Unhealthy Commodity Industries Research Articles

Building a Systems Map: Applying Systems Thinking to Unhealthy Commodity Industry Influence on Public Health Policy.

Unhealthy commodity industries (UCIs) engage in political practices to influence public health policy, which poses barriers to protecting and promoting public health. Such influence exhibits characteristics of a complex system. Systems thinking would therefore appear to be a useful lens through which to study this phenomenon, potentially deepening our understanding of how UCI influence are interconnected with one another through their underlying political, economic and social structures. As such this study developed a qualitative systems map to depict the complex pathways through which UCIs influence public health policy and how they are interconnected with underlying structures. Online participatory systems mapping workshops were conducted between November 2021 and February 2022. As a starting point for the workshops, a preliminary systems map was developed based on recent research. Twenty-three online workshops were conducted with 52 geographically diverse stakeholders representing academia, civil society, public office and global governance organisations. Analysis of workshop data in NVivo and feedback from participants resulted in a final systems map. The preliminary systems map consisted of 40 elements across six interdependent themes. The final systems map consisted of 64 elements across five interdependent themes, representing key pathways through which UCIs impact health policymaking: 1) direct access to public sector decision-makers; 2) creation of confusion and doubt about policy decisions; 3) corporate prioritisation of commercial profits and growth; 4) industry leveraging the legal and dispute settlement processes; and 5) industry leveraging policymaking, norms, rules, and processes. UCI influence on public health policy is highly complex, involves interlinked practices, and is not reducible to a single point within the system. Instead, pathways to UCI influence emerge from the complex interactions between disparate national and global political, economic and social structures. These pathways provide numerous avenues for UCIs to influence public health policy, which poses challenges to formulating a singular intervention or limited set of interventions capable of effectively countering such influence. Using participatory methods, we made transparent the interconnections that could help identify interventions future work.

Pills and the damage done: the opioid epidemic as man-made crisis.

The prescription opioid epidemic has slowly evolved over the past quarter century with increasingly detrimental consequences for public health. Man-made crises are often unforeseen and characterized by a situation without natural causes where - because of human intent, error, negligence, or the failure of manmade systems - the level of needs in the population exceeds available resources to counter the problem. This paper presents the prescription opioid epidemic as a man-made crisis and explores the public health impact of opioid manufacturers and other industries producing commodities with addictive potential as a shared vulnerability among countries. We examine this concept within the framework of the commercial determinants of health. We address three key aspects of the commercial determinants of health: (1) Cross-industry mechanisms, (2) policy inertia, and (3) the role of industry in science. Within cross-industry mechanisms, we explore parallels between prescription opioid epidemic and unhealthy commodity industries in terms of marketing, corporate use of misinformation, and diversionary tactics. Next, we examine how policy inertia has dominated the slow response to this man-made crisis. Lastly, we discuss how results from clinical trials are used as a key marketing strategy for drugs. The origins of the prescription opioid epidemic may be traced to innovations in drug development with the promise of improved pain management. However, through multiple factors, including fraudulent marketing from pharmaceutical industry and policy inertia, the resulting crisis represents a multi-system failure of regulation exploited by corporate greed.

Commercial lobbying and political contributions: an Australian scoping review

ObjectiveMany of the most effective and equitable policies to reduce the burden of non-communicable diseases threaten the interests of powerful corporations. A first step for public health advocates seeking to challenge powerful corporate interests is to understand the nature and extent of corporate political practices. This scoping review explored public health research on two political practices in Australia: lobbying and political donations. MethodsWe searched six databases, two Google Advanced searches and 11 Australian public health websites. We screened 2866 documents in total, and extracted information about political practices, industry actors and datasets. Results62 studies published between 1980 and 2021 were identified, analysing public health advocacy, policy submissions, direct engagement with government representatives and political donations. We extracted data from 14 studies that focused on direct engagement and/or political donations. Most focused on ‘unhealthy commodity industries.’ ConclusionsAnalysis of lobbying and political contributions in Australia is a nascent but expanding area of public health research. We discuss opportunities for future research to strengthen the evidence base and support public health advocacy to counter harmful corporate practices and promote and protect population health. Implications for Public HealthCountering powerful commercial interests requires greater investment in understanding corporate political activities.

