The Corporatization of Marijuana: Marlboro maker in takeover talks with cannabis firm Cronos

Altria, the maker of Marlboro cigarettes, is in talks about a potential takeover of the Canadian cannabis producer Cronos as it seeks to diversify its business beyond traditional smokers, reports The GuardianCanada legalized recreational use of marijuana this year, and the country is seen as a testing ground for marijuana companies hoping to expand globally as other countries follow suit.  A deal would mark one of the largest combinations between mainstream tobacco and the booming but volatile marijuana sector, which has attracted interest from a variety of large consumer companies that are monitoring the industry for disruptive threats and faster-growing product possibilities.

Last year, the University of California -San Francisco Tobacco Control Policy Making: United States released a report by Rachel Barry and Stanton  Glantz titled  Lessons from Tobacco for Developing Marijuana Legalization Policy


New report expected to boost push to make company climate-risk disclosures mandatory

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The latest alarm bell to be rung on climate change — last Friday’s government report warning that the damage caused by the warming planet could shrink the U.S. economy by 10% by the end of the century — is expected to support the push for mandatory climate-risk disclosures among corporations, according to experts, writes MarketWatch, a business newsletter.

But much remains to be done to get companies to consistently make disclosures on how climate-change-related events, such as the recent deadly wildfires in California, are impacting business. ‘[W]e are looking at an economic crisis that, not unlike the subprime meltdown, will impact every sector of the economy and company within it”, says Mindy Lubber, chief executive of the sustainability-oriented nonprofit Ceres.  According to Lubber, the report differed from other climate studies in one respect: most climate research is science-based and tends to seek to generate a sense of urgency around time frames, public health and the future of the planet. “This one zeroed in on the economic impact, and that’s very important because we are looking at an economic crisis that, not unlike the subprime meltdown, will impact every sector of the economy and company within it,” she said.

In 2017, The Guardian reported that since 1988,  just 100 companies, mostly in the energy sector, were responsible for 71% of the world’s carbon emissions, suggesting that action by a limited number of corporations could yield significant reductions.

Systems Thinking as a Framework for Analyzing Commercial Determinants of Health

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The high burden of noncommunicable diseases (NCDs) is politically salient and eminently preventable. However, effective solutions largely continue to elude the public health community. Two pressing issues heighten this challenge: the first is the public health community’s narrow approach to addressing NCDs, and the second is the involvement of corporate actors in policymaking. While NCDs are often conceptualized in terms of individual-level risk factors, the authors argue that they should be reframed as products of a complex system. This article explores the value of a systems approach to understanding NCDs as an emergent property of a complex system, with a focus on commercial actors.  Drawing on Donella Meadows’s systems thinking framework, this article examines how a systems perspective may be used to analyze the commercial determinants of NCDs and, specifically, how unhealthy commodity industries influence public health policy. The authors find that unhealthy commodity industries actively design and shape the NCD policy system, intervene at different levels of the system to gain agency over policy and politics, and legitimize their presence in public health policy decisions.

Citation: Knai C, Petticrew M, Mays N, Capewell S, Cassidy R, Cummins S, Eastmure E, Fafard P, Hawkins B, Jensen JD, Katikireddi SV. Systems Thinking as a Framework for Analyzing Commercial Determinants of Health.The Milbank Quarterly. 2018;96(3):472-98.

The 2020 Election: Putting Regulating Corporations to Protect Public Health on the Agenda

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The mixed results of the 2018 midterm elections open the season for the 2020 election.  In the coming months, Corporations and Health Watchwill raise some of the  issues that warrant discussion in this election. Today’s focus is on public health regulation of corporations.  Two recent reports provide a starting point for the national conversation that is needed.

4 Takeaways from the Trump-Era Plunge in Corporate Penalties

At a time when the Trump administration is loosening rules established in the aftermath of the 2008 financial crisis, writes The New York Times,  financial penalties imposed on companies and big banks accused of wrongdoing have fallen precipitously since the Obama administration, according to analyses by The New York Times.

In consultation with outside experts, The Times conducted separate examinations of enforcement activity at the Securities and Exchange Commission and the Justice Department, comparing cases filed during the first 20 months of the Trump presidency with those in the final 20 months of the Obama administration.

