BEYOND NON-COMMUNICABLE DISEASES: Expanding The Scope Of Commercial Determinants Of Health Research

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In its first decade, research on commercial determinants of health (CDoH) focused heavily on the role of the tobacco, alcohol, and food industries in the rising burden of widening inequities in non-communicable diseases such as heart conditions, diabetes, cancer, stroke, and lung diseases. While these industries do play a powerful role in shaping global patterns of health and disease, this post highlights two recent studies that expand the scope of this work to other sectors and industries. Readers are invited to send notices of other recent (2021) CDoH articles that study outcomes other than NCDs and sectors beyond food, alcohol, and tobacco.

The COVID-19 Pandemic Exposes Another Commercial Determinant of Health: The Global Firearm Industry


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Firearms have a significant impact on the health of individuals and societies globally, with a disproportionate burden on low- and-middle-income countries (LMICs). The firearms industry uses strategies to promote the sale and use of their products that are detrimental to health and therefore should be viewed through a commercial determinants of health lens. Coupled with the heightened risks during the COVID-19 pandemic, the threat to health posed by the firearms industry necessitates public health research, intervention, and collaboration. Public health practitioners and policy makers should increase efforts to reduce the burden of firearm violence. Public health researchers should use a commercial determinants of health lens when investigating health risks caused by firearms. When discussing solutions to firearm violence, public health practitioners and policy makers should include perspectives from LMICs and vulnerability.

Citation: The COVID-19 Pandemic Exposes Another Commercial Determinant of Health: The Global Firearm Industry, Adnan A. Hyder, Meghan Werbick, Lauren Scannelli and Nino Paichadze, Global Health: Science and Practice June 2021, 9(2):264-267

Pharmaceuticals As a Market For “Lemons”

Drawing on economic theory and institutional analysis, this paper characterizes pharmaceuticals as a multi-tier market of information asymmetry in which actors in each tier have substantial control over how much they disclose about hidden risks of harm. Such a market rewards the production and sale of “lemons.” Current incentives and institutional practices reward developing a large number of barely therapeutically innovative drugs and ignoring their often hidden or understated harmful side effects. The probability of benefits decreases but the chances of lemons adverse events do not. The details presented here deepen understanding of how markets for lemons thrive on information asymmetry, secrecy, and power.

Citation:  Light DW, Lexchin JR. Pharmaceuticals as a market for “lemons”: Theory and practice. Social Science & Medicine. 2021 ;268:113368.

The Commercial Determinants of Three Contemporary National Crises: How Corporate Practices Intersect with the COVID-19 Pandemic, Economic Downturn, and Racial Inequity

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The United States finds itself in the middle of an unprecedented combination of crises: a global pandemic, economic crisis, and unprecedented civic responses to structural racism. While public sector responses to these crises have faced much justified criticism, the commercial determinants of these crises have not been sufficiently examined. In a commentary in The Milbank Quarterly, Maani et al. examine the nature of the contributions of such actors to the conditions that underpin these crises in the United States through their market and nonmarket activities. On the basis of their analysis, the authors make recommendations on the role of governance and civil society in relation to such commercial actors in a post-COVID-19 world.

Redressing the Corporate Cultivation of Consumption: Releasing the Weapons of the Structurally Weak

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Clearing forest for palm oil cultivation in Indonesia. Credit: Rainforest Rescue

Sharon Friel explores in the International Journal of Health Policy and Management how to transform the corporate food system that makes highly  processed, packaged and palatable  unhealthy food and beverages into a healthier and more sustainable food system.

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188 Experts call on UN Human Rights Commission and WHO to develop guidelines on proper roles for market forces in healthy diets and sustainable food systems

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In a letter  in BMJ signed by 188 food and health experts from 38 countries called on the United Nations High Commissioner for Human Rights, Michelle Bachelet, and the Director-General of the World Health Organization, Tedros Ghebreyesus, to initiate an inclusive process to develop guidelines on human rights, healthy diets and sustainable food systems. The letter notes, “As we approach the midpoint in the UN Decade on Nutrition, the status quo is untenable and bold actions are needed.

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Countering the commercial determinants of health: strategic challenges for public health

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A special issue of the Australian journal Public Health Research and Practice edited by Becky Freeman and Colin Sindall considers the ‘commercial determinants of health’ defined as the practices of corporations which produce and market unhealthy commodities such as tobacco, alcohol, soft drinks and processed food.  The limited regulatory control of these industries has contributed to their role in driving the growing global epidemic of noncommunicable disease. The papers in this issue help to further illuminate how the behaviour of these companies serves to undermine advances in chronic disease prevention.

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Civil society action against transnational corporations: implications for health promotion

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Transnational corporations (TNCs) shape population health both positively and negatively through their national and international social, political and economic power and influence; and are a vital commercial determinant of health. In an articlein Health Promotion International, Julia Anaf and colleagues discuss the unequal power relations existing between TNCs that promote their own financial interests, and activists and advocates who support population and environmental health by challenging corporate power. 

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David Sanders: Activist, Teacher, Scholar and Public Health Practitioner

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David Sanders 1945-2019

Professor David Sanders , an activist, scholar, colleague, mentor, role model and friend to health activists around the world passed away in Wales on 30th August after a heart attack. David was a founding member of the People’s Health Movement in 2000 and the co-chair of PHM for the past six years. A pediatrician by qualification, David was very much interested in the issues of public health. He went on to head the School of Public Health at University of Western Cape in Cape Town, South Africa from its inception in 1993 till 2009.

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JOIN TO RECLAIM PEOPLES RIGHTS OVER INVESTORS AND CORPORATE PROFITS AND IMPUNITY

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Neoliberal globalization has opened the doors for the savage exploitation of the world by the big economic powers. Megaprojects, agribusiness and militarization, among other processes, express a patriarchal, neoliberal and racist system that amounts to an assault  on life as such. As a result, peoples’ rights have been systematically violated, the Earth and its resources destroyed, pillaged and contaminated, while corporations continue committing economic and ecological crimes with total impunity. They also throw us into an environmental and climate crisis of unknown proportions, for which they do not take responsibility.

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The Corporation, the Individual and Public Health

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Since corporations are at the center of  many of the world’s  most serious public health crises, improvements in health require more focus on the harmful practices of global corporations.   In an interview with Corporate Crime Reporter, a newsletter for those concerned about corporate crime, Corporations and Health Watch’s Nicholas Freudenberg explained the rationale for this approach to public health. In decent societies, Freudenberg said, healthy choices ought to be easy choices. 

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