Corporate Political Activity: Taxonomies and Model of Corporate Influence on Public Policy.

Non-communicable diseases (NCDs) kill 41 million people a year. The products and services of unhealthy commodity industries (UCIs) such as tobacco, alcohol, ultra-processed foods and beverages and gambling are responsible for much of this health burden. While effective public health policies are available to address this, UCIs have consistently sought to stop governments and global organisations adopting such policies through what is known as corporate political activity (CPA). We aimed to contribute to the study of CPA and development of effective counter-measures by formulating a model and evidence-informed taxonomies of UCI political activity. We used five complementary methods: critical interpretive synthesis of the conceptual CPA literature; brief interviews; expert co-author knowledge; stakeholder workshops; testing against the literature. We found 11 original conceptualisations of CPA; four had been used by other researchers and reported in 24 additional review papers. Combining an interpretive synthesis of all these papers and feedback from users, we developed two taxonomies - one on framing strategies and one on action strategies. The former identified three frames (policy actors, problem, and solutions) and the latter six strategies (access and influence policy-making, use the law, manufacture support for industry, shape evidence to manufacture doubt, displace, and usurp public health, manage reputations to industry's advantage). We also offer an analysis of the strengths and weaknesses of UCI strategies and a model that situates industry CPA in the wider social, political, and economic context. Our work confirms the similarity of CPA across UCIs and demonstrates its extensive and multi-faceted nature, the disproportionate power of corporations in policy spaces and the unacceptable conflicts of interest that characterise their engagement with policy-making. We suggest that industry CPA is recognised as a corruption of democracy, not an element of participatory democracy. Our taxonomies and model provide a starting point for developing effective solutions.

Evaluation of frameworks demonstrating the role of private sector in non-communicable disease management and control: a systematic review and thematic synthesis

ObjectivesConduct a systematic review of existing frameworks to understand the for-profit private sector’s roles in non-communicable disease (NCD) control and management. Control includes population-level control measures that prevent NCDs and...

A comparative study of industry responses to government consultations about alcohol and gambling in the UK.

There is growing evidence that common strategies are used across unhealthy commodity industries (UCIs) to influence policy decisions in line with their commercial interests. To date, there have been relatively few studies comparing corporate political activity (CPA) across UCIs, especially comparing the alcohol and gambling industries. A comparative and inductive thematic analysis of alcohol and gambling industry submissions to two House of Lords (HoL) inquiries in the UK was conducted. Themes in the framing, arguments and strategies used by the alcohol and gambling industries in CPA were compared. Alcohol and gambling industry responses largely used the same framings, both in terms of the problems and solutions. This included arguing that harms are only experienced by a 'minority' of people, emphasising individual responsibility and shifting blame for harms to other industry actors. They promoted targeted or localised solutions to these harms, in place of more effective population level solutions, and emphasised the perceived harms of introducing regulation not in the industries' interests. These findings are consistent with previous literature suggesting that UCIs use the same framing and arguments to shape the narrative around their harms and solutions to those harms. This study also identified novel strategies such as shifting blame of harms to other industry actors. Policy makers should be aware of these strategies to avoid undue industry influence on policy decisions and understanding commonalities in strategies may help to inform more effective public health responses across all UCIs.

Strategies used by the soft drink industry to grow and sustain sales: a case-study of The Coca-Cola Company in East Asia

BackgroundThe market and non-market activities of the food and beverage industry contribute to unhealthy and unsustainable dietary patterns, increasingly in low-income and middle-income countries (LMICs). We aimed to describe how...

Newspaper framing of food and beverage corporations’ sponsorship of sport: a content analysis

