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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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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: 109] [Impact Index Per Article: 109.0] [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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Baum F, Anaf J. A World Beyond Transnational Corporations: Meeting Human Rather Than Corporate Need Comment on "'Part of the Solution': Food Corporation Strategies for Regulatory Capture and Legitimacy". Int J Health Policy Manag 2022; 11:2748-2751. [PMID: 36300255 PMCID: PMC9818118 DOI: 10.34172/ijhpm.2022.7540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/12/2022] [Indexed: 01/21/2023] Open
Abstract
This paper provides a commentary on Lacy-Nichols and Williams' analysis of the emerging tactics of the ultraprocessed food transnational corporations (TNCs). Our paper provides an overview of the growth in power and influence of TNCs in the past three decades and considers how this change impacts on health and health equity. We examine how wealth inequities have increased dramatically and how many of the health harms are externalised to governments or individuals. We argue that human interests and corporate interests differ. The article concludes with a consideration of alternative ways of organising an economy that are more human centred and health promoting. We suggest five changes are required: improved measurement of economic outputs beyond gross domestic product (GDP); improved regulation of finance and TNCs; development of localised economic models including cooperatives; reversal of privatisations; making the reduction of economic inequalities a goal of financial policy. We consider the barriers to these changes happening.
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Affiliation(s)
- Fran Baum
- Stretton Health Equity, Stretton Institute, University of Adelaide, Adelaide, SA, Australia
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Crocetti AC, Cubillo (Larrakia) B, Lock (Ngiyampaa) M, Walker (Yorta Yorta) T, Hill (Torres Strait Islander) K, Mitchell (Mununjali) F, Paradies (Wakaya) Y, Backholer K, Browne J. The commercial determinants of Indigenous health and well-being: a systematic scoping review. BMJ Glob Health 2022; 7:bmjgh-2022-010366. [PMID: 36319033 PMCID: PMC9628540 DOI: 10.1136/bmjgh-2022-010366] [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: 08/08/2022] [Accepted: 10/04/2022] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Health inequity within Indigenous populations is widespread and underpinned by colonialism, dispossession and oppression. Social and cultural determinants of Indigenous health and well-being are well described. Despite emerging literature on the commercial determinants of health, the health and well-being impacts of commercial activities for Indigenous populations is not well understood. We aimed to identify, map and synthesise the available evidence on the commercial determinants of Indigenous health and well-being. METHODS Five academic databases (MEDLINE Complete, Global Health APAPsycInfo, Environment Complete and Business Source Complete) and grey literature (Australian Indigenous HealthInfoNet, Google Scholar, Google) were systematically searched for articles describing commercial industry activities that may influence health and well-being for Indigenous peoples in high-income countries. Data were extracted by Indigenous and non-Indigenous researchers and narratively synthesised. RESULTS 56 articles from the USA, Canada, Australia, New Zealand, Norway and Sweden were included, 11 of which were editorials/commentaries. The activities of the extractive (mining), tobacco, food and beverage, pharmaceutical, alcohol and gambling industries were reported to impact Indigenous populations. Forty-six articles reported health-harming commercial practices, including exploitation of Indigenous land, marketing, lobbying and corporate social responsibility activities. Eight articles reported positive commercial industry activities that may reinforce cultural expression, cultural continuity and Indigenous self-determination. Few articles reported Indigenous involvement across the study design and implementation. CONCLUSION Commercial industry activities contribute to health and well-being outcomes of Indigenous populations. Actions to reduce the harmful impacts of commercial activities on Indigenous health and well-being and future empirical research on the commercial determinants of Indigenous health, should be Indigenous led or designed in collaboration with Indigenous peoples.
