Roundup of 2014 Stories on Health Impact of Corporations

For observers of how corporations find ways to profit at the expense of public health, the news coverage of 2014 provides a wealth of evidence. Here are three stories that caught my eye last year. Next week I’ll present stories about the food, firearms and tobacco industries, the other sectors that Corporations and Health Watch follows.

 

Auto Recalls at General Motors, Chrysler, Ford, Toyota, Honda and Others Set New Record

 

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Last year, reported the New York Times, more than 60 million vehicles have been recalled in the United States, double the previous annual record in 2004. In all, there have been about 700 recall announcements — an average of two a day — affecting the equivalent of one in five vehicles on the road. The eight largest automakers have each recalled more vehicles in the United States this year than they have on average since 1966, when data collection began, with G.M., Honda, and Chrysler each setting corporate records, the review by The Times found.

 

GMs failed ignition switches on Chevy Cobalts and several other models were one source for the recalls. Another was airbags manufactured by Takata, a Japanese parts maker, that occasionally exploded injuring or killing passengers or drivers. According to Consumer Reports, 7.8 million vehicles, made by 10 different automakers, have been recalled to replace frontal air bags on the driver’s, passenger’s sides or both. An ominous lesson from the Takata recalls is that globalization of the auto industry and the concentration of parts makers into a few giant companies can result in many manufacturers relying on the same few parts suppliers. If these parts fail, the population impact can be enormous.

 

 

AstraZeneca, Eli Lilly, GlaxoSmithKline, Merck and Other Drug Makers Pay Doctors and Hospitals Billions to Promote their Drugs

 

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According to the Centers for Medicare & Medicaid Services, as of December 19, 2014,  drug makers paid at least 366,000 U.S. doctors and 900 teaching hospitals $3.7 billion for gifts, meals, travel, speaking about their products, or attending promotional events.

 

In a series of stories called Dollars for Docs: How Industry Dollars Reach Your Doctors, Pro Publica describes the many ways that drug companies pay doctors—often physicians who have been previously sanctioned for unethical or illegal practices– to promote their products. Pro Publica also provides a database that allows readers to look up what companies have paid which doctors. This information is now available thanks to the Physician Payment Sunshine Act, a part of the Affordable Care Act that went into effect in 2014.  Would requiring other companies in other sectors to report who they paid to promote their products help consumers to make more informed judgments on products?

 

 

 

Alcohol Makers Market Powdered Alcohol

 

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Powdered alcohol hasn’t even arrived in stores yet, but some states already are moving to ban the product touted by its inventor as an easy way to mix a drink on the go. The UK-based Daily Mail reports that Colorado is the latest state considering prohibiting ‘Palcohol’ amid concern it will increase underage drinking. The product is marketed as an ounce of rum or vodka in powdered form, which is then added to water. Each serving is the equivalent of a shot of liquor, according to Lipsmark, the company that owns Palcohol. The company awaits labeling approval from the Alcohol and Tobacco Tax and Trade Bureau. The Food and Drug Administration said it does not have a legal basis to block the product after examining the non-alcoholic ingredients in the powder. Will this product make it to market in 2015? Stay tuned.

In May 2014, David H. Jernigan, Director of the Center on Alcohol Marketing and Youth at the Johns Hopkins Bloomberg School of Public Health noted:

 

“Based on our experience with jello shots, alcoholic energy drinks, and other “cutting  edge” alcohol products, we anticipate that allowing powdered alcohol onto the market  will have grave consequences for our nation’s young people. Youth is a time of risk-taking and experimentation, and these types of products have proven most popular among the heaviest drinking and more risk-prone youth. Powdered alcohol is also highly concealable, making it all too easy for youth to access and consume. Currently 4300 young people under age 21 die each year from alcohol-related causes; our efforts should be focused on making alcoholic products less, not more, available to our nation’s youth.”

Alcohol abuse costing Britain £6 billion a year

Alcohol abuse could be costing the United Kingdom up to £6 billion a year in NHS bills, premature death, losses to business and drink-related crimes and accidents, reported The Daily Mail. A study by the Royal College of Physicians said drink-related health problems could account for up to 12% of total NHS spending on hospitals, about £3 billion. Campaigners said that with the estimated £3 billion lost through absenteeism, unemployment, premature deaths and alcohol-related crimes and accidents the total cost of excessive drinking is £6 billion.

Alcohol-related illness and death in Scottish neighbourhoods: is there a relationship with the number of alcohol outlets?

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Researchers at the Centre for Research on Environment, Society and Health (CRESH) at the University of Edinburgh and the University of Glasgow in Scotland have released a new report on alcohol outlet density and health. Key messages are below and full report is here.

