At the Eighth European Public Health Conference in Milan, Italy last week, public health researchers from the United States and the United Kingdom examined how portrayals of corporate practices that influenced health are portrayed in the media in the United States and Europe and how public health professionals and policy makers perceive the role of the alcohol, tobacco and food industries in shaping public policy. The session was sponsored by the University of Glasgow Social and Public Health Sciences Unit and the journal Policy &Politics. The presentations included:
Heide Weishaar (UK) and Katherine Smith (UK). Better the devil you (don’t) know? A comparison of the tobacco, alcohol and processed food industries’ perceived political legitimacy. Download their presentation.
By Nicholas Freudenberg, Founder, Corporations and Health Watch
Readers of Corporations and Health Watch are familiar with the argument that the corporate practices that harm health are for the most part perfectly legal. However, recent media coverage of the scandals at Volkswagen and Johnson & Johnson led me to ask why some businesses choose to break the law. In the first, documented thoroughly in Steven Brill’s 15 chapter “docuserial” America’s Most Admired Lawbreaker posted last month on the Huffington Post Highline, the drug and medical device maker Johnson and Johnson (J&J) promoted Risperdal, an antipsychotic drug approved by the FDA for treating schizophrenia to children and older people for a much wider set of indications than those approved by the FDA. In 2013, Johnson & Johnson agreed to pay more than $2.2 billion in criminal and civil fines to settle accusations that it improperly promoted Risperdal.
Coca-Cola, the world’s largest maker of sugary beverages, has spent almost $120 million in the past five years to pay for academic health research, partnerships with major medical groups and community fitness programs aimed at curbing the obesity epidemic, reports the New York Times.
How does the size of governments and corporations compare? To answer this question, I identified one metric often used to measure the size of organizations: annual revenues. I then found a source for annual revenues for governments, The CIA World Fact Book and another for corporations, The Global Fortune 500 List. Both provided data for 2014. The results below show that of the 100 governments and corporations with the highest annual revenues in 2014, 63 are corporations and 37 are governments. Previous analysts have compared corporations to national economies, a different measure. In 2000, Anderson and Cavanagh found that of the 100 largest economies in the world, 51 were global corporations and 49 were countries. In 2012, the economic analyst D. Steven White listed the top 175 “economic entities” in the world for 2011, using GDP for nations and revenues for corporations. Of these, 63% were corporations and 37% were nations.
Eight years ago, I wrote in CHW about how and why corporations buy scientists to advance their business goals. Sadly, the problem continues. This week the New York Times published a story on how Coca Cola has funded researchers at the University of South Carolina, the University of Colorado and the West Virginia University to make the case that exercise, not reduced consumption of sugary beverages, is the solution to obesity. Coke has also funded the Global Energy Balance Network, a nonprofit network of the researchers it funds, to advance this argument more widely.
Monsanto, the world’s largest producer of genetically modified seeds and herbicides, is campaigning for a federal law to block state and local GMO labelling laws. Here are a few recent stories on the campaign and its response.
To translate the recent U.S. Dietary Guidelines Recommendation to reduce sugar intake into practice, advocates might learn more by reading the business news than nutrition journals. Consider the following:
Coca Cola said its fourth quarter profit in 2014 fell 55% from the previous year based on reduced demand for sugary and diet soft drinks; Pepsi reported a 24% decline in the same period
Kellogg, the world’s largest maker of breakfast cereals said persistent declines in products like Frosted Flakes and Pop-Tarts contributed to a 7.7% drop in the last quarter of 2014 compared to the previous year.
Mondelez International, the maker of Oreo Cookies and Cadbury chocolate, reported a $149 million hit to fourth quarter earnings.