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Affiliation(s)
- Alessandro Connor Crocetti
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Beau Cubillo (Larrakia)
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Mark Lock (Ngiyampaa)
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Troy Walker (Yorta Yorta)
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Karen Hill (Torres Strait Islander)
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | | | - Yin Paradies (Wakaya)
- Deakin University Alfred Deakin Institute for Citizenship and Globalisation, Burwood, Victoria, Australia
| | - Kathryn Backholer
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Jennifer Browne
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
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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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Leuenberger A, Cambaco O, Zabré HR, Lyatuu I, Utzinger J, Munguambe K, Merten S, Winkler MS. "It Is Like We Are Living in a Different World": Health Inequity in Communities Surrounding Industrial Mining Sites in Burkina Faso, Mozambique, and Tanzania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111015. [PMID: 34769535 PMCID: PMC8582703 DOI: 10.3390/ijerph182111015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/29/2021] [Accepted: 10/12/2021] [Indexed: 11/23/2022]
Abstract
Background: Health equity features prominently in the 2030 Agenda for Sustainable Development, yet there are wide disparities in health between and within countries. In settings of natural resource extraction (e.g., industrial mines), the health of surrounding communities is affected through myriad changes in the physical, social, and economic environment. How changes triggered by such projects translate into health inequities is poorly understood. Methods: This qualitative study explores potential layers of inequities by systematically coding perceived inequities of affected communities. Drawing on the framework method, we thematically analyzed data from 83 focus group discussions, which enrolled 791 participants from 10 study sites in Burkina Faso, Mozambique, and Tanzania. Results: Participants perceived inequities related to their individual characteristics, intermediate factors acting on the community level, and structural conditions. Due to environmental pollution and land loss, participants were concerned about unsecured livelihoods. Positive impacts, such as job opportunities at the mine, remained scarce for local communities and were claimed not to be equally distributed among community members. Conclusion: Extractive industries bear considerable risks to widen existing health gaps. In order to create equal opportunities among affected populations, the wider determinants of health must be considered more explicitly in the licensing process of resource extraction projects.
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Affiliation(s)
- Andrea Leuenberger
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; (O.C.); (H.R.Z.); (I.L.); (J.U.); (S.M.); (M.S.W.)
- University of Basel, P.O. Box, CH-4003 Basel, Switzerland
- Correspondence:
| | - Olga Cambaco
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; (O.C.); (H.R.Z.); (I.L.); (J.U.); (S.M.); (M.S.W.)
- University of Basel, P.O. Box, CH-4003 Basel, Switzerland
- Manhiça Health Research Centre, Maputo C.P. 1929, Mozambique;
| | - Hyacinthe R. Zabré
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; (O.C.); (H.R.Z.); (I.L.); (J.U.); (S.M.); (M.S.W.)
- University of Basel, P.O. Box, CH-4003 Basel, Switzerland
- Research Institute of Health Sciences, Ouagadougou B.P. 7192, Burkina Faso
| | - Isaac Lyatuu
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; (O.C.); (H.R.Z.); (I.L.); (J.U.); (S.M.); (M.S.W.)
- University of Basel, P.O. Box, CH-4003 Basel, Switzerland
- Ifakara Health Institute, P.O. Box, Dar es Salaam 78 373, Tanzania
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; (O.C.); (H.R.Z.); (I.L.); (J.U.); (S.M.); (M.S.W.)
- University of Basel, P.O. Box, CH-4003 Basel, Switzerland
| | - Khátia Munguambe
- Manhiça Health Research Centre, Maputo C.P. 1929, Mozambique;
- Faculty of Medicine, Eduardo Mondlane University, Maputo C.P. 257, Mozambique
| | - Sonja Merten
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; (O.C.); (H.R.Z.); (I.L.); (J.U.); (S.M.); (M.S.W.)
- University of Basel, P.O. Box, CH-4003 Basel, Switzerland
| | - Mirko S. Winkler
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; (O.C.); (H.R.Z.); (I.L.); (J.U.); (S.M.); (M.S.W.)
- University of Basel, P.O. Box, CH-4003 Basel, Switzerland
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Associations between Natural Resource Extraction and Incidence of Acute and Chronic Health Conditions: Evidence from Tanzania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116052. [PMID: 34199822 PMCID: PMC8200105 DOI: 10.3390/ijerph18116052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 05/29/2021] [Accepted: 05/31/2021] [Indexed: 12/03/2022]
Abstract
Natural resource extraction projects are often accompanied by complex environmental and social-ecological changes. In this paper, we evaluated the association between commodity extraction and the incidence of diseases. We retrieved council (district)-level outpatient data from all public and private health facilities from the District Health Information System (DHIS2). We combined this information with population data from the 2012 national population census and a geocoded list of resource extraction projects from the Geological Survey of Tanzania (GST). We used Poisson regression with random effects and cluster-robust standard errors to estimate the district-level associations between the presence of three types of commodity extraction (metals, gemstone, and construction materials) and the total number of patients in each disease category in each year. Metal extraction was associated with reduced incidence of several diseases, including chronic diseases (IRR = 0.61, CI: 0.47–0.80), mental health disorders (IRR = 0.66, CI: 0.47–0.92), and undernutrition (IRR = 0.69, CI: 0.55–0.88). Extraction of construction materials was associated with an increased incidence of chronic diseases (IRR = 1.47, CI: 1.15–1.87). This study found that the presence of natural resources commodity extraction is significantly associated with changes in disease-specific patient volumes reported in Tanzania’s DHIS2. These associations differed substantially between commodities, with the most protective effects shown from metal extraction.
