Corporations and Health Watch

Back to School on Corporations and Health Part 5

Posted on September 5, 2018 by Corporations and Health Watch

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

enterprise.

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

BRINGING CORPORATIONS INTO THE PUBLIC HEALTH CLASSROOM September 2017

BACK TO SCHOOL BOOKS ON CORPORATIONS AND HEALTH august 2014

TEACHING ABOUT CORPORATIONS AND HEALTH June 2010

TEACHING ABOUT CORPORATIONS AND HEALTH: BRINGING CORPORATE PRACTICES INTO PUBLIC HEALTH CLASSROOMS December 2007

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

Posted on August 23, 2018 by Corporations and Health Watch

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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. https://doi.org/10.1002/wmh3.274

Grading PespiCo’s Retiring CEO Indra Nooyi on Public Health

Posted on August 13, 2018 by Corporations and Health Watch

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“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?

	2006	2017	Percent increase
Total PepsiCo revenues	$35 billion	$63.5 billion	81%
Revenues from “healthier” foods	$13.3 billion	$31.8 billion	139%
Revenues from “less healthy” foods	$21.7 billion	$31.7 billion	46%

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.

E-cigarette maker Juul targeted teens with false claims of safety, lawsuit says

Posted on August 2, 2018 by Corporations and Health Watch

A Juul in the hand…(credit)

When a San Diego-based mother posted an emergency alert on Nextdoor, a community discussion app, she hoped a Good Samaritan could help, according to court filings, reports The Washington Post. Her son was hysterical after losing a flash drive with his homework near the local McDonald’s, she wrote, uploading a photo along with the message. A neighbor quickly replied, explaining that the chewing-gum-sized object in the picture was not a flash drive: It was a Juul vaping device. “That’s just an indication of how quickly Juuls became prevalent,” recounted Esfand Nafisi, a lawyer who is handling two of three lawsuits initiated against Juul Labs last month. “You blinked your eye, and suddenly they were all over the place.”

“I think Juul has been insincere from the very beginning in saying it’s only for adult smokers,” said Robert Jackler, principal investigator at a Stanford University School of Medicine program that studies the impact of tobacco advertising. He noted that Juul Labs executives have boasted that they run “the most educated company, the most diligent, the most well-researched.”

Two recent court cases challenge Juul’s practices.

Read the complaintfiled against Juul in United States District Court Southern District of New York in June 2018.

Read the complaintfiled in United States District Court District of Northern California in April 2018.

Four Recent Books on the Political Economy of Global Health

Posted on July 25, 2018 by Corporations and Health Watch

Four recent books dealing with the political economy of global health are reviewed in a recent issue of Critical Public Health. Drawing on the material covered in these sources, the reviewer argues that the concepts of capitalism, imperialism and class (at the national and global levels) are fundamental to a critical public health in the present era of economic globalization.

Analysis of corporate political activity strategies of the food industry: evidence from France

Posted on July 18, 2018 by Corporations and Health Watch

A new study in Public Health Nutrition analyzed the corporate political activity (CPA) of major food industry actors in France. The analysis shows that the main practices used by Coca-Cola and McDonald’s were the framing of diet and public health issues in ways favorable to the company, and their involvement in the community. The French National Association of Agribusiness Industries primarily used the ‘information and messaging’ strategy (e.g. by promoting deregulation and shaping the evidence base on diet- and public health-related issues), as well as the ‘policy substitution’ strategy. Nestlé framed diet and public health issues and shaped the evidence based on diet- and public health-related issues. Carrefour particularly sought involvement in the community. The authors found that, in 2015, the food industry in France was using CPA practices that were also used by other industries in the past, such as the tobacco and alcohol industries. Because most, if not all, of these practices proved detrimental to public health when used by the tobacco industry, we propose that the precautionary principle should guide decisions when engaging or interacting with the food industry.

Obstetrician-Gynecologists and Industry Let the Sunshine In!

Posted on July 11, 2018 by Corporations and Health Watch

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“What is an ethically responsible relationships between obstetrician-gynecologists(ob-gyns) and the pharmaceutical and medical device industries”, asks Lewis Wall in an editorial in Obstetrics & Gynecology? He notes the inherent conflicts between the worldview of the pharmaceutical-medical device industry, where pursuit of profit overrides all other considerations, and the overriding obligation of physicians to put the health interests of their patients first. When the trust that obligation engenders is lost, he writes “medical practice breaks down.”

Industry Payments to Obstetricians and Gynecologists Under the Sunshine Act

Another article in Obstetrics & Gynecology examines industry payments to ob-gyns. To evaluate financial relationships between obstetrician–gynecologists (ob-gyns) and industry, including the prevalence, magnitude, and the nature of payments, the authors of this report conducted a cross-sectional study using a list of industry contributions to U.S. obstetricians and gynecologists obtained through the Centers for Medicare and Medicaid Services Open Payments Database from August 1, 2013, to December 31, 2015. They concluded that obstetricians and gynecologists receive a substantial amount of payments from industry. Most of these payments were for honoraria, faculty compensation, or consulting and totaled less than $400 per health care provider. Although this total amount is less than typically received by surgical providers, the median payment value for obstetrics and gynecology subspecialists surpasses the median payment to orthopedic surgeons, the highest compensated specialty group in total. These financial relationships warrant further exploration with future research.

