Conceptualising the Commercial Determinants of Health Using a Power Lens: A Review and Synthesis of Existing Frameworks

Document Type : Review Article

Authors

1 Global Obesity Centre, Deakin University, Geelong, VIC, Australia

2 Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia

Abstract

Background
There is increasing recognition that power imbalances that favour corporations, especially those active in unhealthy commodity industries, over other actors are central to the ways in which corporations influence population health. However, existing frameworks for analysing corporate strategies and practices that impact on health do not incorporate concepts of power in consistent ways. This paper aimed to review the ways in which corporate power has been incorporated into such frameworks, and to propose a revised framing of the commercial determinants of health
(CDoH) that makes concepts of power explicit.
 
Methods
We conducted a narrative review of frameworks that identify corporate strategies and practices and explain how these influence population health. Content analysis was conducted to identify explicit references to different qualities of power – its origins, nature, and manifestations.
 
Results
Twenty-two frameworks were identified, five of which used theories of power. A wide range of contexts that shape, and are shaped by corporate power were discussed, as were a diversity of corporate, social and ecological outcomes. A variety of material and ideational sources of power was also covered. We proposed an integrated ‘Corporate Power and Health’ framework to inform analysis of the CDoH, organised around key questions on power set out by Foucault. The proposed framework draws from a number of well-established corporate power theories and synthesises key features of existing CDoH frameworks.
 
Conclusion
Public health advocates, researchers and policy-makers would likely be better placed to understand and address the CDoH by engaging with theories of power to a greater extent, and by explicitly incorporating concepts of corporate power in analyses of how the deployment of corporate strategies and practices influence population health.