  • There are large variations in numbers of alcohol outlets within neighbourhoods across Scotland.
  • Across the whole of Scotland, neighbourhoods with higher numbers of alcohol outlets had significantly higher alcohol-related death rates.
  • Alcohol-related death rates in neighbourhoods with the most alcohol outlets were more than double the rates in those with the fewest outlets. There were 34 alcohol-related deaths per 100,000 people in neighbourhoods with the most off-sales outlets, compared with 13 per 100,000 in neighbourhoods with the fewest.
  • Across the whole of Scotland, alcohol-related hospitalisation rates were significantly higher in neighbourhoods with the most alcohol outlets.

Public Policies and the Risk Factors for NCDs in Brazil

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At the Todo Juntos Contra O Cancer (Together Against Cancer) conference in Sao Paulo, Brazil last week, several presenters explored the role of the food, alcohol and tobacco industries in non-communicable diseases in Brazil and elsewhere. The moderator of the panel was Claudia Collucci, a reporter for Folha de Sao Paulo, a major Brazilian newspaper. The panel at this session included:

 

Professor Carlos A. Monteiro, Department of Nutrition, School of Public Health, University of Sao Paulo, who spoke on Ultra-processed foods and health, exploring the need for public policies to reduce the proportion of calories derived from ultra-processed foods;

 

Dr. Maristela Monteiro, Senior Advisor for Alcohol and Substance Abuse at the Pan American Health Organization, who spoke on Alcohol as a risk factor for public health in the Americas , an overview of the burden of disease imposed by alcohol and the policies used to reduce this burden.

 

Paula Johns, Executive Director, ACT – Alliance for the Control of Tobacco Use, Brazil, who spoke on Success and challenges in tobacco control, a look at the challenges faced and strategies employed to curb smoking prevalence in Brazil.

 

Nicholas Freudenberg, Distinguished Professor of Public Health at City University of New York, who spoke on Changing the Practices of the Tobacco, Alcohol, Automotive, and Food Industries to Prevent Noncommunicable Diseases, an examination of the role of corporate business and political practices on NCDs.

Defining Strategies for Promoting Product Through ‘Drink Responsibly’ Messages in Magazine Ads for Beer, Spirits and Alcopops

A study of “drink responsibly” messages in US magazines published in Drug and Alcohol Dependence found that “responsibility messages were overwhelmingly used to promote product rather than convey relevant public health information… Existing responsibility messages are largely ineffective at conveying relevant public health information, and should be supplemented by or replaced with prominently placed, externally developed, cognitively tested warnings that do not reinforce marketing messages.”

Climate Change, Food and Health: Taking Action to Address Root Causes

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The “good” news is that three of the world’s most serious threats —human-induced climate change, accelerating epidemics of chronic diseases, and growing food insecurity — have common causes and therefore potentially common solutions. The 2014 Climate Summit at the United Nations later this month provides an opportunity for scientists, government leaders, activists and concerned citizens from around the world to examine these common causes and identify the actions we can take to modify the underlying causes of these intersecting crises.

 

What are these common roots?   Our economy’s continued dependence on fossil fuels ensures that carbon continues to accumulate, accelerating rising global temperatures and their impact on weather, climate and human well-being. The global energy industry from Exxon to BP to Gazprom uses its economic and political power to thwart widespread implementation of alternatives. Evidence shows that coal plays an especially important role in climate change yet countries like China, the United States and others continue to support coal production. According to Greenpeace, the fossil fuel industry is planning 14 massive coal, oil and gas projects that would produce as much new carbon dioxide emissions in 2020 as the entire US, and delay action on climate change for more than a decade.

 

Hyperconsumption describes lifestyles and health behaviors that put people at risk of premature death and preventable chronic illnesses. Each year the tobacco, alcohol and processed food industries spend billions of dollars aggressively promoting their products around the world, despite the World Health Organization’s finding that increased consumption of tobacco, alcohol and unhealthy food are primary drivers of growing rates of chronic diseases, today’s leading global killers. The production and distribution practices of the food, alcohol and tobacco industries contribute to global warming and also magnify global health inequalities.

 

Autocentrism is the irrational promotion of automobiles as the main mode of human transportation. Despite growing evidence that active transportation like walking and bicycling and mass transitcontribute to more physical activity, better health, fewer emissions of carbon and other pollutants, and people-friendlier cities and towns, the automobile industry and the governments that support it resist pursuing alternatives at a scale that can achieve their benefits.

 

Industrial agriculture describes the transformation of food production from small and medium size farmers and manufacturers to a system where giant multinational corporations like Monsanto, Cargill, Coca Cola, McDonald’s, Nestle and Walmart control every stage of our food system from patented seeds, monoculture farming, and integrated distribution to global marketing and retail outlets. Industrial agriculture insists that the bottom line is their profit, not human need. Its practices on fertilizers, transportation, meat production and global trade contribute to carbon emissions, diet-related diseases and food insecurity.

