The cultural hegemony of chronic disease association discourse in Canada

Abstract

In this paper, we explore how corporate domination of two major disease associations in Canada, Heart and Stroke Canada (HSC) and Diabetes Canada (DC), as manifested in membership of their boards of directors may be acting with biomedical complicity to create hegemonic discourse on the nature of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). This is problematic as the activities that derive from this discourse thwart public policy action to address the primary causes and means of managing chronic disease: Canadians’ living and working conditions. Through critical analysis of the membership of HSC and DC boards of directors, we link their corporate and biomedical backgrounds with the limiting of chronic disease association messaging to narrow discredited behavioural approaches. We also draw attention to other means by which the corporate sector is able to shape disease association discourse on the causes and means of managing chronic disease. To rectify this, we call for membership of these boards to include those knowledgeable with broader understandings of health and those most likely to suffer CVD and T2DM: the poor, excluded, and marginalised. Since we recognise these associations will not voluntarily undertake these actions, we present means to force this shift.