As public health students and faculty head back to school this week, Corporations and Health Watch continues its tradition of starting the academic year with a commentary on teaching about corporations and health. Our argument for including teaching about the impact of corporations on health in public health and related academic programs is based on the following premises:
Corporations are the dominant economic and political institution of the 21st century and thus have a profound influence on global well-being.
The business and political practices of corporations are a modifiable social determinant of health and thus a promising target for public health interventions.
To achieve local, national and global public health goals of reducing premature mortality, shrinking inequalities in health, and controlling non-communicable diseases and injuries will require making changing corporate behavior as important a public health priority as changing individual behavior.
Few public health academic programs adequately prepare their students to investigate, analyze or contribute to modifying the corporate policies and practices that harm health.
To be effective in fulfilling their responsibility to prevent illness, promote health and reduce health inequalities, public health professionals should be able to demonstrate the following competencies:
Identify corporate business and political practices that affect health.
Develop public health strategies to encourage health-promoting corporate practices and discourage or end health-damaging ones.
Analyze the public health advantages and disadvantages of various government/market relationships
Create alliances with consumer, environmental, labor and health organizations and movements that seek to change harmful corporate practices and policies
Describe the roles of public health professionals and researchers in modifying harmful corporate practices or policies.
These competencies can be developed in several ways. Core public health courses can includes sessions on these topics as they relate to, for example, epidemiology, health policy, environmental health, or health education. Some programs have developed specialized courses on the topic, allowing interested students to pursue this interest. (To see a syllabus for a doctoral course Interdisciplinary Perspectives on Corporations and Health 1900-2012 at City University of New York click here to request a copy.) Or a student-faculty interest group can bring together those who want to pursue research, advocacy or practice on the corporate impact on public health.
Front entrance to the Bloomberg School of Public Health Photo credit
For the time being, you’re more likely to find a corporate name on the front of a school of public health than to have corporate practices discussed in the classroom. Fortunately, however, a growing number of resources are available to faculty who want to teach about this topic and students who want to learn more or write papers on corporations and health. I offer here a short list of such sources.
10 Sources on Corporations and Health for Use in Basic Public Health Classes
(with suggestions for use in Epidemiology (EPI), Health Policy & Management (HPM), Social and Behavioral Health (SBH), or Environmental & Occupational Health (EOH) Core Courses)
Biglan A. Corporate Externalities: A Challenge to the Further Success of Prevention Science. Prev Sci. 2011; 12(1): 1–11. (HPM, SBH)
Brandt AM. Inventing conflicts of interest: a history of tobacco industry tactics. Am J Public Health. 2012;102(1):63-71.(EPI, SBH, HPM)
Freudenberg N, Galea S. The impact of corporate practices on health: implications for health policy. J Public Health Policy. 2008;29(1):86-104 (SBH,HPM)
Huff, J. 2007. Industry influence on occupational and environmental public health. International Journal of Occupational and Environmental Health 13.1: 107–117. (EPI, EOH)
Stuckler D, McKee M, Ebrahim S, Basu S Manufacturing Epidemics: The Role of Global Producers in Increased Consumption of Unhealthy Commodities Including Processed Foods, Alcohol, and Tobacco. PLoS Med 2012; 9(6): e1001235. (EPI, SBH, HPM)
Wiist, W.H. (Ed). Bottom Line or Public Health. Tactics Corporations Use to Influence Health and Health Policy, and What We Can Do to Counter Them. NY: Oxford University Press, 2010. (relevant chapters for all 4 courses)
Woodcock J, Aldred R. Cars, Corporations, and Commodities: Consequences for the Social Determinants of Health. Emerging Themes in Epidemiology. 2008 Feb 21;5:4. (EPI, EOH, SBH)
In addition to these selected resources, a bibliographic essay on Business and Corporate Practices can be found in the Public Health section of Oxford Online Bibliographies.