 

One reason that climate change, chronic disease and food insecurity have worsened in recent decades is that the industries involved and business and international trade associations they have created have coordinated a massive effort to roll back regulations that protect public health and the environment and discredit the science that documents the dangers the world faces.

 

Underlying these trends has been the growing concentration of wealth and power in the hands of corporations and the moneyed interests that own and control them. The synergistic impact of these developments has been a rise in inequality and declines in democracy, developments that make it harder to propose and mobilize public support for alternative policies.

 

Some who agree on the magnitude of the threats and the evidence on common causes of climate change, premature deaths from chronic diseases and growing food insecurity are reluctant to act because they believe the problems are too big and complex and the perpetrators too powerful to make change possible. But the acceleration of each of these problems results from human decisions made over the course of the last few decades. And what people decide in one time, they can change in another.

 

To the chorus of the powerful that there is no alternative to the status quo the response of the majority must be that another world is possible. By encouraging public discussion of the common roots of climate change, chronic diseases and food insecurity, we can begin to shine a light on the actions that will lead us to that other world.

 

Every generation is judged by the world we leave our children and grandchildren. The decisions we make in the years to come will determine whether our legacy is shortened lifespans, growing hunger, and further deterioration of the environment that supports life. Or we can decide that our gift will be better health, food security and a more sustainable planet. The choice is ours.

 

Another World is Possible

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For more information, read the recent Lancet summary on climate change and health and Chapter 7 on food security and Chapter 11 on Human Health from the Intergovernmental Panel on Climate Change, 2014.

 

Back to School Books on Corporations and Health

For those who make a living teaching about health, August means getting ready for returning to the classroom and introducing new students to what we think is important. A basic premise of Corporations and Health Watch is that every health professional should understand something about the ways corporations influence health and what can be done to prevent or modify corporate practices that harm health.

 

To help CHW readers contribute to that goal, I suggest five books to add to public health, medical, nursing, social work or related course readings and discussions.  These books have been published or updated in the last year or so, are available for less than $30, and can be used in a variety of courses including introductory public health, health policy, social and behavioral health, epidemiology or social epidemiology and more specialized courses.

 

I suggest books –in addition to the texts and journal articles we usually assign—because they give students an opportunity to read in more depth on a single topic, evaluate the range of evidence that authors present, and react to the opinions the authors draw from this evidence. The brief descriptions of each book are those provided by the publisher.

 

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Corporations Are Not People: Reclaiming Democracy from Big Money and Global Corporations

By Jeff Clements, Updated Edition, 2014, Berrett and Kohler

 

Describes the new fabrication of rights and power for corporations and money, at the expense of the rights of human beings and of democracy itself.  A resource for everyone who want to join the historic work to overcome partisan divides and re-engage in self-government by all Americans — community by community, state by state, and, ultimately, in Washington itself. This 2014 edition is updated throughout with surprising information and analysis about the impacts of unlimited money in federal, state, and even local elections; the spreading “corporate capture of the courts” resulting from the dangerous fabrication of “corporate rights” in the Constitution; and the growing, historic response from people of all political viewpoints to defend democracy and rebuild government of the people. A completely new chapter—“Do Something”- shows how thousands of so-called ordinary people are working to build the “most dynamic, grass-roots movement in the United States,” and offers “portals” for people to connect and act.

 

 

 

 

 

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The Gun Debate What Everyone Needs to Know
Philip J. Cook and Kristin A. Goss, Oxford University Press, 2014

 

No topic is more polarizing than guns and gun control. From a gun culture that took root early in American history to the mass shootings that repeatedly bring the public discussion of gun control to a fever pitch, the topic has preoccupied citizens, public officials, and special interest groups for decades. The Gun Debate: What Everyone Needs to Know® delves into the issues that Americans debate when they talk about guns. With a balanced and broad-ranging approach, noted economist Philip J. Cook and political scientist Kristin A. Goss thoroughly cover the latest research, data, and developments on gun ownership, gun violence, the firearms industry, and the regulation of firearms. The authors also tackle sensitive issues such as the effectiveness of gun control, the connection between mental illness and violent crime, the question of whether more guns make us safer, and ways that video games and the media might contribute to gun violence. No discussion of guns in the U.S. would be complete without consideration of the history, culture, and politics that drive the passion behind the debate. Cook and Goss deftly explore the origins of the American gun culture and the makeup of both the gun rights and gun control movements.

