Commercial determinants of health: future directions

Friel, Sharon; Collin, Jeff; Daube, Mike; Depoux, Anneliese; Freudenberg, Nicholas; Gilmore, Anna; Johns, Paula; Laar, Amos; Marten, Robert; Mialon, Mélissa

doi:10.1016/s0140-6736(23)00011-9

Cited by 61 publications

(48 citation statements)

References 94 publications

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“…Our findings relate specifically to the Swedish context, in which alcohol trade is subject to state regulation; Swedish legislation prohibits the marketing of any alcoholic beverages on public television and radio and a government monopoly is responsible for the retail sale of alcoholic beverages [ 38 ]. It is thus possible that the impact of private sector activities on how alcohol’s health effects are reported may be greater in countries with less restrictive alcohol policies [ 39 – 41 ].…”

Section: Discussionmentioning

confidence: 99%

Mixed messages? Exposure to reports about alcohol’s suggested cardiovascular effects and hazardous alcohol use: a cross-sectional study of patients in cardiology care

Welfordsson,

Danielsson,

Björck

et al. 2024

BMC Public Health

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Background Hazardous alcohol use is a leading risk factor for disability and death, yet observational studies have also reported reduced cardiovascular disease mortality among regular, low-level drinkers. Such findings are refuted by more recent research, yet have received significant media coverage. We aimed to explore: (1) how patients with cardiovascular diseases access health information about moderate drinking and cardiovascular health; (2) the perceived messages these sources convey, and (3) associations with own level of alcohol use. Methods We conducted a cross-sectional survey of patients in cardiology services at three hospitals in Sweden. The study outcome was hazardous alcohol use, assessed using the AUDIT-C questionnaire and defined as ≥ 3 in women and ≥ 4 in men. The exposure was accessing information sources suggesting that moderate alcohol consumption can be good for the heart, as opposed to accessing information that alcohol is bad for the heart. Health information sources were described using descriptive statistics. Gender, age and education were adjusted for in multiple logistic regression analyses. Results A total of 330 (66.3%) of 498 patients (mean age 70.5 years, 65% males) who had heard that drinking moderately can affect the heart described being exposed to reports that moderate alcohol use can be good for the heart, and 108 (21.7%) met criteria for hazardous alcohol use. Health information sources included newspapers (32.9%), television (29.2%), healthcare staff (13.4%), friends/family (11.8%), social media (8.9%) and websites (3.7%). Participants indicated that most reports (77.9%) conveyed mixed messages about the cardiovascular effects of moderate drinking. Exposure to reports of healthy heart effects, or mixed messages about the cardiovascular effects of alcohol, was associated with increased odds of hazardous alcohol use (OR = 1.67, 95%CI = 1.02–2.74). Conclusions This study suggests that many patients in cardiology care access health information about alcohol from media sources, which convey mixed messages about the cardiovascular effects of alcohol. Exposure to reports that moderate drinking has protective cardiovascular effects, or mixed messages about the cardiovascular effects of alcohol, was associated with increased odds of hazardous alcohol use. Findings highlight a need for clear and consistent messages about the health effects of alcohol.

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Section: Discussionmentioning

confidence: 99%

Mixed messages? Exposure to reports about alcohol’s suggested cardiovascular effects and hazardous alcohol use: a cross-sectional study of patients in cardiology care

Welfordsson,

Danielsson,

Björck

et al. 2024

BMC Public Health

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“…[202]. The future of global health and equity will rely on the commercial sector and thus a framework that considers ethics in compliance mechanisms for commercial entities [203].…”

Section: Solutions-turning the Cornermentioning

confidence: 99%

The Founder: Dispositional Greed, Showbiz, and the Commercial Determinants of Health

Logan¹,

D’Adamo

Prescott

2023

IJERPH

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Marketing unhealthy products by multinational corporations has caused considerable harm to individual health, collective wellbeing, and environmental sustainability. This is a growing threat to all societies and a significant contributor to the rising global burden of non-communicable diseases and early mortality. While there is growing consideration of the commercial determinants of health, this is largely focused on the methods by which unhealthy products are marketed and disseminated, including efforts to manipulate policy. Little attention has been paid to the underlying psychological traits and worldviews that are driving corporate greed. Here, we consider the role of “dispositional greed” in the commercial determinants of health with a focus on the historical attitudes and culture in the ultra-processed food industry—exemplified by “The Founder” of the McDonald’s franchise. We argue that greed and associated psychological constructs, such as social dominance orientation and collective narcissism, permeate the commercial determinants of health at a collective level. This includes how a culture of greed within organizations, and individual dispositional greed, can magnify and cluster at scale, perpetuated by social dominance orientation. We also consider the ways in which “showbiz” marketing specifically targets marginalized populations and vulnerable groups, including children—in ways that are justified, or even celebrated despite clear links to non-communicable diseases and increased mortality. Finally, we consider how greed and exploitative mindsets mirror cultural values and priorities, with trends for increasing collective narcissism at scale, recognizing that many of these attitudes are cultivated in early life. A healthier future will depend on navigating a path that balances material prosperity with physical and spiritual wellbeing. This will require cultural change that places higher value on kindness, reciprocity, and mutualistic values especially in early life, for more equitable flourishing.

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“…The increasing attention given to the well‐being economy of health could also assist with measuring the impact of commercial activities. So too will consideration of progressive economic models, international frameworks, government regulation, compliance mechanisms for commercial entities, regenerative business types and models that incorporate health, social and environmental goals, and strategic civil society mobilisation 18 …”

Section: Join the Movementmentioning

confidence: 99%

Why action on the commercial determinants of health is vital

Baum

Friel

Liberman

et al. 2023

Health Prom J of Aust

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Why action on the commercial determinants of health is vitalThe In Conversation: Boundary Spanners, Thinkers and Policy ActorsRound Table Series provides a platform for researchers, policy actors and implementation experts to elevate discussion on emerging issues, present research and facilitate conversation around impacts and possible solutions. 1 This editorial is based on one of the In Conversation sessions.

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Commercial determinants of health: future directions

Cited by 61 publications

References 94 publications

Mixed messages? Exposure to reports about alcohol’s suggested cardiovascular effects and hazardous alcohol use: a cross-sectional study of patients in cardiology care

Mixed messages? Exposure to reports about alcohol’s suggested cardiovascular effects and hazardous alcohol use: a cross-sectional study of patients in cardiology care

The Founder: Dispositional Greed, Showbiz, and the Commercial Determinants of Health

Why action on the commercial determinants of health is vital

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