Finally, several Corporations and Health Watch contributing writers have websites or blogs that include additional timely material. Check out these sites: David Jernigan, Michele Simon, Bill Wiist.
Previous CHW Posts on Teaching about Corporations and Health
WASHINGTON (Aug. 28, 2012) – The finalization of historic new federal automobile standards covering new passenger vehicles sold between 2017 and 2025 is one of the biggest actions ever taken to reduce U.S. oil use and a huge step on the path toward halving the country’s projected consumption within 20 years, the Union of Concerned Scientists (UCS) said today.
Under the new standards, which arose from a widely supported agreement between automakers, the White House, and California state officials, average fuel economy for new cars and light trucks would nearly double, and global warming pollution levels for the new vehicle fleet would be cut in half by model year 2025.
“This is truly a watershed moment. Twenty years from now we’ll be looking back on this as the day we chose innovation over stagnation,” said Michelle Robinson, director of UCS’s Clean Vehicles program. “These standards will protect consumers from high gas prices, curb global warming pollution, cut our oil use, and create new jobs in the American auto industry and around the nation.”
The new standards build on a similar set of regulations that are already saving consumers money at the pump and cutting oil use. The Environmental Protection Agency and Department of Transportation are implementing the standards for model years 2012 through 2016, which allow automakers to produce a fleet of vehicles that simultaneously complies with both the Clean Air Act and Corporate Average Fuel Economy standards.
According to UCS analysis, the combined standards will:
Cut oil use by as much as 3.1 million barrels per day by 2030 – roughly the amount we import from the Persian Gulf and Venezuela combined;
Save consumers $8,000 over the life of a model year 2025 vehicle, compared to the average vehicle on the road today, even after paying for fuel-saving technology; and
Reduce U.S. global warming pollution by as much as 570 million metric tons in 2030, the equivalent of taking a third, or 85 million, of today’s cars and trucks off the road for an entire year.
In addition to support from automakers, lawmakers, scientists, consumer advocates, environmental groups, and national security experts, a recent poll from the Consumer Federation of America found that 74 percent of Americans support the new standards. Most respondents also said they want higher fuel economy in their next vehicle purchase, but despite this deep popularity and the many benefits of the standards, a vocal minority continues to speak out against the rules.
“If you are against these common-sense standards, you are against saving consumers money, against consumer choice, and for leaving our economy open to being crippled yet again by our expensive oil use,” said Robinson.
Automakers are already producing cleaner, more efficient vehicles that meet the standards.
“From advanced engines and transmissions to hybrid powertrains, automakers are already demonstrating what they can do with fuel-efficient technology,” said Jim Kliesch, research director for the Clean Vehicles program. “Thanks to these standards, this is just the beginning of the fuel-saving choices consumers will have on the showroom floor.”
The new standards are a critical step to turn around our nation’s growing rate of oil consumption, and just one of many. By tapping deeper into existing efficiency technology and promoting innovative solutions here in the United States, our nation can build on the groundwork these standards create and put the nation on a course to cut its projected oil use in half over a 20-year period.
UCS’s Half the Oil Plan lays out a practical and feasible path to reach that goal, and includes technologies and policies that make passenger vehicles and commercial trucks more efficient, hybrid and electric vehicles more practical, and vehicle fuels less polluting.
“Automakers are already showing us what they can do with a skilled and determined workforce,” Robinson said. “We need to build on that groundwork and take an even bigger bite out of our oil consumption.”
Click here to learn more about the new standards and the role they play in long-term oil savings.
To forestall policy on climate change, the Wall Street Journal editorial board routinely downplays scientific consensus, overstates the cost of taking action, and claims that politics, not science, motivates those concerned about the climate. But in a new analysis of more than 100 editorials from 1976 to present, Media Matters for America shows that the Wall Street Journal used these same rhetorical tactics in previous decades on acid rain and ozone depletion and these arguments did not stand the test of time.