The analysis found a 62 percent drop in penalties imposed and illicit profits ordered returned by the S.E.C. At the Justice Department, the analysis found a 72 percent decline in corporate penalties from criminal prosecutions, and a similar percent drop in certain civil penalties against financial institutions. Read the full story “Trump Administration Spares Corporate Wrongdoers Billions in Penalties.”

The War on Regulation: A Guide to the Ongoing Assault on Public Protections to Boost Corporate Profits

The war on regulation – carried out by the Trump administration, conservatives in Congress and private industry – is premised on a great deal of misinformation and misleading claims.  A recent report by the Coalition for Sensible Safeguards, a national alliance of more than 160 consumer, labor, scientific, research, public health and other groups, provides readers with what they  need to know to understand what’s at stake in the war on regulation and why regulatory safeguards matter. Read the full report.

2018 Lobbying and  Campaign Contributions from the Pharmaceutical and Food Industries

This week is Election Day and thanks to the Center for Responsive Politics  OpenSecrets.Org, the most comprehensive resource for federal campaign contributions, lobbying data and analysis available anywhere, voters can see what the Pharmaceutical/Health Care Products, Food and Beverages and other industries have spent on lobbying and campaigns contributions this election cycle and in the past.  The industries have already made their choices known in the 2018 midterm elections. Have you?

Total 2018 Lobbying Spending for Pharmaceuticals/Health Products Sector: $216,134, 421

Total Number of Clients Reported: 384

Total Number of Lobbyists Reported: 1,407

 2018 Campaign Contributions from this industry  $33.1 million 

 Pharmaceuticals/Health Products: Long-Term  Campaign Contribution Trends

Food and Beverages

Total  2018 Lobbying  Spending for Food & Beverage Sector: $22,393,837
Total Number of Clients Reported: 61
Total Number of Lobbyists Reported: 294                                                                                               Total Campaign Spending 2018:  $15 million

Food & Beverage: Long-Term Campaign Contribution Trends

The Influence of Industry Sponsorship on the Research Agenda: A Scoping Review

Corporate interests have the potential to influence public debate and policymaking by influencing the research agenda, namely the initial step in conducting research, in which the purpose of the study is defined and the questions are framed. In this scoping review, authors identified  and synthesized studies that explored the influence of industry sponsorship on research agendas across different fields.

The 36 articles reviewed included nineteen cross-sectional studies that quantitatively analyzed patterns in research topics by sponsorship and showed that industry tends to prioritize lines of inquiry that focus on products, processes, or activities that can be commercialized. Seven studies analyzed internal industry documents and provided insight on the strategies the industry used to reshape entire fields of research through the prioritization of topics that supported its policy and legal positions. Ten studies used surveys and interviews to explore the researchers’ experiences and perceptions of the influence of industry funding on research agendas, showing that they were generally aware of the risk that sponsorship could influence the choice of research priorities.

The authors concluded that corporate interests can drive research agendas away from questions that are the most relevant for public health. Strategies to counteract corporate influence on the research agenda are needed, including heightened disclosure of funding sources and conflicts of interest in published articles to allow an assessment of commercial biases. They also recommended policy actions beyond disclosure such as increasing funding for independent research and strict guidelines to regulate the interaction of research institutes with commercial entities. The results of the scoping review support the need to develop strategies to counteract corporate influence on the research agenda.

Citation: Fabbri A, Lai A, Grundy Q, Bero LA.The Influence of Industry Sponsorship on the Research Agenda: A Scoping Review. American journal of public health. 2018 Nov;108(11):e9-16.

