Assessing the health impact of transnational corporations: a case study on McDonald’s Australia

Abstract

BackgroundThe practices of transnational corporations affect population health through production methods, shaping social determinants of health, or influencing the regulatory structures governing their activities. There has been limited research on community exposures to TNC policies and practices. Our pilot research used McDonald’s Australia to test methods for assessing the health impacts of one TNC within Australia.MethodsWe adapted existing Health Impact Assessment methods to assess McDonald’s activities. Data identifying potential impacts were sourced through document analysis, including McDonald’s corporate literature; media analysis and semi-structured interviews. We commissioned a spatial and socioeconomic analysis of McDonald’s restaurants in Australia through Geographic Information System technology. The data was mapped against a corporate health impact assessment framework which included McDonald’s Australia’s political and business practices; products and marketing; workforce, social, environmental and economic conditions; and consumers’ health related behaviours.ResultsWe identified both positive and detrimental aspects of McDonald’s Australian operations across the scope of the CHIA framework. We found that McDonald’s outlets were slightly more likely to be located in areas of lower socioeconomic status. McDonald’s workplace conditions were found to be more favourable than those in many other countries which reflects compliance with Australian employment regulations. The breadth of findings revealed the need for governments to strengthen regulatory mechanisms that are conducive to health; the opportunity for McDonald’s to augment their corporate social responsibility initiatives and bolster reputational endorsement; and civil society actors to inform their advocacy towards health and equity outcomes from TNC operations.ConclusionOur study indicates that undertaking a corporate health impact assessment is possible, with the different methods revealing sufficient information to realise that strong regulatory frameworks are need to help to avoid or to mediate negative health impacts.

Corporate practices and health: a framework and mechanisms

“…For example, in their otherwise thorough framework for conducting corporate health impact assessment Baum and colleagues do not mention how corporations may interfere with the research process and redefine what constitutes scientific evidence for policy making. Neither do they include a measure of how corporations engage in changing the social discourse around the role of the state or the social value of regulation [32, 33]. …”

Reframing the impact of business on health: the interface of corporate, commercial, political and social determinants of health

“…This could help executives, for example, to articulate to shareholders why certain public health goals have been pursued above profit margins—an example of which can be seen in the work of Tobacco Free Portfolios. Anaf et al have shown how re-conceptualisations of the nature of business and its impact can be applied practically by developing new systems for performing corporate health impact assessments 20. More needs to be done to promote nuanced approaches to the impact of business on health.…”

A citizens’ jury on regulation of McDonald's products and operations in Australia in response to a corporate health impact assessment

“…Chronic diseases are the leading cause of illness, disability and death in Australia, accounting for 90% of all deaths in 2011 12 . The subsequent impacts on health and wellbeing have established the importance of developing an integrated research agenda 6,13 measuring health impacts, 14 and gaining citizen feedback on health impact findings to strengthen impact on policy 15…”

“…The first aim of this paper is to report the outcomes from a citizens’ jury examining the appropriate regulatory responses to a health impact assessment of McDonald's products and operations in Australia 14 . Development of the corporate health impact assessment (CHIA) approach included adapting health impact assessment methodology and applying a framework to identify a range of ways that TNCs in different industry sectors may distally or proximally affect population health and health equity 6 .…”

“…We decided to conduct a citizens’ jury to determine the views and recommendations of citizens on the findings from a Corporate Health Impact Assessment (CHIA) of the products and operations of McDonald's in Australia 14 (see Supplementary file 1). The impetus for conducting the CHIA was the growing recognition that although TNCs have grown in power and influence over the past three decades, and have a significant impact on population health, the public health sector has not developed an integrated research agenda by which to study the corporation as a “foundational, social institution that affects health” 13,32 .…”