According to a new report from scientists at the Max Planck Institute for Chemistry, the Institute of Atmospheric Physics and the Joint Research Centre of the European Commission, in 2050, the air quality worldwide will be as bad as it already is nowadays in urban areas of Southeast Asia, one of the most polluted places on Earth. Air pollution in Europe and North America would also increase, but due to the effect of mitigation policies – that have been in place for more than two decades now – to a much lesser extent than in Asia. Urban air pollution is estimated to kill 1.2 million people each year and the largest single source is motor vehicle exhaust.
The average fuel economy of new vehicles sold in the United States dropped in June for the third straight month, according to a study by University of Michigan researchers. Falling gas prices and higher sales of SUVs and light trucks contributed to the decline in fuel economy. Less efficient cars generate more air pollution.
This week, 50,000 delegates will gather in Rio de Janiero for the United Nations Conference on Sustainable Development. While the slogan is ambitious — “the future we want,” in comparison to the first Earth Summit held in Rio in 1992, the goals of this twentieth anniversary celebration are modest. As Andrea Correa de Lago, Brazil’s head of environment at the Ministry of Foreign Affairs and chief negotiator on climate change, said last February, “It is not an idealistic conference, we are not going to say we are saving the planet through goals and measures that we know are not going to be taken seriously.”
Rather, the opportunity for this meeting is to create a framework for longer term discussion about how best to promote a sustainability agenda. One difference for this year’s conference compared to 1992 will be the active participation of city governments, NGOs, and the private sector. As a result, said Rodrigo Rosa, Rio+20 coordinator at Rio de Janeiro’s Mayor’s Office, “Rio+20’s strength will not be inside the offices, but in the movement. This year we’ll have a great amount of parallel events that didn’t happen in 1992. Politicians are reactive, they take decisions after there’s will in civil society. I think Rio+20 will contribute to that.”
For public health activists seeking to build a movement for sustainability, Rio+20 provides an opportunity to consider the causes and solutions to two of the gravest threats to global sustainability: human-induced climate change and the rise of non-communicable diseases (NCDs) such as cardiovascular disease, diabetes, cancer and respiratory conditions. A recent report in Lancet summarizes the connections between climate change and NCDs, arguing that many of the world’s “development goals have not been achieved partly because social (including health), economic, and environmental priorities have not been addressed in an integrated manner.”
As Manish Bapna, Acting President and Executive Vice President & Managing Director of the World Resources Institute recently observed, developing effective strategies to achieve more sustainable economic growth requires addressing two related trends:
The rise of the multinational corporations. Having grown dramatically in size, reach, and number in recent decades, global corporations wield increasing influence over the environment and society. Global supply chains only magnify their role. Today, what happens in a factory in China, South Africa, or Thailand can reverberate around the planet.
The expansion of the global middle class. Exploding growth in the developing world has created a vast new middle class, which could near five billion by 2030, of whom 66 percent will live in Asia. That is a lot of new consumers. How will they live, eat, shop, and get to work? Will they emulate the worst habits of the developed world, or will they embrace a role as better stewards of the planet?
In fact, the rise of both NCDs and global warming in the last few decades can be explained in significant part by the efforts of multinational corporations in the automobile, energy, food and beverage, tobacco, alcohol, pharmaceutical and other industries to target these emerging middle classes in China, India, Brazil, Indonesia and elsewhere for their brand of hyper consumption. As markets become saturated in developed nations, these new markets are the corporations’ hope for profitability in this century. But the lifestyle that corporations promote to achieve their business goals is itself a fundamental cause of unsustainable energy use and chronic diseases. Its remedy requires changing not individual behavior but corporate practices. As the Third World Network, an NGO in Malaysia, put it in their Rio+20 briefing paper, “If governments want to enable sustainable development, then they must regulate transnational corporations who are drivers of unsustainable development.”
