Abstract
More than half of the world’s 100 largest economies are corporations, and an increasing proportion of global deaths are caused by exposure to highly processed foods, alcohol, tobacco, and air pollution. This chapter explores the full spectrum of commercial activities that impact human health, starting with the historical perspective and moving to consider the various frameworks that have been developed in the past decade to both harness and address these commercial determinants. Numerous examples are used to illustrate the actions of industry groups to subvert health-focused policies and foster a damaging narrative that solely blames individuals for harmful levels of consumption. Common industry tactics are dissected, and practical rebuttals are presented to tackle ubiquitous arguments. This chapter also redresses the current harm-focused CDOH balance by considering the positive direct and indirect impact that commerce and corporations can exert through their operations, closing with a selection of simple rubrics that can be used to conduct quick but nuanced assessments of individual firms. In sum, this chapter introduces readers to the field of CDOH; covers the core concepts with the attending historical, political, and philosophical background; and provides the tools required to engage in CDOH research and advocacy.
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Further Reading
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Declaration of Interests
I work for the English NHS as a family physician and for the World Health Organisation as an independent consultant. During medical school I worked part-time in a pub. At no other point in my career have I worked for – or received money or in-kind goods or services from – tobacco, alcohol, food and beverage, gambling, or firearms industries, nor conducted any research wholly or part-funded by industry. In 2018, I joined the Conservative party and stood as a local counsellor on a platform of population health reform, but renounced my membership in 2019. At one time or another, I have voted for four of the UKs main political parties; the Green party, the Liberal Democrats, the Conservatives, and Labour, with a tendency to pragmatic centrism. I hold no stocks or shares, and my individual savings account (ISA) is held with an ethical bank (Co-Op Bank). Unfortunately, both my NHS pension and Oxford University pension funds continue to invest in damaging industries. I have lobbied both to disinvest. Happily, Oxford University recently announced that it will disinvest from fossil fuels.
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A Note on Referencing
In all books there is a constraint on the permissible number of references. I have provided core references but necessarily omitted citations for a vast number of claims in this chapter. The evidences for all of the examples used in this chapter are easy to find with a quick internet search. I hope that these mini-case studies spark your interest and I encourage you to review the evidence for yourself.
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Allen, L.N. (2020). Commercial Determinants of Global Health. In: Haring, R., Kickbusch, I., Ganten, D., Moeti, M. (eds) Handbook of Global Health. Springer, Cham. https://doi.org/10.1007/978-3-030-05325-3_57-1
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