How a flood of corporate funding can distort NIH research

Posted on June 28, 2018 by Corporations and Health Watch

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“This month, National Institutes of Health Director Francis Collins seemed to shut down a noxious ethical problem,” writes Paul Thacker, a former Senate staff member, in The Washington Post. “The agency released a 165-page internal investigation of an alcohol consumption study that had been funded mostly by beer and liquor companies. The study’s lead investigator and NIH officials were in frequent contact with the alcohol industry while designing the study, which, according to the postmortem, seemed predetermined to find alcohol’s benefits but not potential harms, such as cancer. In several email exchanges published in the report, NIH scientists seemed to joke about taking a drink every time somebody said “cheers,” which was a proposed acronym for their study. Collins ended the trial and promised to create new ethical boundaries for how NIH officials deal with industry. But the intellectual corruption at our government research agencies runs much deeper, and this was only the latest scandal involving hidden corporate influence. I spent 3 1 / 2 years as a Senate investigator studying conflict-of-interest problems at the NIH and the research universities it funds. During that time, I found that the agency often ignored obvious conflicts. Even worse, its industry ties go back decades and are never really addressed unless the agency faces media scrutiny and demands from the public and Congress for change.”

Corporate Efforts to Derail Mass Transit

Posted on June 22, 2018 by Corporations and Health Watch

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In 1985, two urban policy scholars, J. Allen Whitt and Glenn Yago, wrote:

The urban transportation systems that carry us around are not solely the result of technological innovation or efficiency. They are also a product of the rising and sinking political and market power of industrial interest groups, the changing relations among social classes, the politics of urban development struggles, and the inherent dynamics of the economic system… These factors, particularly corporate control of transportation policy, have profoundly shaped urban streetcar, automobile, bus, and rail transport in the United States during this century. We conclude that this private dominance over urban transportation policy has often led to narrow, profit-seeking behavior that has thwarted the development of more effective public transit.

This week, The New York Times reported that in the last few years Americans for Prosperity, the conservative group financed by oil billionaires Charles and David Koch has contributed hundreds of thousands of dollars to defeat plans to expand or improve mass transit in Little Rock, Phoenix, Nashville, southeast Michigan, and central Utah. The group has also contributed to effort to defeat more than two dozen transit-related measures such as states proposals to raise gas taxes to fund transit or transportation infrastructure.

“Stopping higher taxes is their rallying cry”, Ashley Robbins a transportation researcher at Virginia Tech, told The New York Times. “But at the end of the day, fuel consumption helps them.” Although Americans for Prosperity opposes pubic spending on mass transit, it supports spending tax money on highways and roads. Koch brother-owned industries produce gasoline, asphalt, seatbelts, tires and other auto parts, businesses that could be harmed by new investments in mas transit.

Public health research shows that improving mass transit and reducing automobile use can bring multiple health and environmental benefits: less premature mortality from lung disease, fewer asthma symptoms, more physical activity and less sedentary time, fewer injuries and deaths from auto crashes, more social interactions and less isolation, less road rage, more walkable and attractive cities, less air pollution, reduced carbon emissions, less urban sprawl.

Despite these benefits, for more than a century public policy at the federal, regional, state and local levels has been disproportionately influenced by commercial interests that favor increased automobile use over the well-being of our population and our environment. Public health professionals and researchers need to explore new ways to bring this debate about democracy, health and the environment into the policy and political arenas.

How do Americans rate the fairness of US corporate practices?

Posted on June 14, 2018 by Corporations and Health Watch

Responses to: Which of these behaviors is most important in evaluating how just a corporation is? Source

What do Americans think of corporate practices? And what business practices most disturb Americans? Each year JUST Capital conducts a poll of a representative sample of U.S. adults to answer these questions.

JUST Capital, a nonprofit group, seeks to “build a more just marketplace that better reflects the true priorities of the American people.” The group believes that “business, and capitalism, can and must be a positive force for change.” We believe that if they have the right information, people will buy from, invest in, work for, and otherwise support companies that align with their values. And we believe that business leaders are searching to win back the trust of the public in ways that go beyond money. By shifting the immense resources and ingenuity of the $15 trillion private sector onto a more balanced – and more just – course, we can help build a better future for everyone.

The findings from its 2017 survey of about 4,100 adult US respondents, shown above, provides some informative insights. First, the outcome most important to corporate managers, i.e., providing returns to investors, is the least important practice that respondents use to rate the fairness of a corporation. Second, the national discourse on jobs and job creation makes that practice by far the highest rated factor in judging a corporation’s fairness. Third, some of the practices of greatest interest to health advocates, such as the health consequences of products (rated as most important by 35.4% of respondents), efforts to minimize pollution (38.6%), and providing a safe workplace (11.5%) rank lower than other factors.

The survey also compares responses by several demographic characteristics, including age, gender, income, region, political party, ideology and investor status. Of interest, none of these factors predict large differences in beliefs about fairness. Any survey is of course influenced by the wording of questions and other surveys have shown age and other differences in how Americans view corporations.

JUST Capital provides more detailed reports of their annual surveys from 2014 to 2017. It also publishes Roadmap for Corporate America, its summary of the 2017 survey and recommendations for how corporations can respond to survey findings.