Keywords

References

  1. Brownell KD, Warner KE. The perils of ignoring history: Big Tobacco played dirty and millions died. How similar is Big Food? Milbank Q. 2009;87(1):259-294. doi:10.1111/j.1468-0009.2009.00555.x
  2. Nestle M. Food Politics: How the Food Industry Influences Nutrition and Health. Berkeley, CA: University of California Press; 2002.
  3. Slade J. The tobacco epidemic: lessons from history. J Psychoactive Drugs. 1989;21(3):281-291. doi:10.1080/02791072.1989.10472169
  4. Freudenberg N, Galea S. The impact of corporate practices on health: implications for health policy. J Public Health Policy. 2008;29(1):86-104. doi:10.1057/palgrave.jphp.3200158
  5. Kickbusch I, Allen L, Franz C. The commercial determinants of health. Lancet Glob Health. 2016;4(12):e895-e896. doi:10.1016/s2214-109x(16)30217-0
  6. Spitzer S. A systemic approach to occupational and environmental health. Int J Occup Environ Health. 2005;11(4):444-447, 449-455. doi:10.1179/oeh.2005.11.4.444
  7. Millar JS. The corporate determinants of health: how big business affects our health, and the need for government action! Can J Public Health. 2013;104(4):e327-329. doi:10.17269/cjph.104.3849
  8. Wiist WH. The corporation: an overview of what it is, its tactics, and what public health can do. In: Wiist WH, ed. The Bottom Line or Public Health: Tactics Corporations Use to Influence Health and Health Policy, and What We Can Do to Counter Them. Oxford, UK: Oxford University Press; 2010.
  9. Moodie R, Stuckler D, Monteiro C, et al. Profits and pandemics: prevention of harmful effects of tobacco, alcohol, and ultra-processed food and drink industries. Lancet. 2013;381(9867):670-679. doi:10.1016/s0140-6736(12)62089-3
  10. World Health Organization (WHO). Fact Sheets: Noncommunicable Diseases. WHO; 2018. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases.  Accessed April 18, 2019.
  11. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1659-1724. doi:10.1016/s0140-6736(16)31679-8
  12. Lee K, Freudenberg N. Addressing the commercial determinants of health begins with clearer definition and measurement. Glob Health Promot. 2020;27(2):3-5. doi:10.1177/1757975920931249
  13. Thorn M. Addressing power and politics through action on the commercial determinants of health. Health Promot J Austr. 2018;29(3):225-227. doi:10.1002/hpja.216
  14. Kickbusch I. Addressing the interface of the political and commercial determinants of health. Health Promot Int. 2012;27(4):427-428. doi:10.1093/heapro/das057
  15. Kickbusch I. Addressing the commercial determinants is critical to emerging economies. Cien Saude Colet. 2015;20(4):968-969. doi:10.1590/1413-81232015204.19962014
  16. McKee M, Stuckler D. Revisiting the corporate and commercial determinants of health. Am J Public Health. 2018;108(9):1167-1170. doi:10.2105/ajph.2018.304510
  17. Madureira Lima J, Galea S. Corporate practices and health: a framework and mechanisms. Global Health. 2018;14(1):21. doi:10.1186/s12992-018-0336-y
  18. Hastings G. Why corporate power is a public health priority. BMJ. 2012;345:e5124. doi:10.1136/bmj.e5124
  19. Madureira Lima J, Galea S. The corporate permeation index-a tool to study the macrosocial determinants of non-communicable disease. SSM Popul Health. 2019;7:100361. doi:10.1016/j.ssmph.2019.100361
  20. Maani N, Collin J, Friel S, et al. Bringing the commercial determinants of health out of the shadows: a review of how the commercial determinants are represented in conceptual frameworks. Eur J Public Health. 2020;30(4):660-664. doi:10.1093/eurpub/ckz197
  21. Foucault M. The subject and power. Crit Inq. 1982;8(4):777-795. doi:10.1086/448181
  22. Fuchs D. Commanding heights? the strength and fragility of business power in global politics. Millenium Annual Conference on Facets of Power in International Relations; 2005; London:39.
  23. Fuchs D. Exploring the Role of Business in Global Governance. Business Power in Global Governance. Boulder, Colorado: Lynne Rienner Publishers; 2007.
  24. Fuchs D, Di Giulio A, Glaab K, et al. Power: the missing element in sustainable consumption and absolute reductions research and action. J Clean Prod. 2016;132:298-307. doi:10.1016/j.jclepro.2015.02.006
  25. Clapp J, Scrinis G. Big food, nutritionism, and corporate power. Globalizations. 2017;14(4):578-595. doi:10.1080/14747731.2016.1239806
  26. Pulker CE, Trapp GSA, Scott JA, Pollard CM. What are the position and power of supermarkets in the Australian food system, and the implications for public health? a systematic scoping review. Obes Rev. 2018;19(2):198-218. doi:10.1111/obr.12635
  27. Milsom P, Smith R, Baker P, Walls H. Corporate power and the international trade regime preventing progressive policy action on non-communicable diseases: a realist review. Health Policy Plan. 2020. doi:10.1093/heapol/czaa148
  28. Mikler J. Theorizing Global Corporations’ Power. The Political Power of Global Corporations. Cambridge, UK: Polity Press; 2018.
  29. Clapp J, Fuchs D. Corporate Power in Global Agrifood Governance. Cambridge, Mass: MIT Press; 2009.
  30. Lukes S. Power: A Radical View. London: Macmillan; 1974.
  31. Lukes S. Power: A Radical View. The Original Text with Two Major New Chapters. London: Palgrave Macmillan; 2005.