Of course single quarter results have multiple causes, including recent currency fluctuations but the trends are long term. Carbonated soft drink sales in the United States have declined for 10 consecutive years as consumers continue to give up sugary sodas. And while Big Soda continues to market heavily in nations like China, Brazil and India, even there problems are emerging. “In China we are seeing probably the weakest food-and-beverage market in 10 years,” Ahmet Bozer, president of Coca-Cola International told reporters on a conference call earlier this month. And in Mexico, another big market, the recent 7 cents per liter soda tax has already reduced sales.
Of course, food companies respond to these declines with new efforts to restore profitability including more marketing and new product development. But even some of these strategies, such as charging higher per-ounce prices on the new mini-cans Pepsi and Coke are selling, do not end up claiming a bigger stomach share for sugary beverages, the previous solution to any drop in sales. Overall, according to recent food availability data from the United States Department of Agriculture, estimated consumption of sweeteners is nearly 14% lower than it was at its peak in 1999, when the average American took in almost 422 calories per day in sugar and other sweeteners.
Of course many Americans, especially teenage boys, still consume too much sugar. As Marlene Schwartz, director of the Rudd Center for Food Policy and Obesity, told US News and World Report, “It’s a little bit like having only a foot and a half of snow instead of 2 feet.”
But the steady declines in sugar consumption should encourage health professionals and activists to consider what we are doing right –and what to do more of. Here are three suggestions:
1. Push on every front for new public health protections on added sugar.
Some observers suggest that falling sugar consumption demonstrates the success of market forces. The opposite argument is more compelling: every industry effort to reduce sugar in its products, label more fully and engage in more public activities to take sugary products out of schools is a direct result of pressure from health professionals and a food movement. More pressure will lead to greater responses.
Some researchers think now is the time for more study of the relative benefits of sugar taxes, calorie listing or warning labels. However, the experience from tobacco suggests the more the better. Tobacco use declined as more taxes, smoking bans, and hard-hitting educational campaigns were implemented So bring on the policies and let’s evaluate them in real world settings. Every public debate about sugar policy helps to educate people about the health dangers of added sugar and encourages industry to further reduce sugar , thus contributing to lower sugar consumption, whether the policy is passed or not.
2. Take on Big Sugar.
In a moral economy, heavily marketing to children and young people the products most associated with the rising burden of diet-related diseases like would not be considered an ethical business model. When the American public lost faith in the credibility of the tobacco industry as a participant in shaping public health policy, significant health advances were achieved. If snapping a can of Coke open becomes associated not with bringing happiness but more diabetes for our children, the capacity of Coke and other producers of high sugar products to undermine public health policy will be diminished. Counter-marketing campaigns like the truth campaign on tobacco can accelerate the declining respect for food companies that depend on sickening products for profitability.
Another way to take on Big Sugar is to sever the links between these industries and health care, professional and educational institutions. Professional organizations like the American Academy of Nutrition and Dietetics, the American Academy of Family Physicians and others continue to take money from Coca Cola and other manufacturers of high sugar products. Many educational and health organizations (including my own, I am sorry to say) continue to have pouring rights contracts with Coke or Pepsi. Few hospitals or universities have considered divesting from companies that depend on products that contribute to diet-related diseases. Taking on these links can provoke further discussion about the role of sugar in our diet and the consequences of promoting sugary products.
3. Create environments that make alternative to sugary products easy choices.
In many institutions, vending machines and soda fountains in cafeterias make soda the most available drink. For institutional leaders, vending machines are a revenue stream while the alternative, water fountains, are a revenue drain. That equation needs to change. Mobilizing parents, students, health professionals and workers to ensure that water fountains are more available than soda and that they are adequately maintained will help to make it easier for millions of people to choose water over soda.
In the long run, creating healthier food environments will require changing a food system that has made the needs of a handful of increasingly concentrated multinational food companies a higher priority than promoting the health and reducing food insecurity for the world’s population. But in today’s world, the continuing declines in sugar consumption—and the new Dietary Guidelines recommendation to cut back more on sugar– provide health professionals and the food movement with an opportunity to accelerate a trend that can prevent premature deaths and avoidable illnesses.