Commercial determinants of health

Private sector activities influencing health

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Junk food and its advertising are commercial determinants of health. Gift from tobacco industry lobbyists to a European politician in 2013. Air pollution causes 7 million premature deaths every year.[1]

The commercial determinants of health are the private sector activities that influence individual and group differences in health status.[2] Commercial determinants of health can affect people's health positively (such as sport or medical industries) or negatively (such as arms and tobacco industries).[2][3] They are part of the broader social determinants of health.

## Types

[edit]

Corporate activities influences the legal, physical, and price environments in which people live. For example:[2][4]

* Political influence (including indirect or grassroots lobbying[5] and direct lobbying)[6] (impeding policy through lobbying such as lobbying against sugary drink taxes[7], or phasing out tobacco sales to youth[8], or bans on junk food and takeaway management zones around schools[9]);
* Perceptions shaping through marketing (such as when the sugar industry shifted the blame for ill health from dietary sugar to dietary fat and cholesterol[10]), including product design (such as DuPont designing and selling carcinogenic products like teflon cooking pans and other products[11]), packaging and advertising (enhancing the acceptability, such as in the case of Nestle and others selling unhealthy baby formula as better than mother's milk around the world[12]);
* Supply chains (amplifying company influence around the globe);
* Corporate social responsibility strategies[13] such as Coca-Cola and Pepsi funding 96 nutrition charities[14];
* Labour conditions such as the meat-packing industry's abuse of workers as documented in Upton Sinclair's book The Jungle or in more recent reporting[15];
* Financial practices (such as crypto and blockchain[16]);
* Funding of science such as when the food industry funded members of the US 2020 dietary guidelines advisory committee.[17]

## Impact

[edit]

Commercial determinants of health impact a wide range of injuries and noncommunicable diseases (especially cardiovascular diseases,[18] cancer,[19] chronic respiratory diseases and diabetes). For example:[2][20]

* Smoking[21] (tobacco industry);
* Air pollution[1] (fossil-fuel industry);
* Alcohol use[22] (alcohol industry);
* Obesity[23] and physical inactivity[24] (food industry);
* Deaths resulting from driving on roads (roads lobby)[25][26]
* Deaths resulting from weapons (arms industry).[27]

According to The Lancet, 'four industries (tobacco, unhealthy food, fossil fuel, and alcohol) are responsible for at least a third of global deaths per year'.[20] In 2024, the World Health Organization published a report including these figures.[28][29]

## See also

[edit]

* Health policy
* Social determinants of health
* Political determinants of health

## Notes and references

[edit]