BackgroundUnhealthy diets are a leading contributor to obesity, disability and death worldwide. One factor cited as contributing to rises in obesity rates is the pervasive and ubiquitous marketing of unhealthy foods and beverages (F&Bs) across a variety of mediums, such as sport sponsorship at both professional and amateur levels. Despite increased academic attention on the detrimental impacts of sport sponsorship within the obesogenic environment, this has not been matched by legislative action. One explanation may be the way that F&B corporations’ sport sponsorship is framed within policy debates. Framing is the deliberate ways in which (often contested) issues are presented in communication. This paper examines how sport sponsorship by F&B corporations is framed through media reports.MethodsThis study employed a mixed methods content and framing analysis. First, we conducted a quantitative newsprint content analysis (n = 234). This then informed and directed a thematic framing analysis of a sub-set of articles (n = 54) that specifically associated sport sponsorship by F&B corporations with obesity and childhood obesity.ResultsThe findings suggest that two competing frames are evident within newspaper coverage: 1) public health and 2) industry. The public health frame rejects the sponsorship of sport by High in Fat Sugar and Salt (HFSS) product corporations in particular, calling for such sponsorship to be restricted or banned. The industry frame characterises sponsorship of sport as a form of corporate social responsibility, positioning industry as good moral actors and part of the solution to childhood and adult obesity. These frames are evident across other Unhealthy Commodity Industries (UCIs) policy debates. However, the prominence of industry actors within the sample is potentially indicative of their discursive power within this space, particularly with their emphasis on the financial maintenance of sport as well as encouraging physical activity, contributing to the lack of regulatory development of sport sponsorship by F&B corporations.ConclusionsThe findings of this study are particularly useful for public health organisations who seek regulatory change, as it may provide further insight into countering industry framing practices, raising the salience of regulation of sport sponsorship and thus increasing the likelihood of regulatory development that seeks to improve population health.

How Do Industry-Funded Alcohol and Gambling Conferences Frame the Issues? An Analysis of Conference Agendas.

There is a growing evidence base that unhealthy commodity industries (including alcohol and gambling) promote industry-favorable framings of product harms and solutions. These framings adopt a focus on the individual while overlooking broader influences and solutions. One potential method to influence the framing of harms and solutions is funding and organizing conferences. This study aims to examine how industry-funded alcohol and gambling conferences present themselves and frame product harms and solutions. We conducted a descriptive examination and framing analysis of industry-funded alcohol and gambling conference descriptions and agendas or programs to examine how conferences were presented. We also examined how the included topics framed the issues of product harm and solutions. A hybrid approach (using both deductive and inductive coding) was used for framing analysis, informed by previous research. All the included conferences were targeted at professionals outside of the respective industry, many specifically mentioning researchers or policy makers. Several of the conferences offered professional credits for attendance. We identified four key frames that are consistent with the existing evidence base: a complex link between product consumption and harm, focus on the individual, deflection from population-level approaches, and medicalization/specialization of solutions. We found industry-favorable framings of harms and solutions within the alcohol and gambling conferences included in our sample. These conferences are aimed at professionals outside of the industry, including researchers and policy makers, with several offering professional credits for attendance. Greater awareness of the potential for industry-favorable framings at conference settings is required.

The corporate influence on food charity and aid: The "Hunger Industrial Complex" and the death of welfare.

There is an existing literature on how food companies, including the unhealthy food commodity industries, influence policy through a number of approaches. Direct approaches include lobbying and funding of research. Backdoor or indirect tactics used by food companies to demonstrate engagement include funding community groups, tactics previously used by the tobacco industry. Food industry support for food charities engaged in food donations is an area that has not received attention. This is another backdoor approach and one which may compromise more general public health policy. It is no surprise that the companies that engage in this can be largely fall under the rubric of unhealthy food commodity industries. This link is sometimes referred to as the “hunger industrial complex” and is based on the argument that an alliance exists between the food industry and the food banking movement. With rising levels of food insecurity there is pressure on the food system to donate food to charitable enterprises such as food banks and soups kitchens, which is often encouraged by government policy such as “Good Samaritan legislation”. Food businesses contribute surplus food and often promote it as part of their corporate social responsibility agenda. The argument presented here is not an anti-food charity one but one which challenges the development of charitable food aid as a system and a replacement for public policy. The reasons for this can be summarized under three headings: (1) such donation systems compromise the wider application of public food welfare and give the impression that food poverty is being addressed; (2) the links with food corporations provide a backdoor for influence on wider food policies; and (3) researchers taking money from food charities may be compromised by the direct and indirect relationships with companies. The focus in this paper is on the latter two issues; the first will be established as a context with work we have published elsewhere. This article draws on examples from the UK of how charities have linked with chocolate and soft drink companies. Examples include: “For every Easter egg bought on the Cadbury Worldwide Hide, Cadbury will donate an Easter egg to a food bank in our network”; a Coca-Cola initiative in December 2021 “Win a meal, give a meal on-pack competition across Coca-Cola Original Taste and Coca-Cola Zero Sugar consumption packs, giving consumers the chance to win food-related vouchers, while donating to FareShare”; and an October 2021 initiative where “McDonald's joins forces with FareShare to fund 1 million meals for UK families”. These relationships go beyond companies donating surplus food to food charities such as food banks and pantries to encouraging consumers to buy their products with the promise that the company will contribute products to such charities or provide cash donations in return for the purchase of their product.

