consortium, UK
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Mark P Petticrew
- London School of Hygiene and Tropical Medicine, London, UK
- SPECTRUM Consortium, UK
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Mialon M, Vandevijvere S, Carriedo-Lutzenkirchen A, Bero L, Gomes F, Petticrew M, McKee M, Stuckler D, Sacks G. Mechanisms for addressing and managing the influence of corporations on public health policy, research and practice: a scoping review. BMJ Open 2020; 10:e034082. [PMID: 32690498 PMCID: PMC7371213 DOI: 10.1136/bmjopen-2019-034082] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE We identified mechanisms for addressing and/or managing the influence of corporations on public health policy, research and practice, as well as examples of where these mechanisms have been adopted from across the globe. DESIGN We conducted a scoping review. We conducted searches in five databases on 4 June 2019. Twenty-eight relevant institutions and networks were contacted to identify additional mechanisms and examples. In addition, we identified mechanisms and examples from our collective experience working on the influence of corporations on public health policy, research and practice. SETTING We identified mechanisms at the national, regional and global levels. RESULTS Thirty-one documents were included in our review. Eight were peer-reviewed scientific articles. Nine discussed mechanisms to address and/or manage the influence of different types of industries; while other documents targeted specific industries. In total, we identified 49 mechanisms for addressing and/or managing the influence of corporations on public health policy, research and practice, and 43 of these were adopted at the national, regional or global level. We identified four main types of mechanisms: transparency; management of interactions with industry and of conflicts of interest; identification, monitoring and education about the practices of corporations and associated risks to public health; prohibition of interactions with industry. Mechanisms for governments (n=17) and academia (n=13) were most frequently identified, with fewer for the media and civil society. CONCLUSIONS We identified several mechanisms that could help address and/or manage the negative influence of corporations on public health policy, research and practice. If adopted and evaluated more widely, many of the mechanisms described in this manuscript could contribute to efforts to prevent and control non-communicable diseases. TRIAL REGISTRATION DETAILS The protocol was registered with the Open Science Framework on 27 May 2019 (https://osf.io/xc2vp).
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Affiliation(s)
- Melissa Mialon
- School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
- School of Nutrition and Dietetics, University of Antioquia, Medellin, Colombia
| | | | | | - Lisa Bero
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Fabio Gomes
- Pan American Health Organization, Washington, District of Columbia, USA
| | - Mark Petticrew
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, London, UK
| | - Martin McKee
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, London, UK
| | - David Stuckler
- Dondena Research Centre and Department of Policy Analysis and Public Management, Bocconi University, Milano, Lombardia, Italy
| | - Gary Sacks
- Global Obesity Centre, Deakin University, Burwood, Victoria, Australia
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McCambridge J, Kypri K, Sheldon TA, Madden M, Babor TF. Advancing public health policy making through research on the political strategies of alcohol industry actors. J Public Health (Oxf) 2020; 42:262-269. [PMID: 31220307 PMCID: PMC7297281 DOI: 10.1093/pubmed/fdz031] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 02/04/2019] [Indexed: 12/16/2022] Open
Abstract
Development and implementation of evidence-based policies is needed in order to ameliorate the rising toll of non-communicable diseases (NCDs). Alcohol is a key cause of the mortality burden and alcohol policies are under-developed. This is due in part to the global influence of the alcohol industry. We propose that a better understanding of the methods and the effectiveness of alcohol industry influence on public health policies will support efforts to combat such influence, and advance global health. Many of the issues on the research agenda we propose will inform, and be informed by, research into the political influence of other commercial actors.
