He gets up early to go to work. In front of the bus stop, some people are having breakfast on a terrace. Before getting on the bus, he observes the name of a sugary drink on the local napkin rings. In front of his job there are some people placing a canvas with advertising for a car whose driving we are assured sustainable.
The day ends and in the supermarket he sees a girl who asks for some cereals because a character from an animated series appears on the box. When he got home, while he was preparing dinner, the protagonist of the last movie he saw in the cinema appeared on television while enjoying a beer. He finishes dinner and turns off the television to go to sleep.
This routine is surely not alien to many. We receive constant stimuli throughout the day that remind us of the name of brands and products. They can be of all kinds: sugary drinks, ultra-processed foods, fast food, cars and alcohol. Later, when we decide to acquire one, our decision will be conditioned by the one that occupies a privileged place in our memory, either by pure repetition or by connecting with some relevant emotion for us.
This is the basis of advertising: that certain products and brands, or even the act of consuming itself, are more likely to be acquired.
And this has implications for our individual and collective health.
The commercial determinants of health
While the influence of corporations on our consumption patterns has been known for decades, public health interest in corporate business strategies and their impact on health is more recent.
the first article that incorporated this concept was written in 2012 by Ilona Kickbusch, who would later write a comment for the magazine The Lancet Global Health in which it would detail its framework of “commercial determinants of health”, summarized in the following figure.
The authors define the commercial determinants of health as “those strategies and approaches carried out by the private sector to promote products and decisions that are detrimental to health”.
They point out three interrelated factors that have modified the scenario of consumption and business on a global scale and increased the power of the companies involved:
-
Increased demand for products.
-
Expanding the reach of markets, for example to low- and middle-income countries in recent decades.
-
The continued internationalization of trade and investment.
In recent years, scientific evidence on the commercial determinants of health has increased, as pointed out by the latest special issue of the magazine The Lancet dedicated to the subject and published this year.
Business ‘lobbies’ against our health
Living in a market society, the main objective of any company is to obtain and maximize its profits. In a context of hyper-competitiveness, companies are continually under pressure to maintain and increase their market share compared to their competitors.
This encourages the use of practices aimed at maintaining and increasing demand, which ultimately allows them to maintain business profits.
Thus, the health consequences of consuming these products is conditioned by the influence of these corporations on the social environment in which we live through the availability of their products, their cultural desirability, and their price.
One of the most common ways that companies have to influence our environment is through the lobbiesthat is, trying to exert pressure at the legislative level to hinder the approval of laws that may reduce their benefits or to favor legislation that is favorable to their interests.
For example, it is estimated that sugary drink companies invested more than a hundred million dollars to exert political pressure between 2009 and 2015 in the United States.
Although this is the form that is most widely known and denounced at a social level, the influence exercised by these companies can be through other channels:
-
Marketing aimed at increasing the desire and acceptance of unhealthy merchandise by the population.
-
Corporate social responsibility strategies to divert attention from reportable practices and launder damaged reputations. An example of this would be the increasingly well-known and persecuted greenwashing.
-
Expansion of supply chains to increase the power of influence of these companies worldwide. By expanding their market share, the largest multinationals have a greater global voice compared to regional small and medium-sized companies.
The perfect example: tobacco companies
If there were an instruction manual on business strategies to increase the consumption of products with an impact on health, it would undoubtedly be written by the tobacco companies.
Throughout the 20th century, especially during the second half, these companies designed a series of strategies in order to maintain sales in those countries where the scientific community began to question their products. Also with the aim of increasing its presence in newly created markets in low-income countries.
Historically, tobacco companies have used advertising to normalize the presence of their products and encourage the incorporation of new smokers, especially young people. To do this, the tobacco companies wanted the young population to associate their products with adult life, having fun and obtaining a certain social status. An example of this is evident in the series Mad Mencentered on a 1960s advertising company.
Also designed advertising campaigns aimed at women in which smoking was linked to empowerment and independence. In the case of the black population of the United States, they associated smoking with elements of urban culture.
Currently, the strategies aimed at attracting young smokers are focused on the development of flavored cigarettes or in convey the idea that e-cigarettes are healthy and use its design to attract young people appealing to a more modern aesthetic and linked to technology, in opposition to the traditional cigarette, outdated for the new generations even on an aesthetic level.
Efforts by tobacco companies to maintain their market share have also focused on delay or avoid the implementation of regulations contrary to their interests. To do this, the industry has resorted to different tactics with the aim of putting pressure on political power: financing electoral campaigns, creating anti-regulation groups made up of people apparently without ties to the industry, threatening the potential loss of jobs and obtaining the approval of legislative measures of a self-regulatory nature tailored to the industry itself and aligned with its interests.
Another common tactic is to frame any type of regulation as contrary to individual liberty, while continuing to limit people’s ability to lead healthier lives.
These types of strategies, among others, have been designed and improved for decades by the tobacco industry. Today they are imitated by other industries whose products have a detrimental impact on the health of the population.
Knowing the commercial determinants of health and the strategies developed by these industries is essential for public health, since they indicate what type of public policies can best counteract the interest of companies in worsening people’s health.
Pedro Gullon TosioAssistant Professor Doctor of Public Health, University of Alcala and Mario Fontan VelaDoctoral student in Epidemiology and Public Health, University of Alcala
This article was originally published on The Conversation. read the original.