Children's, parents' and professional stakeholders' views on power concerning the regulation of online advertising of unhealthy food to young people in the UK: A qualitative study.

Examinations of corporate power have demonstrated the practices and activities Unhealthy Commodity Industries (UCIs) employ to exert their power and influence on the public and health policy. The High in Fat Sugar and Salt (HFSS) product industry have exploited the online environment to market their products to young people. Regulating UCIs’ marketing can limit the power of those industries and is argued to be one of the most appropriate policy responses to such marketing. However, there is minimal consideration of how stakeholders view regulation of online advertising of HFSS products to young people. This UK-focused study addressed this through a secondary analysis of focus groups with young people (n = 15), the primary analysis of focus groups with parents (n = 8), and interviews with professional stakeholders (n = 11). The findings indicated that participants’ views on the regulation of online advertising of HFSS products were informed by how professional stakeholders exerted instrumental, structural and discursive power. Participants cited regulation as a means to re-negotiate problematic power dynamics to increase young people’s and parents’ autonomy over young people’s diets, yet concern remained as to the impact regulation may have on individual autonomy. To garner increased public support for such regulatory policies, it may be beneficial for advocates to emphasise the empowering elements of those regulatory policies. Advocacy actors may wish to shift their framing of regulation from one that focuses on restricting industry practices, to one that centres on empowering individuals.

Physical Activity Promotion as a Means to Foster Human and Planetary Health: The Need to Avoid Potential Conflicts of Interests With Unhealthy Commodity Industries.

"Physical Activity Promotion as a Means to Foster Human and Planetary Health: The Need to Avoid Potential Conflicts of Interests With Unhealthy Commodity Industries" published on 25 May 2022 by Human Kinetics.

How unhealthy commodity industries find a global audience in the English Premier League: three case studies of brand engagement

ABSTRACT Establishing the English Premier League has resulted in a dramatic rise in commercial activities, raising public health concerns around unhealthy brand marketing. The present paper deals with three linked case studies analysing the marketing techniques of three of the Premier League’s partners in the 2019/20 season: Coca-Cola, Budweiser, and Cadbury. Data from Twitter were triangulated with promotional materials, product promotions in supermarkets and grey literature. An inductive thematic analysis explored the strategies used to engage fans. The studies show sponsors purchasing access to fans and inserting their brands into the emotional and passionate environment of EPL football. Sponsors evoke cultural traditions to align with and engage fans, to encourage consumption. Consumption is ’responsibilised’ and positioned as an individual choice. The marketing techniques identified exploit social and cultural dimensions of EPL football to increase consumption of unhealthy brands, with the potential to negatively impact on the health of the EPL’s audience.

Understanding the long-term policy influence strategies of the tobacco industry: two contemporary case studies

ObjectiveThis paper explores transnational tobacco companies’ (TTCs) long-term policy influence strategies using two case studies, harm reduction and illicit tobacco, to identify lessons for the tobacco control movement and wider...