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Affiliation(s)
- Jim McCambridge
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK
| | - Kypros Kypri
- School of Medicine & Public Health, University of Newcastle, Australia
| | - Trevor A Sheldon
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK
| | - Mary Madden
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK
| | - Thomas F Babor
- Department of Community Medicine and Health Care, UConn Health, Farmington, Connecticut
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Walls H, Cook S, Matzopoulos R, London L. Advancing alcohol research in low-income and middle-income countries: a global alcohol environment framework. BMJ Glob Health 2020; 5:e001958. [PMID: 32377401 PMCID: PMC7199708 DOI: 10.1136/bmjgh-2019-001958] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 03/03/2020] [Accepted: 03/27/2020] [Indexed: 11/12/2022] Open
Abstract
Alcohol-related harm has gained increased attention in high-income countries (HICs) in recent years which, alongside government regulation, has effected a reduction in alcohol consumption. The alcohol industry has turned its attention to low-income and middle-income country (LMIC) markets as a new source of growth and profit, prompting increased consumption in LMICS. Alcohol use in LMICs is also increasing. There is a need to understand particularly in LMICs the impact of industry strategy in shaping local contexts of alcohol use. We draw on conceptualisations from food systems research, and research on the commercial determinants of health, to develop a new approach for framing alcohol research and discuss implications for alcohol research, particularly in LMICs, focusing on South Africa as an illustrative example. We propose a conceptualisation of the ‘alcohol environment’ as the system of alcohol provision, acquisition and consumption—including, critically, industry advertising and marketing—along with the political, economic and regulatory context of the alcohol industry that mediates people’s alcohol drinking patterns and behaviours. While each country and region is different in terms of its context of alcohol use, we contrast several broadly distinct features of alcohol environments in LMICs and HICs. Improving understanding of the full spectrum of influences on drinking behaviour, particularly in LMICs, is vital to inform the design of interventions and policies to facilitate healthier environments and reduce the harms associated with alcohol consumption. Our framework for undertaking alcohol research may be used to structure mixed methods empirical research examining the role of the alcohol environment particularly in LMICs.
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Affiliation(s)
- Helen Walls
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Sarah Cook
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Richard Matzopoulos
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa.,School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Leslie London
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Rincón-Gallardo Patiño S, Rajamohan S, Meaney K, Coupey E, Serrano E, Hedrick VE, da Silva Gomes F, Polys N, Kraak V. Development of a Responsible Policy Index to Improve Statutory and Self-Regulatory Policies that Protect Children's Diet and Health in the America's Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020495. [PMID: 31941054 PMCID: PMC7013653 DOI: 10.3390/ijerph17020495] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 01/06/2020] [Accepted: 01/09/2020] [Indexed: 01/15/2023]
Abstract
In 2010, 193 Member States of the World Health Organization (WHO) endorsed World Health Assembly Resolution WHA63.14 to restrict the marketing of food and beverage products high in fat, sugar and salt (HFSS) to children to prevent obesity and non-communicable diseases (NCDs). No study has examined HFSS marketing policies across the WHO regional office countries in the Americas. Between 2018 and 2019, a transdisciplinary team examined policies to restrict HFSS food and beverage product marketing to children to develop a responsible policy index (RESPI) that provides a quality score based on policy characteristics and marketing techniques. After designing the RESPI, we conducted a comprehensive literature review through October 2019 to examine policies in 14 countries in the WHO Americans Region. We categorized policies (n = 38) as either self-regulatory or statutory and calculated the RESPI scores, ranked from 0 (lowest) to 10 (highest). Results showed Brazil, Canada, Chile, and Uruguay had the highest RESPI scores associated with statutory policies that restricted point of sale, cartoon, licensed media characters and celebrities; and HFSS products in schools and child care settings, and broadcast and print media. Policymakers can use the RESPI tool to evaluate marketing policies within and across geopolitical boundaries to protect children's diet and health.
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Affiliation(s)
- Sofía Rincón-Gallardo Patiño
- Department of Human Nutrition, Foods, and Exercise, College of Agriculture and Life Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (E.S.); (V.E.H.); (V.K.)