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Leuenberger A, Winkler MS, Cambaco O, Cossa H, Kihwele F, Lyatuu I, Zabré HR, Farnham A, Macete E, Munguambe K. Health impacts of industrial mining on surrounding communities: Local perspectives from three sub-Saharan African countries. PLoS One 2021; 16:e0252433. [PMID: 34086737 PMCID: PMC8177516 DOI: 10.1371/journal.pone.0252433] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 05/16/2021] [Indexed: 11/18/2022] Open
Abstract
Industrial mining projects can play an important role in global sustainable development if associated health risks are minimised and opportunities maximised. While a broad body of evidence from quantitative studies exists that establishes the interlinkages between mining operations and effects on public health, little research has been conducted investigating health impacts from the perspective of affected communities. This is particularly true in sub-Saharan Africa, where about a third of the remaining global mineral resources are endowed and health-related indicators for sustainable development are lagging behind. In this multi-country qualitative study, we explore community perceptions regarding impacts of industrial mining on their health and well-being. In nine study sites in Burkina Faso, Mozambique and Tanzania, we conducted 83 participatory focus group discussions with a total of 791 participants (385 men, 406 women). Our findings reveal a broad range of perceived impacts on environmental, economic and social determinants of health, with secondary health implications related to morbidity, mortality and well-being. Overall, perceived negative impacts prevailed, mainly related to environmental pollution, change in livelihoods or social disruption. Perceived positive impacts on health and well-being were related to interventions implemented by the mines such as new or improved water sources, health care facilities, roads and schools. The consistency of these findings across countries and study sites suggests a structural problem and indicates a pressing need to address health by acting on the wider determinants of health in mining regions. Participatory health impact assessment should be strengthened in host countries to foster strategic interventions, include marginalised population groups, and protect and promote the health of local communities. By including community perspectives on health before and during project implementation, policymakers can take advantage of economic opportunities while avoiding the pitfalls, bringing their communities closer to achieving good health and well-being goals by 2030 and beyond.
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Affiliation(s)
- Andrea Leuenberger
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Mirko S. Winkler
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Olga Cambaco
- Manhiça Health Research Centre, Maputo, Mozambique
| | - Herminio Cossa
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Manhiça Health Research Centre, Maputo, Mozambique
| | | | - Isaac Lyatuu
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Hyacinthe R. Zabré
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Research Institute of Health Sciences, Ouagadougou, Burkina Faso
| | - Andrea Farnham
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Khátia Munguambe
- Manhiça Health Research Centre, Maputo, Mozambique
- Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
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Lyatuu I, Loss G, Farnham A, Winkler MS, Fink G. Short-term effects of national-level natural resource rents on life expectancy: A cross-country panel data analysis. PLoS One 2021; 16:e0252336. [PMID: 34048480 PMCID: PMC8162665 DOI: 10.1371/journal.pone.0252336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/12/2021] [Indexed: 11/18/2022] Open
Abstract
While a substantial amount of literature addresses the relationship between natural resources and economic growth, relatively little is known regarding the relationship between natural resource endowment and health at the population level. We construct a 5-year cross-country panel to assess the impact of natural resource rents on changes in life expectancy at birth as a proxy indicator for population health during the period 1970-2015. To estimate the causal effects of interest, we use global commodity prices as instrumental variables for natural resource rent incomes in two-stage-least squares regressions. Controlling for country and year fixed effects, we show that each standard deviation increase in resource rents results in life expectancy increase of 6.72% (CI: 2.01%, 11.44%). This corresponds to approximately one additional year of life expectancy gained over five years. We find a larger positive effect of rents on life expectancy in sub-Saharan Africa (SSA) compared to other world regions. We do not find short-term effects of rents on economic growth, but show that increases in resource rents result in sizeable increases in government revenues in the short run, which likely translate into increased spending across government sectors. This suggests that natural resources can help governments finance health and other development-oriented programs needed to improve population health.
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Affiliation(s)
- Isaac Lyatuu
- Ifakara Health Institute, Dar es Salaam, United Republic of Tanzania
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
| | - Georg Loss
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Andrea Farnham
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Mirko S. Winkler
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Günther Fink
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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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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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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