1. ^ a b "Ambient (outdoor) air pollution". who.int. World Health Organization. 19 December 2022. Retrieved 11 November 2023. "Air pollution is one of the greatest environmental risk to health. [...] The combined effects of ambient air pollution and household air pollution are associated with 6.7 million premature deaths annually."
2. ^ a b c d "Commercial determinants of health". who.int. World Health Organization. 21 March 2023. Retrieved 10 November 2023.
3. ^ Banatvala, Nick; Bovet, Pascal, eds. (2023). "The role of the private sector in NCD prevention and control". Noncommunicable Diseases: A Compendium. London: Routledge. doi:10.4324/9781003306689. ISBN 978-1-032-30792-3. Open access.
4. ^ Ilona Kickbusch; Luke Allen; Christian Franz (December 2016). "The commercial determinants of health". The Lancet Global Health. 4 (12): e895–e896. doi:10.1016/S2214-109X(16)30217-0. PMID 27855860.
5. ^ Bloomberg Government. "Grassroots Lobbying vs. Direct Lobbying — What's the Difference?". Retrieved 13 May 2024.
6. ^ Jacobs, Andrew (16 September 2019). "A Shadowy Industry Group Shapes Food Policy Around the World". The New York Times.
7. ^ Krupnick, Matt (12 November 2022). "'This industry will stop at nothing': big soda's fight to ban taxes on sugary drinks". The Guardian. Retrieved 27 December 2024.
8. ^ Gregory, Andrew (Mon 15 Apr 2024 08.00 CEST). "Tobacco firms lobbying MPs to derail smoking phase-out, charity warns. Tactics include proposals to raise smoking age to avoid outright ban, and exemptions for cigars, says Cancer Research UK chief". The Guardian. Retrieved December 27, 2024. `{{cite journal}}`: Check date values in: `|date=` (help)
9. ^ Keeble, Matthew (27 August 2024). "Retailer Responses to Public Consultations on the Adoption of Takeaway Management Zones Around Schools: A Longitudinal Qualitative Analysis". International Journal of Health Policy and Management. 13: 8294. doi:10.34172/ijhpm.8249. PMID 2322-5939. Retrieved 27 December 2024. `{{cite journal}}`: Check `|pmid=` value (help); More than one of `|pages=` and `|page=` specified (help)
10. ^ Kearns, Cristin (1 November 2016). "Sugar Industry and Coronary Heart Disease Research: A Historical Analysis of Internal Industry Documents". JAMA Internal Medicine. 176 (11): 1680. doi:10.1001/jamainternmed.2016.5394. Retrieved 27 December 2024.
11. ^ Rich, Nathaniel (Jan. 6, 2016). "The Lawyer Who Became DuPont's Worst Nightmare Rob Bilott was a corporate defense attorney for eight years. Then he took on an environmental suit that would upend his entire career — and expose a brazen, decades-long history of chemical pollution". The New York Times. `{{cite news}}`: Check date values in: `|date=` (help)
12. ^ Mole, Beth (23 April 2024). "Nestlé baby foods loaded with unhealthy sugars—but only in poorer countries Health experts say children under age 2 should have zero added sugars in their diets". Ars Technica.
13. ^ Steele, Sarah (December 1 2019). "Are Industry-Funded Charities Promoting 'Advocacy-Led Studies' or 'Evidence-Based Science'?: A Case Study of the International Life Sciences Institute". Globalization and Health. 15 (1). doi:10.1186/s12992-019-0478-6. `{{cite journal}}`: Check date values in: `|date=` (help)CS1 maint: unflagged free DOI (link)
14. ^ Sifferlin, Alexandra (10 October 2016). "Soda Companies Fund 96 Health Groups In the U.S." Time. Retrieved 27 December 2024.
15. ^ AP News (8 August 2023). "Meat processor ordered to pay fines after teen lost hand in grinder". The Associated Press.
16. ^ Davies, Nathan (17 December 2024). "An assessment of cryptocurrencies as a global commercial determinant of health". Health Promotion International. 39 (6). doi:10.1093/heapro/daae190.
17. ^ Mialon, Mélissa (2022 March 6). "Conflicts of interest for members of the US 2020 dietary guidelines advisory committee". Public Health Nutrition. 27 (1). doi:10.1017/S1368980022000672. Retrieved December 24, 2027. `{{cite journal}}`: Check date values in: `|access-date=` and `|date=` (help)
18. ^ Fact sheet "Cardiovascular diseases (CVDs)". who.int. World Health Organization. 11 June 2021. Retrieved 11 November 2023. "Cardiovascular diseases (CVDs) are the leading cause of death globally. An estimated 17.9 million people died from CVDs in 2019, representing 32% of all global deaths."
19. ^ Fact sheet "Cancer". who.int. World Health Organization. 3 February 2022. Retrieved 11 November 2023. "Around one-third of deaths from cancer are due to tobacco use, high body mass index, alcohol consumption, low fruit and vegetable intake, and lack of physical activity."
20. ^ a b The Lancet (23 March 2023). "Unravelling the commercial determinants of health". The Lancet (Editorial). 401 (10383): 1131. doi:10.1016/S0140-6736(23)00590-1. PMID 36966781.
21. ^ Fact sheet "Tobacco". who.int. World Health Organization. 31 July 2023. Retrieved 11 November 2023. "Tobacco kills more than 8 million people each year, including an estimated 1.3 million non-smokers who are exposed to second-hand smoke."
22. ^ Fact sheet "Alcohol". who.int. World Health Organization. 9 May 2022. Retrieved 11 November 2023. "The harmful use of alcohol is a causal factor in more than 200 disease and injury conditions. Worldwide, 3 million deaths every year result from harmful use of alcohol."
23. ^ Fact sheet "Obesity and overweight". who.int. World Health Organization. 9 June 2021. Retrieved 11 November 2023.
24. ^ Fact sheet "Physical activity". who.int. World Health Organization. 5 October 2022. Retrieved 11 November 2023. "People who are insufficiently active have a 20% to 30% increased risk of death compared to people who are sufficiently active."
25. ^ Ennis, Grant (1 March 2023). Dark PR: How Corporate Disinformation Undermines Our Health and the Environment (1st ed.). Daraja Press. p. 265\. ISBN 978-1990263484. Retrieved 28 October 2024.
26. ^ Miner, Patrick (17 February 2024). "Car harm: A global review of automobility's harm to people and the environment". Journal of Transport Geography. 15 (103817). doi:10.1016/j.jtrangeo.2024.103817.
27. ^ Maani, Nason (7 March 2023). "The firearm industry, power and the law with Jon Lowy". Money Power Health.
28. ^ "Just four industries cause 2.7 million deaths in the European Region every year". World Health Organization. 12 June 2024. Retrieved 12 June 2024. "Four corporate products – tobacco, ultra-processed foods, fossil fuels and alcohol – cause 19 million deaths per year globally, or 34% of all deaths."
29. ^ Anna Bawden; Denis Campbell (12 June 2024). "Tobacco, alcohol, processed foods and fossil fuels 'kill 2.7m a year in Europe'". The Guardian. Retrieved 12 June 2024.

## Further reading

[edit]

* Nason Maani; Mark Petticrew; Sandro Galea (2022). The Commercial Determinants of Health. Oxford University Press. p. 416\. ISBN 978-0-19-757875-9.
* Banatvala, Nick; Bovet, Pascal, eds. (2023). "The role of the private sector in NCD prevention and control". Noncommunicable Diseases: A Compendium. London: Routledge. doi:10.4324/9781003306689. ISBN 978-1-032-30792-3. Open access.
* Gilmore, Anna B; et al. (April 2023). "Defining and conceptualising the commercial determinants of health". The Lancet. 401 (10383): 1194–1213. doi:10.1016/s0140-6736(23)00013-2. hdl:1893/35148. ISSN 0140-6736. PMID 36966782. S2CID 257698115.
* Commercial determinants of noncommunicable diseases in the WHO European Region, WHO Regional Office for Europe, 2024.
* Ennis, Grant (1 March 2023). Dark PR: How Corporate Disinformation Undermines Our Health and the Environment (1st ed.). Québec, Canada: Daraja Press. p. 265\. ISBN 978-1990263484.
* Kickbusch, Ilona. “Addressing the Interface of the Political and Commercial Determinants of Health.” Health Promotion International 27, no. 4 (December 1, 2012): 427–28. https://doi.org/10.1093/heapro/das057.

## External links

[edit]

* Commercial determinants of health (World Health Organization)

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