- Correspondence: ; Tel.: +1-540-831-9719
| | - Srijith Rajamohan
- Advanced Research Computing, Information Technology, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (S.R.); (N.P.)
| | - Kathleen Meaney
- School of Visual Arts, College of Architecture and Urban Studies, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA;
| | - Eloise Coupey
- Department of Marketing, Pamplin College of Business, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA;
| | - Elena Serrano
- Department of Human Nutrition, Foods, and Exercise, College of Agriculture and Life Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (E.S.); (V.E.H.); (V.K.)
| | - Valisa E. Hedrick
- Department of Human Nutrition, Foods, and Exercise, College of Agriculture and Life Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (E.S.); (V.E.H.); (V.K.)
| | - Fabio da Silva Gomes
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, World Health Organization, Washington, DC 20037, USA;
| | - Nicholas Polys
- Advanced Research Computing, Information Technology, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (S.R.); (N.P.)
| | - Vivica Kraak
- Department of Human Nutrition, Foods, and Exercise, College of Agriculture and Life Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (E.S.); (V.E.H.); (V.K.)
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Pradyumna A, Egal F, Utzinger J. Sustainable food systems, health and infectious diseases: Concerns and opportunities. Acta Trop 2019; 191:172-177. [PMID: 30605627 DOI: 10.1016/j.actatropica.2018.12.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/27/2018] [Accepted: 12/30/2018] [Indexed: 11/17/2022]
Abstract
Food systems have been identified as one of the key issues in the 2030 Agenda for Sustainable Development. Hence, food systems are embodied in the Sustainable Development Goals (SDGs) with a range of ramifications on different goals and targets. Current food systems practices are exposing the vulnerability of populations to various health issues. Indeed, several health challenges, such as malnutrition, infectious diseases, antimicrobial resistance and non-communicable diseases, are caused by existing food systems practices. There is growing awareness of the seriousness of the situation across sectors, including the public health community. The recommended paradigm shift in agriculture and diet are already underway at smaller scales through local efforts. Engaging with food systems towards health, equity, sustainability and resilience is a major opportunity for, as well as responsibility of, the public health community and asks for a training, research, monitoring and advocating role to be played towards policy reform and intersectoral action.
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Affiliation(s)
- Adithya Pradyumna
- Swiss Tropical and Public Health Institute, CH-4002 Basel, Switzerland; University of Basel, CH-4001 Basel, Switzerland.
| | | | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, CH-4002 Basel, Switzerland; University of Basel, CH-4001 Basel, Switzerland
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Anaf J, Baum F, Fisher M, London L. The health impacts of extractive industry transnational corporations: a study of Rio Tinto in Australia and Southern Africa. Global Health 2019; 15:13. [PMID: 30782175 PMCID: PMC6379971 DOI: 10.1186/s12992-019-0453-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 01/29/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Operations of transnational corporations (TNCs) affect population health through production methods, shaping social determinants of health, or by influencing regulation of their activities. Research on community exposures to TNC practices and policies has been limited. Our research on extractive industries examined Rio Tinto in Australia and Southern Africa to test methods for assessing the health impacts of corporates in high and middle income jurisdictions with different regulatory frameworks. METHODS We adapted existing Health Impact Assessment methods. Data identifying potential impacts were sourced through media analysis, document analysis, company literature and semi-structured interviews. The data were mapped against a corporate health impact assessment framework (CHIA) which included Rio Tinto's political and business practices; productions; and workforce, social, environmental and economic conditions. RESULTS Both positive and detrimental aspects of Rio Tinto's operations were identified. Requirements imposed by Rio Tinto on its global supply chain are likely to have positive health impacts for workers. However, political lobbying and membership of representative organisations can influence government policy in ways that are unfavourable to health and equity. Positive impacts include provision of direct employment under decent working conditions, but countered by an increase in precariousness of employment. Commitments to upholding sustainable development principles are undermined by limited site remediation and other environmental impacts. Positive contributions are made to national and local economies but then undermined by business strategies that include tax minimisation. CONCLUSION Our study confirmed that it is possible to undertake a CHIA on an extractive industry TNC. The different methods provided sufficient information to understand the need to strengthen regulations that are conducive to health; the opportunity for Rio Tinto to extend corporate responsibility initiatives and support their social licence to operate; and for civil society actors to inform their advocacy towards improving health and equity outcomes from TNC operations.