The double burden of maldistribution: a descriptive analysis of corporate wealth and income distribution in four unhealthy commodity industries

ABSTRACT The health and ecological harms created and spread by firms active in many unhealthy commodity industries (UCIs) have received considerable attention from the public health community. However, less focus has been paid to analysing the distribution of wealth and income – important social and economic determinants of health – by these industries. This study aimed to examine long-term trends in wealth and income distribution by publicly listed corporations active in four UCIs: fossil fuels; tobacco; ultra-processed foods; and alcohol. Quantitative analysis of a range of data was conducted for firms listed on stock exchanges in the United States (US). Wealth and income distribution metrics were analysed at the industry level, including effective corporate tax rates and shareholder value ratios. The equity ownership structures and investor location of 20 of the largest firms were also explored. Since the 1980s, US-listed firms in the examined UCIs have distributed much less of their wealth and income to governments and much more to shareholders and investors mostly based in high-income countries. The study provides evidence that firms active in UCIs create a ‘double burden of maldistribution’: their externalised social and ecological harms disproportionately affect disadvantaged population groups and governments in low- and middle-income countries; whilst, simultaneously, they are increasingly transferring wealth and income to a group over-represented by a small and privileged elite. The identified distributive injustice warrants increased policy attention.

Social media use and adolescent engagement in health risk behaviours: a systematic review and meta-analysis

BackgroundSocial media might influence adolescents' perceived social norms and subsequent engagement in behaviours with potentially negative effects on health (health-risk behaviours). We systematically reviewed studies investigating the relationship between social media and health-risk behaviours in adolescents (age 10–19 years). MethodsWe searched five databases (CINAHL, Embase, MEDLINE, APA PsycINFO, and SocINDEX), four preprint repositories (SSRN, SocArXic, PsyArXiv, and MedRxiv), and Google Scholar from Jan 1, 1997, to April 30, 2020, for studies reporting social media use (time spent, frequency, and exposure to health-risk behaviour content) and engagement in health-risk behaviours (PROSPERO: CRD42020179766). No geographical or language limits were applied, but only English-language studies were included, due to translation issues. Risk of bias was assessed using a modified Newcastle Ottawa Scale. We used random-effects meta-analysis; potential effect modification was explored with meta-regression and stratified analyses. FindingsOf 13 142 hits, 84 studies (n=571 175 participants) were included (79% [66 studies] cross-sectional): 55% (46 studies) with high risk of bias, 20% (17 studies) moderate, and 25% (21 studies) low. The most commonly investigated exposure was frequency of social media use (43 studies). Binary exposure meta-analyses showed that frequent social media use (versus infrequent) was associated with increased tobacco use (OR 1·8, 95% CI 1·4–2·3; n=236 300; four studies), alcohol use (1·5, 1·4–1·6; n=208 318; six studies), drug use (1·2, 1·0–1·5; n=59 823; three studies), gambling (2·8, 2·0–4·0; n=26 537; five studies), sexual risk (1·7, 1·4–2·1; n=46 483; eight studies), anti-social behaviour (1·7, 1·4–2·0; n=53 539; four studies), and multiple risk behaviours (1·8, 1·3–2·4; n=43 571; two studies). Increased time (2·3, 1·6–3·4; n=10 831; three studies) and exposure to health-risk behaviour content (2·4, 1·3–4·7; n=14 731; five studies) was associated with increased harmful alcohol use. Heterogeneity varied across different outcomes (I2 16–98%). Sensitivity analyses showed that effect sizes were generally larger for cross-sectional studies than cohort studies. For alcohol use, anti-social, and sexual risk behaviours, effects were mostly larger in studies adjusted for pre-specified critical confounders (age, sex, and socioeconomic position) and those at low or moderate risk of bias, while for gambling and tobacco use, larger effects were found in unadjusted studies, and those with higher risk of bias. InterpretationSocial media use is adversely associated with unhealthy adolescent behaviours, with exposure to harmful content potentially linked to increased risk. However, more robust longitudinal studies are needed. Given increasing use of social media by adolescents and targeting of social media by unhealthy commodity industries, action to mitigate risks is needed. FundingMedical Research Council, Chief Scientist Office, NHS Research Scotland, and Wellcome Trust.

