Power and Other Commercial Determinants of Health: An Empirical Study of the Australian Food, Alcohol, and Gambling Industries

Abstract

Background: Commercial determinants of health (CDoH) represent a critical frame for exploring undue corporate and commercial influence over health. Power lenses are integral to understanding CDoH. Impacts of food, alcohol, and gambling industries are observable CDoH outcomes. This study aims to inform understanding of the systems and institutions of commercial and/or corporate forces working within the Australian food, alcohol, and gambling industries that influence health and wellbeing, including broader discourses materialised via these systems and institutions. Methods: Twenty semi-structured interviews were conducted with key-informants on Australian public policy processes. Interviewees were current and former politicians, political staff members, regulators and other public servants, industry representatives, lobbyists, journalists, and researchers with expertise and experience of the Australian food, alcohol, and/or gambling industries. Interviews sought participants’ perceptions of Australian food, alcohol, and gambling industries’ similarities and differences, power and influence, relationships, and intervention opportunities and needs. Results: Strategies and tactics used by Australian food, alcohol and gambling industries are similar, and similar to those of the tobacco industry. They wield considerable soft (e.g., persuasive, preference-shaping) and hard (e.g., coercive, political, and legal/economic) power. Perceptions of this power differed considerably according to participants’ backgrounds. Participants framed their understanding of necessary interventions using orthodox neoliberal discourses, including limiting the role of government, emphasising education, consumer freedom, and personal choice. Conclusion: Food, alcohol and gambling industries exercise powerful influences in Australian public policy processes, affecting population health and wellbeing. Per Wood et al.’s framework, these manifest corporate, social, and ecological outcomes, and represent considerable instrumental, structural and discursive power. We identify power as arising from discourse and material resources alike, along with relationships and complex industry networks. Addressing power is essential for reducing CDoH harms. Disrupting orthodox discourses and ideologies underpinning this should be a core focus of public health advocates and researchers alike.

Nutritional Criminology: Why the Emerging Research on Ultra-Processed Food Matters to Health and Justice

“…treatment capture: wherein the industry provides funds for the treatment of harm, but again this takes any focus from the need to prevent the harm [281][282][283]. To the extent that nutrition influences behavior, experts across the criminal justice continuum should closely scrutinize the tactics of the ultra-processed food industry, especially in the context of food insecurity and food and social inequalities [284][285][286][287].…”

Gambling and financial harms: a multi-level approach

“…Commercial determinants of harmful gambling are increasingly well known (e.g., de Lacy-Vawdon et al, 2023;Reith & Wardle, 2022). For example, the gambling industry has been shown to wield different forms of soft and hard power over consumers and regulatory action (de Lacy-Vawdon et al, 2023).…”

“…Commercial determinants of harmful gambling are increasingly well known (e.g., de Lacy-Vawdon et al, 2023;Reith & Wardle, 2022). For example, the gambling industry has been shown to wield different forms of soft and hard power over consumers and regulatory action (de Lacy-Vawdon et al, 2023). This power is visible in actions such as marketing, product design and preference-shaping, but also in political agenda setting and framing, direct relationships with decision-makers, and industry influence over research (de Lacy-Vawdon et al, 2023;Johnson et al, 2023;Reith & Wardle, 2022;Adams, 2022;Cassidy et al, 2013).…”

“…For example, the gambling industry has been shown to wield different forms of soft and hard power over consumers and regulatory action (de Lacy-Vawdon et al, 2023). This power is visible in actions such as marketing, product design and preference-shaping, but also in political agenda setting and framing, direct relationships with decision-makers, and industry influence over research (de Lacy-Vawdon et al, 2023;Johnson et al, 2023;Reith & Wardle, 2022;Adams, 2022;Cassidy et al, 2013). These power structures span beyond the gambling industry, and link to wider societal processes such as neoliberal capitalist ideology, globalisation, and financialisation (de Lacy-Vawdon et al, 2023;Reith 2013;Nicoll, 2013).…”

Young people’s views about the use of celebrities and social media influencers in gambling marketing

“…The commercial gambling industry is one of the most innovative health-harming industries of modern times, posing a significant threat to public health ( Badu et al ., 2023 ; Glozah et al ., 2023 ; Thomas et al ., 2023a ). While the commercial gambling industry operates from a similar playbook to other health-harming industries such as tobacco and alcohol ( Cowlishaw and Thomas, 2018 ; de Lacy-Vawdon et al ., 2023 ), governments have rarely recognized the tactics of the gambling industry as a public health issue ( van Schalkwyk et al ., 2021 ; Thomas et al ., 2023a ). Consequently, there have been limited efforts outside of personal responsibility strategies to protect communities from harm ( Miller et al ., 2016 ; van Schalkwyk et al ., 2021 ; Arnot et al ., 2023d ; Badu et al ., 2023 ).…”