 

 

 

 
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Lethal But Legal Corporations, Consumption, and Protecting Public Health
Nicholas Freudenberg, Oxford University Press, 2014

 

Decisions made by the food, tobacco, alcohol, pharmaceutical, gun, and automobile industries have a greater impact on today’s health than the decisions of scientists and policymakers. As the collective influence of corporations has grown, governments around the world have stepped back from their responsibility to protect public health by privatizing key services, weakening regulations, and cutting funding for consumer and environmental protection. Today’s corporations are increasingly free to make decisions that benefit their bottom line at the expense of public health. Lethal but Legal examines how corporations have influenced — and plagued — public health over the last century, first in industrialized countries and now in developing regions. It is both a current history of corporations’ antagonism towards health and an analysis of the emerging movements that are challenging these industries’ dangerous practices. The reforms outlined here aim to strike a healthier balance between large companies’ right to make a profit and governments’ responsibility to protect their populations. While other books have addressed parts of this story, Lethal but Legal is the first to connect the dots between unhealthy products, business-dominated politics, and the growing burdens of disease and health care costs. By identifying the common causes of all these problems, then situating them in the context of other health challenges that societies have overcome in the past, this book provides readers with the insights they need to take practical and effective action to restore consumers’ right to health.

 

 

 

badpharmaBad Pharma: How Drug Companies Mislead Doctors and Harm Patients
by Ben Goldacre (New paperback edition, 2014) Macmillan Publishers.

 

We like to imagine that medicine is based on evidence and the results of fair testing and clinical trials. In reality, those tests and trials are often profoundly flawed. We like to imagine that doctors who write prescriptions for everything from antidepressants to cancer drugs to heart medication are familiar with the research literature about these drugs, when in reality much of the research is hidden from them by drug companies. We like to imagine that doctors are impartially educated, when in reality much of their education is funded by the pharmaceutical industry. We like to imagine that regulators have some code of ethics and let only effective drugs onto the market, when in reality they approve useless drugs, with data on side effects casually withheld from doctors and patients. All these problems have been shielded from public scrutiny because they are too complex to capture in a sound bite. Ben Goldacre shows that the true scale of this murderous disaster fully reveals itself only when the details are untangled. He believes we should all be able to understand precisely how data manipulation works and how research misconduct in the medical industry affects us on a global scale. With Goldacre’s characteristic flair and a forensic attention to detail, Bad Pharma reveals a shockingly broken system in need of regulation. This is the pharmaceutical industry as it has never been seen before.

 

 

 

 

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Food Politics: How the Food Industry Influences Nutrition and Health by Marion Nestle, University of California Press, Revised and Updated Paperback, 2013

 

We all witness, in advertising and on supermarket shelves, the fierce competition for our food dollars. In this engrossing exposé, Marion Nestle goes behind the scenes to reveal how the competition really works and how it affects our health. The abundance of food in the United States—enough calories to meet the needs of every man, woman, and child twice over—has a downside. Our overefficient food industry must do everything possible to persuade people to eat more—more food, more often, and in larger portions—no matter what it does to waistlines or well-being. Like manufacturing cigarettes or building weapons, making food is very big business. Food companies in 2000 generated nearly $900 billion in sales. They have stakeholders to please, shareholders to satisfy, and government regulations to deal with. It is nevertheless shocking to learn precisely how food companies lobby officials, co-opt experts, and expand sales by marketing to children, members of minority groups, and people in developing countries. We learn that the food industry plays politics as well as or better than other industries, not least because so much of its activity takes place outside the public view.

 

 

 

 

 

 

For previous Corporations and Health Watch Back to School posts see:
Corporations and Health Watch Goes Back to School: 10 Recent Articles for Fall 2013 Courses
Bringing Corporations and Health into the Public Health Curriculum
Corporations and Health Watch Goes Back to School: 10 Ways to Bring the Health Impact of Business Practices into the Classroom

South Africa Delays Ban on Alcohol Advertising

The Lancet reports that a plan to ban alcohol advertising that was approved by the South African Cabinet in 2013 but not yet released for public comment is now subject to a regulatory impact assessment that could delay implementation for months. The liquor industry is strongly opposed to the bill and has mobilized interest groups to challenge its merits. An advertising ban in South Africa could trigger bans in neighboring countries, thwarting the alcohol industry’s efforts to develop new markets targeting women, a group whose drinking rates are generally low in Africa.

Wine and Spirits Getting Stronger, Setting Back Effort to Cut Illnesses and Death

The Guardian reports that wine and spirits are getting stronger in the United Kingdom, affecting government efforts to get the drinks industry to remove 1bn units of alcohol from high street stores. The average volume of alcohol in drinks edged up from 7.25% to 7.31% between 2011 and 2012, according to a little-noticed Department of Health report. Health ministers want the industry to remove 1bn units from supermarket and off-license shelves by the end of 2015 to help cut alcohol-related illnesses and deaths.

Underage Youth and Adults Differ in their Alcohol Brand Preferences

A new report published online by Substance Abuse finds that youth are not merely mimicking the alcohol brand choices of adults but choose to disproportionally consume brands such as Keystone Light beer, Bacardi malt beverages, Malibu rum, Captain Morgan rum and Smirnoff malt beverages. This suggests that other factors may influence youth drinking preferences.