Defining Appropriate Roles for Corporations in Public Health Research and Practice

Does industry sponsorship of health research influence the public health research agenda? Does it shape public health policy and priorities? In an editorial commentary on the report by  Fabbri et al. that is summarized above, Freudenberg notes that developing comprehensive and effective responses that can mitigate or prevent the harmful practices of lethal but legal industries is a vital public health priority. Corporate practices have become primary social determinants of premature death and preventable illnesses from noncommunicable diseases, injuries, and environmental exposures. Modifying harmful practices is a practical strategy for promoting health and reducing health inequalities. What additional research is needed to integrate the finding of Fabbri et al. on the impact of corporate sponsorship of research into a deeper understanding of the cumulative impact of the many industry practices that influence population health?  Several topics have recently attracted research attention. How can public health researchers best reduce conflicts of interest? Conflicts of interest occur when the public obligations of researchers, government officials, or corporations conflict with their private interests. Undetected or undisclosed conflicts of interest taint the validity of findings and threaten the credibility of public  health researchers. In an era when trust in many forms of authority is declining, industry affiliations that pose conflicts of interest could jeopardize the capacity of public health professionals to communicate credibly with the public to address future public health crises.

Another task is to define and assess appropriate roles for industry in setting public health policy. In the case of tobacco, the World Health Organization used the Framework Convention on Tobacco Control to draw a clear boundary for the industry role in shaping public policy. Should this approach also apply to the food, alcohol, and other industries? Or, as industry representatives argue, are the products of these industries so different from tobacco as to suggest another approach? Research that compares the practices of these industries as well as their products may provide more useful evidence for setting policies. Finally, policy research that compares the longer-term impact on the population health of various regulatory regimes can provide policymakers with the evidence needed to find an appropriate balance between government  and industry roles.

Citation: Freudenberg N. Defining Appropriate Roles for Corporations in Public Health Research and Practice. Am J Public Health. 2018 Nov;108(11):1440-1441

Back to School on Corporations and Health Part 5

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As students and faculty return to school this fall, Corporations and Health Watch continues its series on strategies for integrating the study of corporations and health into public health, social science, business and other educational programs.  This post briefly describes several courses that have been taught in the last few years and provides links to class syllabi.  Instructors who want ideas for readings and topics can consult these course outlines, which present a variety of ideological perspectives.  Links are also provided to previous CHW posts on teaching about corporations and health.

Poisoned Worlds: Corporate Behavior and Public Health  Columbia University

This course traces the historical importance of occupational and environmental diseases related to tobacco and food industries and chemical manufacturers. It outlines the histories of traditional occupational hazards like asbestosis and mesothelioma, lead poisoning and other pollutants. Through the use of documents gathered in lawsuits, searches of medical and public health literature and other documentary sources students evaluate historical debates about responsibility for chronic diseases and environmental damage. The scope of the course will include topics ranging broadly from global warming to obesity and low-level lead poisoning, and PCBs. It will focus on the five decades since Silent Spring and the rise of environmental movement. Central to the course will be investigating the uses of history in adjudicating responsibility for chronic conditions and environmental damage affecting men, women, children, workers and communities of color. It will look at the ways history is used in the court and explore how historical information can be used to advocate for populations.

Health Activism  Wellesley College

The diseases, illnesses, and concerns that come under the purview of the health care, public health and global health systems stem from the interplay among scientific understandings, political and economic forces, and the actions of individuals and groups. In this course, we will examine various kinds of what can be labeled “health activism” over the last two centuries. Themes to be addressed will include: activism both in and against health institutions, roles of race/class/gender/disability/ sexuality in health issues, activism in a global health context, reforms, reactions and radicalism.

Pharmaceutical Geographies, Pharmaceutical Economies  University of Minnesota

This seminar examines the emergence and persistence of global disparities in

pharmaceuticals by providing historical, political, economic, and cultural analyses of the

manufacturing, regulation, and distribution of pharmaceuticals. It covers historical and

contemporary issues that underscore the paradoxical nature of the global pharmaceutical



Corporate Sustainability Strategy  Harvard University Extension School

This course explores sustainability from the perspective of a multi-national corporation. It

provides a number of exemplars in various industries to show how they have applied

sustainability tools to their businesses. These will be publicly traded companies, and so there will

be links provided to various forms of information for you to compare and contrast as we move

through the semester. Information will be presented from academic research, white papers

published by respected scholars and experts, and the actual disclosures of major multi-national

companies. Sustainability officers and other sustainability professionals will serve as guest

speakers in the class throughout the semester.