Instrumental, structural & discursive power & the regulation of online advertising of unhealthy food

Abstract Background Examinations of corporate power demonstrate how Unhealthy Commodity Industries (UCIs) exert influence on the public and policymakers. For example, the High in Fat Sugar and Salt (HFSS) product industry exploit online environments to market their products to young people as a form of discursive power, and regulating this marketing can limit the power of those industries and is recognised as an important policy response. Here we address the gap in consideration of stakeholders' views of regulation of online advertising of HFSS products to young people to limit industry power. Methods We undertook primary analysis of 8 focus groups of parents, 11 stakeholder interviews and secondary analysis of 15 focus groups of young people (aged 12 and 15 years-of-age) in various community settings, with 5 individual interviews over the telephone. Focus group participants were recruited from a range of socioeconomic areas following the Scottish Index of Multiple Deprivation quintiles. Stakeholders were recruited from civil society organisations, government bodies and industry. Analysis employed Fuchs and Lederer's (2007) framework on instrumental, structural and discursive power. Results Stakeholders' views on the power of HFSS product industry appeared to predicate their views on regulation as an appropriate policy response. The majority of participants viewed regulation as a means to increase young people's and parents' autonomy over young people's diets by addressing the problematic power dynamic with industry at a policy level, yet concern remained about the adverse impact of regulation on individual autonomy. Conclusions Power is an important consideration when examining acceptability of To increase public support for regulation, it may be beneficial to emphasise the empowering effects of policy proposals. Advocates should shift their framing of regulation from focusing on restricting industry, to focusing on empowering the public. Key messages Views on power appear important when considering public acceptability of regulatory policy. Understanding views on power may improve public health messaging on policy interventions.

“Private and personal”: Corporate political activity, informal governance, and the undermining of marketing regulation in Brazil

ABSTRACT Few studies have investigated corporate political activity by unhealthy commodity industries in low- and middle-income countries, and the significance of social and political context has been largely neglected. This study aimed to explore the stalled development of marketing restriction policies in Brazil with an analysis of strategies used to undermine the Legal Framework for Early Childhood. Using a constructivist approach based on a typology of corporate political strategies, decision-making processes were assessed to understand interference by food companies in the Legal Framework, and how this was perceived by policy actors. Semi-structured interviews were conducted with public health advocates, academics and legislature officials. Three broad strategies that contributed to the stalling of marketing restrictions in the Legal Framework were identified: relational approaches to policy influence; collective participation in formal decision-making; and specific strategy choices (information and financial incentives). Key opportunities for policy influence through informal social networks in the ‘backstage’ of policy making are found to privilege commercial sector actors. Informal policy making may have a critical function in obstructing the development of health-focused regulation in Brazil. This highlights the need for a better understanding of non-codified and hidden corporate efforts to shape the policy environment.

Lacking Clarity or Strategic Ambiguity? Comment on "Competing Frames in Global Health Governance: An Analysis of Stakeholder Influence on the Political Declaration on Non-communicable Diseases".

This commentary engages with Suzuki and colleagues' analysis about the ambiguity of multi-stakeholder discourses in the United Nations (UN) Political Declaration of the 3rd High-Level Meeting of the General Assembly on the Prevention and Control of Non-Communicable Diseases (HLM-NCDs), suggesting that blurring between public and private sector in this declaration reflects broader debates about multi-stakeholder partnerships (MSPs) and public-private partnerships (PPPs) in health governance. We argue that the ambiguity between the roles and responsibilities of public and private actors involved may downplay the role (and regulation) of conflicts of interest (COI) between unhealthy commodity industries and public health. We argue that this ambiguity is not simply an artefact of the Political Declaration process, but a feature of multi-stakeholderism, which assumes that commercial actors´ interests can be aligned with the public interest. To safeguard global health governance, we recommend further empirical and conceptual research on COI and how it can be managed.

Public-Private Partnerships With Unhealthy Commodity Industries: Are They Undermining Real Progress in Non-communicable Disease Prevention? Comment on "Competing Frames in Global Health Governance: An Analysis of Stakeholder Influence on the Political Declaration on Non-communicable Diseases".

Public-private partnerships (PPPs) and whole-of-society approaches are increasingly common in public health promotion and non-communicable disease (NCD) prevention, despite a lack of evidence in favour of their effectiveness in improving health outcomes. While PPPs may have advantages, they also give industry actors more influence over the design and implementation of public health strategies and interventions. Partnering with unhealthy commodity industries in particular - including the alcohol and ultra-processed food and beverages industries - can pose significant risks to public health due to these industries' deep-rooted conflicts of interest. In this commentary, I reiterate Suzuki and colleagues' message about the importance of assessing and managing conflicts of interest before engaging with non-state actors through PPPs or other forms of engagement.