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      Trust, but Verify : Comment on "‘Part of the Solution’: Food Corporation Strategies for Regulatory Capture and Legitimacy"

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          Abstract

          According to Lacy-Nichols and Williams, the food industry is increasingly forestalling regulation with incremental concessions and co-option of policy-making discourses and processes; bolstering their legitimacy via partnerships with credible stakeholders; and disarming critics by amending their product portfolios whilst maintaining high sales volumes and profits. Their assessment raises a number of fundamental philosophical questions that we must address in order to form an appropriate public health response: is it appropriate to treat every act of corporate citizenship with cynicism? If voluntary action leads to better health outcomes, does it matter whether profits are preserved? How should we balance any short-term benefits from industry-led reforms against the longer-term risk stemming from corporate capture of policy-making networks? I argue for a nuanced approach, focused on carefully defined health outcomes; allowing corporations the benefit of the doubt, but implementing robust binding measures the moment voluntary actions fail to meet independently set objectives.

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          Cost-effectiveness of interventions to reduce dietary salt intake.

          To evaluate population health benefits and cost-effectiveness of interventions for reducing salt in the diet. Proportional multistate life-table modelling of cardiovascular disease and health sector cost outcomes over the lifetime of the Australian population in 2003. The current Australian programme of incentives to the food industry for moderate reduction of salt in processed foods; a government mandate of moderate salt limits in processed foods; dietary advice for everyone at increased risk of cardiovascular disease and dietary advice for those at high risk. Costs measured in Australian dollars for the year 2003. Health outcomes measured in disability-adjusted life years (DALY) averted over the lifetime. Mandatory and voluntary reductions in the salt content of processed food are cost-saving interventions under all modelled scenarios of discounting, costing and cardiovascular disease risk reversal (dominant cost-effectiveness ratios). Dietary advice targeting individuals is not cost-effective under any of the modelled scenarios, even if directed at those with highest blood pressure risk only (best case median cost-effectiveness A$100 000/DALY; 95% uncertainty interval A$64 000/DALY to A$180 000/DALY). Although the current programme that relies on voluntary action by the food industry is cost-effective, the population health benefits could be 20 times greater with government legislation on moderate salt limits in processed foods. Programmes to encourage the food industry to reduce salt in processed foods are highly recommended for improving population health and reducing health sector spending in the long term, but regulatory action from government may be needed to achieve the potential of significant improvements in population health.
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            Responding to the Corporate and Commercial Determinants of Health

            We trace the development of the concept of the corporate determinants of health. We argue that these determinants are predicated on the unchecked power of corporations and that the means by which corporations exert power is increasingly unseen. We identify four of the ways corporations influence health: defining the dominant narrative; setting the rules by which society, especially trade, operates; commodifying knowledge; and undermining political, social, and economic rights. We identify how public health professionals can respond to these manifestations of power.
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              Corporate practices and health: a framework and mechanisms

              Background The Global Burden of Disease estimates that approximately a third of deaths worldwide are attributable to behavioural risk factors that, at their core, have the consumption of unhealthful products and exposures produced by profit driven commercial entities. We use Steven Lukes’ three-dimensional view of power to guide the study of the practices deployed by commercial interests to foster the consumption of these commodities. Additionally, we propose a framework to systematically study corporations and other commercial interests as a distal, structural, societal factor that causes disease and injury. Our framework offers a systematic approach to mapping corporate activity, allowing us to anticipate and prevent actions that may have a deleterious effect on population health. Conclusion Our framework may be used by, and can have utility for, public health practitioners, researchers, students, activists and other members of civil society, policy makers and public servants in charge of policy implementation. It can also be useful to corporations who are interested in identifying key actions they can take towards improving population health.

                Author and article information

                Journal
                Int J Health Policy Manag
                Int J Health Policy Manag
                Kerman University of Medical Sciences
                International Journal of Health Policy and Management
                Kerman University of Medical Sciences
                2322-5939
                December 2022
                26 February 2022
                : 11
                : 11
                : 2727-2731
                Affiliations
                London School of Hygiene and Tropical Medicine, London, UK.
                Author notes
                [* ] Correspondence to: Luke N. Allen Email: drlukeallen@ 123456gmail.com
                Author information
                https://orcid.org/0000-0003-2750-3575
                Article
                10.34172/ijhpm.2022.7008
                9818090
                35247935
                4d47d4c5-2a7d-4cbd-a609-4469172eb26c
                © 2022 The Author(s); Published by Kerman University of Medical Sciences

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 14 December 2021
                : 06 February 2022
                Categories
                Commentary

                commercial determinants of health,health policy,food industry,big food

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