Global Food Politics and Policy Harvard School of Education

This course reviews the political landscape of both food and farming, in both rich

and poor countries. This is a highly contested political space. Scientists, economists,

commercial farmers, agribusiness and food companies, environmentalists, consumer

organizations, and social justice advocates often hold sharply different views. Policy

actions by national governments frequently conflict with the preferences of international

organizations, private companies, NGOs, social entrepreneurs, and humanitarian relief

agencies. Understanding the foundation of these conflicts is key to effective public

policy making.


Consumers, Corporations and Public Health Harvard Business School

With 18 percent of U.S. GDP now allocated to health care, it is essential for all business people to have some familiarity with the health care system. This half-credit course examines how

corporations assist and, in some cases, impede the solving of public health challenges. Targeting

MPH and MBA students, the course aims to promote dialogue and understanding between public

health and business professionals. Common ground can be found when we use a deep

understanding of consumer behavior as the starting point for debate and collaboration.


Previous CHW posts on teaching about corporations





Public Health and Corporate Avoidance of U.S. Federal Income Tax



The amount of U.S. federal revenue affects the government’s ability to provide public health services, programs, infrastructure, and research to adequately protect the public’s health. Public health funding shortages are chronic. Corporate income tax avoidance is one source of unrealized federal tax revenue that, if collected and allocated to public health, could help offset those shortages. Major corporate methods of tax avoidance, their effect on federal revenue, and recommended policy changes are described. Corporate tax avoidance and government revenue shortages are framed as social determinants of health, and research questions and data sources for public health researchers for examining the issue are suggested. Although there is no guarantee that any additional corporateincome tax revenue would be directed to public health, the subject warrants the attention of public health researchers and policy advocates. The United States serves as a case study for public professionals in other countries to conduct similar analyses.

Citation:  Wiist, WH. Public Health and Corporate Avoidance of U.S. Federal Income Tax . World Medical & Health Policy. First published: 20 August 2018.

Grading PespiCo’s Retiring CEO Indra Nooyi on Public Health




When PepsiCo. Inc.’s longtime chief executive, Indra Nooyi, announced that she was stepping down, reports The Wall Street Journal, Ivanka Trump was one of many people to voice her admiration for the departing CEO. “Indra, you are a mentor + inspiration to so many, myself included,” Ms. Trump wrote on Twitter.

Ms. Nooyi is finishing her tenure with a sterling reputation as a manager. She is credited with piloting PepsiCo through a rough period for the industry, as consumer tastes moved away from sugary drinks. She successfully fought off an activist investor’s attempt to break up the company and diversified into healthier snack and drink options before many competitors did. PepsiCo’s annual revenue increased 81% during her tenure to $63.5 billion last year.

Still, from a market perspective, her tenure wasn’t a complete success. PepsiCo’s total shareholder return during her time as CEO trailed both the S&P 500 index and rival Coca-Cola Co. PepsiCo’s market capitalization was $165 billion based on last Friday’s closing price, compared with $200 billion for Coca-Cola. When Ms. Nooyi took over, PepsiCo’s market cap of $106 billion was slightly larger than Coca-Cola’s, at $104 billion.

If Wall Street gives Nooyi, mixed grades, what about public health?  Nooyi is known for her desire to expand PepsiCo’sinvolvement in “good-for-you” foods.  What were the results?



Percent increase

Total PepsiCo revenues

$35 billion

$63.5 billion


Revenues from “healthier” foods

$13.3 billion

$31.8 billion


Revenues from “less healthy” foods

$21.7 billion

$31.7 billion


The table above shows that while the proportion of revenues from “healthier” product increased more than for less healthy products like soda and high salt, high fat snacks, the total annual sales of less healthy products (dubbed by Nooyi as the “fun for you” foods) increased by $10 billion — 46% during  her tenure.  

In other words, the total revenues from PepsiCo  products most associated with diet-related chronic diseases increased significantly  under Nooyi’s leadership. This suggests that PepsiCo’s contribution to the burden of premature deaths and preventable illnesses associated with these products also increased.  This illustrates a classic dilemma for public health.  Even if public health advocates succeed in persuading corporations to alter the mix of products they produce, if the company expands at the same time, its overall health damaging impact may increase even as it produces some healthier products.  Moreover, the products PepsiCo and Nooyi label as “good for you” or healthy are often still high in unhealthy ingredients, even if they are fortified with vitamins or other nutrients.