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On powerful platforms, profits and “an existential threat” to public health

Health professionals, researchers and citizens need to demand action from governments to rein in the power and influence of Big Tech over our health and wellbeing, according to Associate Professor Kathryn Backholer, Associate Director of the Global Obesity Centre within the Institute for Health Transformation at Deakin University.

Big Tech’s unprecedented concentration of money, power and data about billions of people is an existential threat to public health, she writes in the article below, calling for data protection, privacy and anti-trust laws, restrictions on the advertising of unhealthy products through digital platforms, and checks on Big Tech’s political influence.


Kathryn Backholer writes:

Few in public health would deny the immediate and observable harmful influences of Big Tobacco, Big Alcohol and Big Food. The power of these corporations and the strategies and approaches used to promote their products, at the expense of public health, is often captured under the scholarly banner of the ‘commercial determinants of health’.

Yet in all this study and discourse, one industry is getting off lightly. An industry that arguably has more power and influence over public health than Big Tobacco, Big Alcohol and Big Food combined. That industry is Big Tech.

The world’s five largest tech companies – Facebook, Google, Apple, Amazon and Microsoft – have transformed the way we live in a very short period of time.

Whilst much can, and has been said, about the benefits that their technologies have brought to society at large, governments, regulators and the health sector need to be doing far more to address the harms – and COVID has underscored the urgency of this. It may be that the sinister side of Big Tech, the side left largely unchallenged and unaccountable, will be its undoing.

Surveillance capitalism

Surveillance capitalism, a term coined by Professor Shoshana Zuboff in 2014, essentially describes mass surveillance of the internet to harvest and commodify unparalleled quantities of personal data.

By the time a child turns 13-years-old, tech companies are estimated to have collected 72 million data points from them. Vast quantities of this personal data is sold to advertisers for targeted marketing on anything and everything, including e-cigarettes, gambling, alcohol and ultra-processed foods.

A recent report from the ACCC highlights the growing concerns that Australians have about the conspicuous ways in which these companies track consumers, collect their data and sell it on to third parties for profit.

Whilst this relentless and targeted marketing negatively influences our health and well-being, it is the cornerstone of Big Tech’s rapid and unprecedented economic growth and consolidation of power.

Algorithmic amplification

Algorithmic amplification is the exponential popularisation of online content at the expense of other viewpoints.

What we see on our social media feeds is algorithmically determined by what is popular among others like us and reinforced by our clicks, likes, comments and shares. Designed to keep us engaged for longer, these ideological echo chambers crush differing points of views and polarise debates.

Increasingly online users are obtaining information and news from unreliable or untrustworthy sources, resulting in the dangerous rise of misinformation (spread of false information) and disinformation (deliberate spread of misleading or false information), unscientific propaganda, hate speech or conspiracy theories.

Even before COVID vaccines were widely available, researchers from the United States and South Africa were urging governments to take action over the spread of anti-vaccination content on social media platforms.

The researchers, who analysed more than 250,000 geo-coded vaccination-related tweets from 2018-2019, urged governments to mandate that social media companies are responsible for taking down anti-vaccination content (whether originating from genuine domestic actors or foreign propaganda operations).

Despite the legal and technical difficulties involved, authoritarian states had shown this was possible, due to their success in pressing technology companies into policing speech on their behalf within their borders.

“Where there is political will, there is the capacity for removing content damaging public health,” the researchers wrote, noting that in 2019 the World Health Organization listed vaccine hesitancy as one of the top 10 threats to world health.

The researchers, who documented how large-scale foreign disinformation campaigns associated with Russia have pushed anti-vaccination messages through Western social media platforms, also called for governments to address “the utilisation of information warfare on the internet”, including through diplomacy.

Foreign disinformation campaigns online were found to be associated with a drop in both mean vaccination coverage over time and negative discussion of vaccines on social media, the researchers reported.

“Social media, while providing an unprecedented capacity for the public to communicate, has also been a major factor in the rise of fringe opinions damaging to public health,” they wrote in BMJ Global Health last October.

As fringe opinions and damaging public health information is spread through the internet, Big Tech is rewarded by more user engagement, more data and more profits.

Unaccountable power and the erosion of democracy

The unaccountable power of Big Tech lies not only in their algorithmic control of our online content, but in how that translates to profits, political power and the erosion of democracy.

In 2019 the US Committee on the Judiciary examined the dominance of Big Tech (Amazon, Apple, Facebook, and Google) and their business practices to determine how their power affects our economy and our democracy. The conclusions were stark – Big Tech “wield their dominance in ways that erode entrepreneurship, degrade Americans’ privacy online, and undermine the vibrancy of the free and diverse press. The result is less innovation, fewer choices for consumers, and a weakened democracy”.

The true definition of democracy, a key tenet of population health and well-being, is where power lies with civil society, not with a handful of transnational corporations.

Yet recent events demonstrate the lengths that Big Tech will go to in challenging the decisions of our democratically elected leaders.

The Australian Government recently proposed new media laws to make Google and Facebook pay for news content. In response, Google threatened to ditch Australia, taking its search engine with it. Facebook placed a block on the inflow and outflow of all Australian news. In the middle of a global pandemic, Australians were left without access to important health information from NGOs, governments and emergency services.

In the US, Big Tech spent reportedly more than $65 million lobbying Washington last year – a record high, conveniently at a time when the threat of regulation looms with President Joe Biden in power. Political spending seeks to secure political allies who will resist legislative measures that will impede the perpetual growth and profits of Big Tech.

Tax evasion

As of September 2020, the combined value of Big Tech was estimated at more than $5 trillion—more than a third of the value of the S&P 100 (an index that tracks the top 100 US blue-chip stocks).

If left unchecked, it is estimated that Big Tech will hold around 30 percent of the world’s gross economic output in the next 10 years.

Despite this wealth, Big Tech has been notorious for exploiting loopholes in global tax rules. The UK based, Fair Tax Foundation, reported that Big Tech firms avoided paying around $149 billion in global tax between 2011 and 2020 by shifting income to low-tax jurisdictions from where they operate – taxes that are vital to support public goods and services, including education, health and social supports, infrastructure and emergency services.

Accountability

Big Tech’s unprecedented concentration of money, power and data about billions of people across the globe is an existential threat to public health.

Our interactions with Big Tech have been accelerated by COVID-19 and along the way Big Tech has gotten even bigger. Never has there been a better time to rein in the power and influence of Big Tech over population health and well-being.

As health professionals and researchers, we need to hold Big Tech to account with the fervour and urgency applied to Big Tobacco.

As governments and regulators, we need to review, reform and enforce data protection, privacy and anti-trust laws, restrict the advertising of unhealthy products through digital platforms and limit the ability of Big Tech to lobby and contribute to political coffers.

As individuals, we need to demand action from our government leaders so that power remains with us and not with a small handful of transnational tech giants.

Kathryn Backholer is an Associate Professor and Associate Director of the Global Obesity Centre within the Institute for Health Transformation at Deakin University. She leads a multi-disciplinary program of research focused on the social, cultural and commercial determinants of health. Her work has a major focus on unhealthy advertising through digital platforms, where she is leading the development of an artificial intelligence system to monitor unhealthy advertising to children.


See our previous coverage of the digital platforms and public health, and also follow #RegulateDigitalPlatforms on Twitter.

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