Global Health Blogs with Professor Swahn

The cost of treat non-communicable diseases (NCD) has always been a struggle for all countires to address. Even recently, the challenge of treating non-communicable diseases continues to grow across the globe, with the global burden of disease increasing from 43% to 54%  between 1990 and 2016. An during 2018, NCDs accounted for an estimated 71% of total deaths globally, with cardiovascular diseases, cancers, diabetes, chronic respiratory diseases accounting 81% of those deaths. By 2025, the WHO (World Health Organization) estimates out of all annual deaths from NCDs, 85% of them will occur in middle- and low- income countries.

So how do we respond? It is clear we have to shift our focus to addressing these commercial determinants of health (CDoH) during the development of public health interventions designed to prevent and comabt non-communicable diseases such as cardiovascular disease, chronic respiratory diseases, cancer, and diabetes. CDoH are strategies and approaches used by the private sector to promote products and behaviors that are detrimental to the consumers health.

In todays world, and by many organization definitions, commercial determinants of health are health influencing factors that stem from the motive of profit and corporation practices used to maximize revenues, political influence, and marke shares. Ultra-processed food items and drinks, alcohol and tobacco, and exposing emplyees to unsafe work conditions or toxic substances are some common examples of how your health can be harmed for the promotion of unhealthy commodities.

Nicholas Freudenberg, a distinguished Professor of Public Health at City University of New York School concludes from his research – “Despite clear evidence of the alarming rise in non-communicable diseases globally, the public health community has achieved only limited consensus on effective preventive action,” he continues “The commercial determinants concept promises a more holistic, integrated and targeted approach.”

Freudenberg’s research allows us to look into some of the measures of commercial determinants of health. In order to address NCDs worldwide, it is crucial that we look at commercial determinants of health as a compounded of risk factors, and how these risk factors interact with each one another. A risk factor is any attribute, characteristic or exposure of an individual that increases the likelihood of developing a disease or injury. This way we can identify vulnerabilities of specific populations over location and time, and across other variables such as socioeconomic status, age, and sex. This could provide researchers a powerful dataset to develop targeted public health interventions to reduce such risks to health and health equity. 

This economic burden is a key driver of rising health inequities in our country and of course is especially heavy for marginalized and disadvantaged communities and individuals, more than those in groups with higher socioeconomic status. Remember, Health is not just determined by genetic and biological factors, but also by the socioeconomic situation surrounding people’s lives, which includes both income levels and the level of education reached. Finally, as the COVID-19 pandemic has shown us, higher rates of NCDs put millions of citizens at higher risk of other threats to their health and well being.

In response, we must develop effective prevention strategies focused on reducing those risk factors associated with these 4 type of diseases. In the past, public health intervention to prevent NCDs has primarily focused on metabolic factors (such as hypertension, hyperlipidemia) and modifiable behavioral risk factors (such as alcohol use, tobacco use, unhealthy diets, physical inactivity). Many political leaders who could make change believe that NCDs are just too large, complex, and expensive to challenge, but this strategy based on four diseases and four risk factors seems makes the situation much simpler. Researchers have now realized NCD prevention plans must address the circumstances in which people are born, live, work, and age, and the systems already put in place to deal with diseases. Public health approaches include screening for hypertension, healthy dieting, quitting smoking  and improvement of food labelling policies.