In past global meetings, much of the focus has been on what governments can and should do, an important and appropriate topic of discussion. But it is equally important to ask what corporations cannot do if sustainable growth is to be achieved. A Lancet editorial hopes that in the future, Rio+20 “is looked upon as launching a new era for human wellbeing, one that is rooted in principles of equity, social justice, and sustainability.” Achieving that goal will require a willingness to reconsider the role of multinational corporations in today’s world. Rio+ 20 will be judged on its progress in this critical task.
The New York Times reports that retail prices for five-year-old full-size S.U.V.’s are 23 percent higher than a year ago, according to Edmunds.com, an automotive information Web site. That is more than double the average price increase of 11 percent for all five-year-old vehicles. Prices for three-year-old S.U.V.’s are up 6 percent, triple the 2 percent average increase for all vehicles that age. However, auto safety experts fear that used SUVs, driven by younger, less skilled drivers and less well maintained than new vehicles may cause even higher rates of driver and pedestrian injuries and fatalities than new SUVs, illustrating the long shadow of an environmentally destructive product.
A recent trip to China has persuaded me that the choices the Chinese people and government make about consumption, health and economic development will shape global patterns of chronic disease and injuries for the rest of this century. Last week, I wrote about Coca Cola and PepsiCo’s plans to encourage increased sugary beverage consumption in the world’s largest market—and the likely implications for China’s growing obesity and diabetes epidemics. In this post I consider the future of the Chinese automobile industry and the implications for health. China’s choices in this and other sectors will affect not only the well-being of the Chinese people but also establish a model that other emerging economics like Brazil, India, Mexico and South Africa may follow.
World’s Largest Auto Market
Traffic jam in Shanghai
China is now the world’s largest auto market. According to a recent report by the J.D Power Associates, an automotive information resource, new-vehicle shoppers in China have the world’s widest range of choices, with 94 brands and 476 models from which to choose. That compares with fewer than 40 brands and nearly 100 fewer models available in the U.S. market, the second-largest automotive market in the world in 2011. LMC Automotive forecasts a nine percent growth in passenger-vehicle sales in 2012, a much lower rate than in previous years when China’s new-vehicle sales surged at double-digit rates. China’s passenger-vehicle market is expected to grow at a compounded annual rate of 12.4 percent during the next four years and will reach an estimated 20.9 million units annually by 2015.
Despite the recent slowdown in auto sales, the rapid growth in automobiles has created some serious problems, reports China’s Xinhua News Agency, including traffic grid-lock, pollution and energy shortages. “China’s auto industry is caught in a dilemma in the wake of energy supply strains, deteriorating environment and traffic woes,” Cui Jingshu, an auto dealer in Changchun, capital city of the northeastern Jilin Province, told Xinhua. Jiang Jun, a researcher with Jilin Academy of Social Sciences, noted that given that each car uses about a ton of oil a year, “the current 200 million tons of annual gasoline and diesel oil supply can only support a maximum of 200 million vehicles.” China currently registers 219 million motor vehicles, of which about 100 million are automobiles.
Motor vehicle exhaust is now a major source of air pollution in the country, adding to the nation’s already serious coal-related pollution. “About one third of the 100 major cities across the country failed to meet air quality standards during recent years, for which vehicle emissions should be blamed,” Jiang said. China has vowed to reduce both energy consumption and carbon emissions per unit of economic output by 18 percent over the next five years, as part of its wider plan to cut the carbon use per unit of GDP by 40 to 45 percent by 2020 from 2005 levels.
Many cities, including Beijing, recently adopted measures to reduce auto use including higher parking charges in downtown areas and a car-quota system, which allows only 240,000 new cars to be registered in the city this year, compared with the 800,000 units that took to the streets in 2010.