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Affiliation(s)
- Julia Anaf
- Southgate Institute for Health, Society and Equity, Flinders University, GPO Box 2001, Adelaide, SA 5001 Australia
| | - Frances Baum
- Southgate Institute for Health, Society and Equity, Flinders University, GPO Box 2001, Adelaide, SA 5001 Australia
| | - Matt Fisher
- Southgate Institute for Health, Society and Equity, Flinders University, GPO Box 2001, Adelaide, SA 5001 Australia
| | - Leslie London
- Department of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Buse CG, Lai V, Cornish K, Parkes MW. Towards environmental health equity in health impact assessment: innovations and opportunities. Int J Public Health 2018; 64:15-26. [PMID: 29911285 DOI: 10.1007/s00038-018-1135-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 06/05/2018] [Accepted: 06/07/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES As global environmental change drives inequitable health outcomes, novel health equity assessment methodologies are increasingly required. We review literatures on equity-focused HIA to clarify how equity is informing HIA practice, and to surface innovations for assessing health equity in relation to a range of exposures across geographic and temporal scales. METHODS A narrative review of the health equity and HIA literatures analysed English articles published between 2003 and 2017 across PubMed, PubMed Central, Biomed Central and Ovid Medline. Title and abstract reviews of 849 search results yielded 89 articles receiving full text review. RESULTS Considerations of equity in HIA increased over the last 5 years, but equity continues to be conflated with health disparities rather than their root causes (i.e. inequities). Lessons from six literatures to inform future HIA practice are described: HIA for healthy cities, climate change vulnerability assessment, cumulative health risk assessment, intersectionality-based policy analysis, corporate health impact assessment and global health impact assessment. CONCLUSIONS Academic reporting on incorporating equity in HIA practice has been limited. Nonetheless, significant methodological advancements are being made to examine the health equity implications of multiple environmental exposures.
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Affiliation(s)
- Chris G Buse
- School of Health Sciences, University of Northern British Columbia, Prince George, BC, Canada.
| | - Valerie Lai
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Katie Cornish
- School of Health Sciences, University of Northern British Columbia, Prince George, BC, Canada
| | - Margot W Parkes
- School of Health Sciences, University of Northern British Columbia, Prince George, BC, Canada
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Madureira Lima J, Galea S. Corporate practices and health: a framework and mechanisms. Global Health 2018; 14:21. [PMID: 29448968 PMCID: PMC5815179 DOI: 10.1186/s12992-018-0336-y] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 01/26/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The Global Burden of Disease estimates that approximately a third of deaths worldwide are attributable to behavioural risk factors that, at their core, have the consumption of unhealthful products and exposures produced by profit driven commercial entities. We use Steven Lukes' three-dimensional view of power to guide the study of the practices deployed by commercial interests to foster the consumption of these commodities. Additionally, we propose a framework to systematically study corporations and other commercial interests as a distal, structural, societal factor that causes disease and injury. Our framework offers a systematic approach to mapping corporate activity, allowing us to anticipate and prevent actions that may have a deleterious effect on population health. CONCLUSION Our framework may be used by, and can have utility for, public health practitioners, researchers, students, activists and other members of civil society, policy makers and public servants in charge of policy implementation. It can also be useful to corporations who are interested in identifying key actions they can take towards improving population health.
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Affiliation(s)
- Joana Madureira Lima
- Department of Sociology, University of Oxford, Manor Rd Building, Manor Road, Oxford, OX1 3UQ, UK.
| | - Sandro Galea
- School of Public Health, Boston University, 715 Albany St, Boston, MA, 02118, USA
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Grundy Q, Held F, Bero L. A Social Network Analysis of the Financial Links Backing Health and Fitness Apps. Am J Public Health 2017; 107:1783-1788. [PMID: 28933939 DOI: 10.2105/ajph.2017.303995] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To identify the major stakeholders in mobile health app development and to describe their financial relationships using social network analysis. METHODS We conducted a structured content analysis of a purposive sample of prominent health and fitness apps available in November 2015 in the United States, Canada, and Australia. We conducted a social network analysis of apps' developers, investors, other funding sources, and content advisors to describe the financial relationships underpinning health app development. RESULTS Prominent health and fitness apps are largely developed by private companies based in North America, with an average of 4.7 (SD = 5.5) financial relations, including founders, external investors, acquiring companies, and commercial partnerships. Network analysis revealed a core of 41 sampled apps connected to 415 other entities by 466 financial relations. This core largely comprised apps published by major technology, pharmaceutical, and fashion corporations. About one third of apps named advisors, many of whom had commercial affiliations. CONCLUSIONS Public health needs to extend its scrutiny and advocacy beyond the health messages contained within apps to understanding commercial influences on health and, when necessary, challenging them.
