Should public health efforts focus on changing individual behaviour and lifestyles? Or on influencing the social determinants of health? Or should they focus on the corporate practices that contribute to poor health?
This issue is discussed in the latest “must read” article recommended below by the JournalWatch service of The Public Health Advocacy Institute WA. The article is by Nicholas Freudenberg, Distinguished Professor of Public Health at the City University of New York School of Public Health at Hunter College.
As a by-the-way, while searching for the paper I came across this US-focused website, Corporations and Health Watch, where Freudenberg is one of the contributing writers.
The website focuses on the health impacts of six industries – alcohol, automobile, firearm, food and beverages, pharmaceutical, and tobacco – and suggests strategies for changing corporate practices. It also has resources, including an archive of articles looking at how corporate practices affect health inequities.
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The Manufacture of Lifestyle: The Role of Corporations in Unhealthy Living
Dr Melissa Stoneham writes:
There are many factors that contribute to an unhealthy lifestyle. Some of these include skipping breakfast, not eating enough fruit and vegetables, being inactive, drinking more than 2 standard drinks a day, smoking tobacco….the list goes on.
However, recently, researchers have debated two views on the connection between lifestyle and health.
This article by Nicholas Freudenberg proposes that corporate practices are a dominant influence on the lifestyles that shape patterns of health and disease.
He makes the case that corporate business practices such as product design, marketing and retailing and corporate political practices such as lobbying, campaign contributions and sponsored research are fundamental causes of the of the lifestyles associated with the growing global burdens of non-communicable diseases and injuries.
The author suggests modifying business practices that promote unhealthy lifestyles is a promising strategy for improving population health and provides four key strategies to do this.
These include:
- Encouraging governments to set advertising standards prohibiting promotion of unhealthy products and making misleading health claims;
- Strengthening laws making corporations liable for the health-related damage associated with products they produce and promote;
- Actively promoting healthier, more sustainable lifestyles, addressing the demand for unhealthy products as well as the supply, and
- Demanding political reforms that reduce corporations’ privileged voice in public policy.
The article suggests that by focusing attention on “lifestylers”, the organisations and institutions that shape lifestyles, as well as on the behaviours associated with unhealthy living (eg, tobacco use, high fat, sugar and salt diets, excess alcohol consumption and so on), we expand our options for developing health-promoting public policies.
As public health advocates, it is our role to encourage governments to set advertising standards prohibiting promotion of unhealthy products and making misleading health claims.
• Nicholas Freudenberg. The manufacture of lifestyle: The role of corporations in unhealthy living. Journal of Public Health Policy, Vol 33, Issue 2; Pages 244 – 256
(Copy available on request to Croakey).
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PHAIWA is an independent public health voice based within Curtin University, with a range of funding partners. The Institute aims to raise the public profile and understanding of public health, develop local networks and create a statewide umbrella organisation capable of influencing public health policy and political agendas. Visit our website at www.phaiwa.org.au
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About JournalWatch
The Public Health Advocacy Institute WA (PHAIWA) JournalWatch service reviews 10 key public health journals on a monthly basis, providing a précis of articles that highlight key public health and advocacy related findings, with an emphasis on findings that can be readily translated into policy or practice.
The Journals reviewed include :-
Australian & New Zealand Journal of Public Health (ANZJPH)
Journal of Public Health Policy (JPHP)
Health Promotion Journal of Australia (HPJA)
Medical Journal of Australia (MJA)
Lancet
Environmental Health Perspectives (EHP)
Tobacco Control (TC)
American Journal of Public Health (AMJPH)
Health Promotion International (HPI)
American Journal of Preventive Medicine (AJPM)
These reviews are then emailed to all JournalWatch subscribers and are placed on the PHAIWA website. To subscribe to Journal Watch go to http://www.phaiwa.org.au/index.php/other-projects-mainmenu-146/journalwatch
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Previous JournalWatch articles:
• How much healthy food is sold at fast food restaurants?
• Why the world needs a dengue day
• Germany’s role in undermining tobacco control
Whilst I endorse the stated aims of encouraging governments, (but even more importantly in my view, the community at large), to set advertising standards regarding misleading health claims and actively promoting healthier, more sustainable lifestyles, and addressing the demand for unhealthy products as well as the supply, I’m not so comfortable with prohibiting promotion of unhealthy products and strengthening laws making corporations liable for the health-related damage associated with products they produce and promote, because I’m not sure how, in a democratic society we can successfully “demand” or successfully and legally achieve these outcomes.”
• As just one instance of the impracticability of “prohibiting” strategies, if one looks closely at the latest New York Bloomberg initiative with regard to “super-size” drinks, the ban will only apply to certain store locations and some of the fast food outlets will still be able to promote and sell these products. So the food junkies will easily find these and other available sources for their eating/drinking addiction! Indeed, with regard to what are the likely success of “socially desirable political reforms” in the Australian contemporary environment , if we look at the public health area alone, we currently have a raft of very laudable but half-baked Government reforms in the offing, complete with duplication and groaning with additional layers of bean counters and bureaucracy- and does anyone think that this makes for better health outcomes?? So, with the political processes ( and people) we have at our disposal, be careful what you wish for in the food/lifestyle area !
I respect and understand that The Public Health Advocacy Institute of WA. would wish to advocate these sort of measures, and it’s important that we have public health advocates who are well-regarded continue to do so. However, I really do worry if as a society we harboured and nurtured the simplistic delusion that the easy answer to people adopting a self-destructive lifestyle was to demonise the suppliers and purveyors of unhealthy products and to impose draconian, ham-fisted “nanny state” solutions to problems that are best tackled in the long-term, by improving community engagement, collaboration and understanding of these issues through better targeted education in schools and at home, and, (however we may hesitate to do so), developing tangible incentives and encouragement for industry to co-operate in food and lifestyle initiatives related to improving community health. After all, we are moving away from punishment and harsh legislation for drug addicts- why promote these techniques as a community solution to the problem of the proliferation within the community of unhealthy food patterns and poor lifestyle choices?