Global Health Blogs with Professor Swahn

We all have heard about social determinants of health but what a lot of people do not know about is- Commercial determinants of Health (CDoH)! CDoH are factors that influence which stem from the profit motive and the practices that corporations use to maximize revenues, market share, and political influence. In other words, CDoH includes not only products but also approaches used by the private sector to maximize profit and capital while producing and promoting products and choices that are detrimental to the health of the community. CDoH not only includes unhealthy products such as sugary beverages, alcohol, tobacco, processed food products but also includes unsafe work conditions, pharmaceuticals, advertisements, gaming industries, low wages, outsourcing to save funds, for-profit health insurance, etc.

Private corporations use marketing through social media platforms or advertisements as one of the main channels of promoting their product, and they are successful which is not surprising because they target the right audience for the product. Additionally, companies expanding globally, especially in low- and middle-income countries is also one of the most crucial drivers. Furthermore, based on the company’s revenue and reach, they influence political activity as well. That is not all though. Such corporation makes large funding to universities thus gaining financial leverage thereby turning research activities, and courses in their favor. Thus, private companies employ a wide range of tactics and approaches to promote their products, thereby promoting unhealthy behavior patterns, and increasing the risks of a lot of diseases.

An amazing article published in ‘The Irish times’ clearly explains how big brands use social media platforms such as Facebook to target young adults, and the need to expand the existing curb on television advertising to other media platforms as well. Neither do children understand the subtle way such promotional posts market their product nor do parents understand the impact of advertising through social media platforms.

According to a report by eater.com, the food and beverage industry spent more than $33 million on lobbying in 2015. Be it lobbying to evade providing health insurance to full-time employees or to lobby for less restrictive rules to increase the sale of their product, such as by McDonald’s and Dunkin’ Donuts, all of these are examples of approaches by corporations to maximize on profits while promoting unhealthy products.  

The next important question is why is studying CDoH necessary? The most crucial reason to make ourselves familiar with the topic of CDoH is for the fact that such products and approaches are hidden in our day to day life so secretly as to make them almost impossible. For instance, sugar loaded flavor in the name of orange juice. Juices that are marketed as 100% pure fiber and fruit are actually full of added sugars or flavored yogurt for that matter. But most of us do not look at the contents of every product we get in a supermarket.

Secondly, the strategies used by big private sector companies target a specific population, mainly targeting kids and people from the low socio-economic stratum. The products promoted by these companies exacerbate the burden of non-communicable diseases (NCDs).

As mentioned by Dr. Paichadze, low and middle income countries like China, Viet Nam, India, and Egypt show a very rapid projected growth in consumption of such products by 2030 which is particularly detrimental to the health of those already suffering from one or multiple NCDs. On the other hand, less growth is projected in high income countries.

 The risk of such products is particularly increased in the past few months. With people across the globe home bound with the pandemic, tobacco, and alcohol industry, corporations selling unhealthy food products, have begun to capitalize on the current scenario by philanthropic actions. In the name of so-called donations and funding for healthcare workers and the health industry, such brands have witnessed a growth in the sale of their products. These corporations are least bothered by the health of the people. For instance, Cadbury India, owned by Mondelez International Inc. has started selling chocolates with a wrapper that says ‘Thank you’ in all local languages as a note of gratitude for the relentless efforts of healthcare workers. In reality, such philanthropic efforts are just a way of increasing revenue and profits.

The report ‘Signaling Virtue, Promoting Harm: Unhealthy commodity industries and COVID-19’ by NCD Alliance was an eye opener. The way food and beverage industries, gaming industries, junk food chains, and formula milk companies are targeting the people, especially during such unprecedented times is shocking. Whether it is McDonald’s offering free thank you meals to frontline workers in exchange for a selfie or Red Bull Australia providing free energy drinks for health workers or subway Canada offering a free facemask with the purchase of two sandwiches, these big brands are taking advantage of the current situation to sell their products or improve their image. Other brands such as Krispy Kreme and Burger King are not far behind. Either through free products or through funding, these brands are gaining financial leverage which will help them promote unhealthy products not just now but for the years to come as well.

An important point to remember here is the fact that people with NCDs are more likely to be infected by the COVID-19 virus and succumb to it. Promotion of burgers and fries and energy drinks, which are full of trans fat and sugar is only increasing the NCD crisis. Understanding CDoH is an important first step in designing interventions particularly suited to prevent and control NCDs. As explained by Dr. Freudenberg in Global Health Promotion journal, understanding how CDoH function and interact with each other is critical to better identify vulnerable population groups. . Years and years of efforts by the community and public health workers is at stake during such tough times. What we require urgently is a wake-up call. People need to realize how such brands are capitalizing on their emotions.