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Affiliation(s)
- Quinn Grundy
- Quinn Grundy and Lisa Bero are with the Faculty of Pharmacy and Fabian Held is with the Faculty of Science, the Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Fabian Held
- Quinn Grundy and Lisa Bero are with the Faculty of Pharmacy and Fabian Held is with the Faculty of Science, the Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Lisa Bero
- Quinn Grundy and Lisa Bero are with the Faculty of Pharmacy and Fabian Held is with the Faculty of Science, the Charles Perkins Centre, The University of Sydney, Sydney, Australia
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Anaf J, Baum FE, Fisher M, Harris E, Friel S. Assessing the health impact of transnational corporations: a case study on McDonald's Australia. Global Health 2017; 13:7. [PMID: 28166801 PMCID: PMC5295215 DOI: 10.1186/s12992-016-0230-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 12/27/2016] [Indexed: 11/10/2022] Open
Abstract
Background The practices of transnational corporations affect population health through production methods, shaping social determinants of health, or influencing the regulatory structures governing their activities. There has been limited research on community exposures to TNC policies and practices. Our pilot research used McDonald’s Australia to test methods for assessing the health impacts of one TNC within Australia. Methods We adapted existing Health Impact Assessment methods to assess McDonald’s activities. Data identifying potential impacts were sourced through document analysis, including McDonald’s corporate literature; media analysis and semi-structured interviews. We commissioned a spatial and socioeconomic analysis of McDonald’s restaurants in Australia through Geographic Information System technology. The data was mapped against a corporate health impact assessment framework which included McDonald’s Australia’s political and business practices; products and marketing; workforce, social, environmental and economic conditions; and consumers’ health related behaviours. Results We identified both positive and detrimental aspects of McDonald’s Australian operations across the scope of the CHIA framework. We found that McDonald’s outlets were slightly more likely to be located in areas of lower socioeconomic status. McDonald’s workplace conditions were found to be more favourable than those in many other countries which reflects compliance with Australian employment regulations. The breadth of findings revealed the need for governments to strengthen regulatory mechanisms that are conducive to health; the opportunity for McDonald’s to augment their corporate social responsibility initiatives and bolster reputational endorsement; and civil society actors to inform their advocacy towards health and equity outcomes from TNC operations. Conclusion Our study indicates that undertaking a corporate health impact assessment is possible, with the different methods revealing sufficient information to realise that strong regulatory frameworks are need to help to avoid or to mediate negative health impacts.
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Affiliation(s)
- Julia Anaf
- Southgate Institute for Health, Society and Equity, Flinders University, GPO Box 2001, Adelaide, SA, 5001, Australia.
| | - Frances E Baum
- Southgate Institute for Health, Society and Equity, Flinders University, GPO Box 2001, Adelaide, SA, 5001, Australia
| | - Matt Fisher
- Southgate Institute for Health, Society and Equity, Flinders University, GPO Box 2001, Adelaide, SA, 5001, Australia
| | - Elizabeth Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney,, 2052, Australia
| | - Sharon Friel
- Regulatory Institutions Network, The Australian National University, Canberra,, ACT 2601, Australia
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Robaina K, Babor TF. Alcohol industry marketing strategies in Latin America and the Caribbean: the way forward for policy research. Addiction 2017; 112 Suppl 1:122-124. [PMID: 28070936 DOI: 10.1111/add.13625] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Katherine Robaina
- Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Thomas F Babor
- Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, CT, USA
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