One influence that helped persuade China to take action on pollution was the 2008 Olympics and the hope that the millions of visitors might see some blue sky through Beijing’s notorious smog. Another influence may have been the social media. In an interview with Yale Environment 360, Ma Jun, a former journalist, author, and founder of the Beijing nonprofit Institute for Public and Environmental Affairs, said that one reason air pollution has recently become such a pressing public issue is because of the concurrent rise of social-media platforms in China — especially the microblogging sites Sina Weibo and Tencent Weibo. Ma Jun went on to explain:
Last year, Beijing suffered from several long spells of hazy days — people began to feel that their quality-of-life and work productivity were impacted, and they worried about the health of their children. Also, so many flights got canceled because of the smog… Even with an ambitious plan, Beijing will probably not be able to meet air-quality standards for 18 or 20 years.
Role of US Auto Industry
China’s domestic auto industry is growing and emphasizes electric cars. But US and European automakers are also rushing to grow their share of business in the world’s largest car market. According to the Wall Street Journal, General Motors:
…plans to add 600 dealerships in China this year, about a 20 percent increase, as the auto maker looks to bolster its presence here amid growing competition and an economic-growth slowdown. Chief Executive Dan Akerson…outlined steps GM is taking to boost sales and market share in China, where it is the largest foreign auto maker. The addition of 600 dealerships would bring the company’s dealer network in China to 3,500 stores, up from 2,900 at the end of 2011. At that size, China’s dealers would begin to rival the company’s U.S. network of 4,400.
General Motors has announced that it will partner with China’s SAIC Motor Corporation on the
Photoshoot for the new GM SAIC automobile in Yangshuo, China
development of an all-new electric vehicle. The final product will be sold in China under the SAIC brand, but GM will benefit from the deal by having a new electric vehicle platform which can be used to spawn new vehicles in other global markets. Ford is also an active player in China and GM’s expansion comes as Ford sales have declined in the slowing Chinese auto market.
One consequence of the current slowdown in auto sales in China, reports the Wall Street Journal this week, is that it is leading Chinese auto makers to increase their exports. According to Forbes, in coming years, China hopes to enter the US auto market, competing in the plug-in electric market and using battery technology from China. Forbes predicts that Chinese auto manufacturers:
…will forgo the internal combustion engine altogether. The Chinese have been putting money into research and development on electric vehicles for years. CODA, a privately held American company based in Los Angeles, makes a sedan that, like the Chevy Volt, will be priced over $40,000 and be eligible for a $7,500 federal tax credit. CODA also happens to make its “glider” — a vehicle without a powertrain — in China. CODA will import a sedan glider for use as electric vehicle. The battery it runs on: also imported from China. “Because we build the glider in China, technically ours will be the first Chinese manufactured car sold in the U.S.,” said CODA representative Larkin Hill.
Air pollution, Beijing
Implications for Health
The United States, birthplace of the corporate-led autocentric mode of development, has no moral authority to tell China or any other country not to make cars more available to its consumers. But this country’s experience with automobile-related air pollution, climate change, clogged highways, inactivity-related obesity and other health problems and auto-distorted urban development has much to say about the perils of letting the automobile industry dictate economic development. Can the US public health community find respectful ways to share these lessons with colleagues and governments in emerging nations? Our success could alter the rising global tide of deaths, illness and injury related to the world’s growing number of motor vehicles.
Bloomberg reveals that during the 2010 midterm elections, big oil and big pharma spent millions of dollars to help elect Republicans to Congress through attack-ads. The Supreme Court’s 2010 Citizen’s United decision paved the way for virtually unrestricted corporate campaign spending, in this case to fund politically active groups like Americans for Prosperity. According to Think Progress, a blog of the Center for American Progress Action Fund, Chevron’s profits have jumped 23.3 percent since its 2010 controbutions.
Last month, the California Air Resources Board (CARB) passed stringent new standards intended to boost the production and sale of electric and hybrid vehicles here and nationwide, reports the Christian Science Monitor. The new rules mandate that 15 percent of new cars sold in the state by 2025 run with zero or near-zero emissions. The result would be some 1.4 million electric, plug-in hybrid, and hydrogen cars on California roads within 13 years. Today, there are 10,000 such vehicles in the state. Perhaps surprisingly, automakers appear to be on board.
Corporations and Health Watch 