  32. Dahl RA. The concept of power. Behav Sci. 1957;2(3):201-215. doi:10.1002/bs.3830020303
  33. Dahl RA. Who Governs? New Haven, CT: Yale University Press; 1961.
  34. Bachrach P, Baratz MS. Two faces of power. Am Polit Sci Rev. 1962;56(4):947-952. doi:10.2307/1952796
  35. Gramsci A. Selections from the Prison Notebooks of Antonio Gramsci. New York: International Publishers; 1971.
  36. Fuchs D, Glaab K. Material Power or Normative Conflict: Determinants of the Interaction Between Global and Local Agrifood Governance. Münster: Social Science Open Access Repository (SSOAR); 2010.
  37. Fuchs D, Kalfagianni A. Discursive power as a source of legitimation in food retail governance. Int Rev Retail Distrib Consum Res. 2009;19(5):553-570. doi:10.1080/09593960903445434
  38. Monbiot G. Neoliberalism–The Ideology at the Root of All Our Problems. The Guardian; 2016.
  39. de Loecker J, Eeckhout J. The Rise of Market Power and the Macroeconomic Implications. Cambridge, Mass: National Bureau of Economic Research; 2017.
  40. Wong G, Greenhalgh T, Westhorp G, Buckingham J, Pawson R. RAMESES publication standards: meta-narrative reviews. BMC Med. 2013;11:20. doi:10.1186/1741-7015-11-20
  41. Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q. 2004;82(4):581-629. doi:10.1111/j.0887-378X.2004.00325.x
  42. North DC. Institutions. J Econ Perspect. 1991;5(1):97-112.
  43. McDonough T, Reich M, Kotz D. Introduction: Social structure of accumulation theory for the 21st century. In: Contemporary Capitalism and its Crises: Social Structure of Accumulation Theory for the 21st Century. Cambridge: Cambridge University Press; 2010.
  44. Sammut-Bonnici T, Galea D. PEST analysis. In: Cooper CL, ed. Wiley Encyclopedia of Management. Hoboken: John Wiley & Sons; 2014.
  45. Sauerland D. Ideologies, institutions, and the new institutionalism. In: Wright JD, ed. International Encyclopedia of the Social & Behavioral Sciences. Elsevier; 2015:561-572.
  46. Kaufmann W, Hooghiemstra R, Feeney MK. Formal institutions, informal institutions, and red tape: a comparative study. Public Adm. 2018;96(2):386-403. doi:10.1111/padm.12397
  47. Gaventa J. Finding the spaces for change: a power analysis. IDS Bull. 2006;37(6):23-33. doi:10.1111/j.1759-5436.2006.tb00320.x
  48. Baum FE, Sanders DM, Fisher M, et al. Assessing the health impact of transnational corporations: its importance and a framework. Global Health. 2016;12(1):27. doi:10.1186/s12992-016-0164-x
  49. Knai C, Petticrew M, Mays N, et al. Systems thinking as a framework for analyzing commercial determinants of health. Milbank Q. 2018;96(3):472-498. doi:10.1111/1468-0009.12339
  50. Rochford C, Tenneti N, Moodie R. Reframing the impact of business on health: the interface of corporate, commercial, political and social determinants of health. BMJ Glob Health. 2019;4(4):e001510. doi:10.1136/bmjgh-2019-001510
  51. Holden C, Lee K. Corporate power and social policy: the political economy of the transnational tobacco companies. Glob Soc Policy. 2009;9(3):328-354. doi:10.1177/1468018109343638
  52. Walls H, Cook S, Matzopoulos R, London L. Advancing alcohol research in low-income and middle-income countries: a global alcohol environment framework. BMJ Glob Health. 2020;5(4):e001958. doi:10.1136/bmjgh-2019-001958
  53. Jamieson L, Gibson B, Thomson WM. Oral health inequalities and the corporate determinants of health: a commentary. Int J Environ Res Public Health. 2020;17(18):6529. doi:10.3390/ijerph17186529
  54. Brown T. Legislative capture: a critical consideration in the commercial determinants of public health. J Law Med. 2019;26(4):764-785.
  55. Farnsworth K, Holden C. The business-social policy nexus: corporate power and corporate inputs into social policy. J Soc Policy. 2006;35(3):473-494. doi:10.1017/s0047279406009883
  56. VeneKlasen L, Miller V, Budlender D, Clark C. A New Weave of Power, People & Politics: The Action Guide for Advocacy and Citizen Participation. Oklahoma City: World Neighbors; 2002.
  57. Flyvbjerg B. Phronetic planning research: theoretical and methodological reflections. Plan Theory Pract. 2004;5(3):283-306. doi:10.1080/1464935042000250195
  58. Fischler C. L’Homnivore. Paris, France: Éditions Odile Jacob; 2001.
  59. Coca-Cola Australia. Toasting a Special Relationship: Coca-Cola and Berlin. https://www.coca-colacompany.com/au/news/toasting-a-special-relationship-coca-cola-and-berlin.  Accessed June 17, 2020. Published 2014.
  60. Freudenberg N. The manufacture of lifestyle: the role of corporations in unhealthy living. J Public Health Policy. 2012;33(2):244-256. doi:10.1057/jphp.2011.60
  61. Marwick C. Tobacco hearings: penetrating the smoke screen. JAMA. 1994;271(20):1562.
  62. Sacks G, Veerman JL, Moodie M, Swinburn B. 'Traffic-light' nutrition labelling and 'junk-food' tax: a modelled comparison of cost-effectiveness for obesity prevention. Int J Obes (Lond). 2011;35(7):1001-1009. doi:10.1038/ijo.2010.228
  63. Eastmure E, Cummins S, Sparks L. Non-market strategy as a framework for exploring commercial involvement in health policy: a primer. Soc Sci Med. 2020;262:113257. doi:10.1016/j.socscimed.2020.113257
  64. Saloojee Y, Dagli E. Tobacco industry tactics for resisting public policy on health. Bull World Health Organ. 2000;78(7):902-910.
  65. Mialon M, Swinburn B, Sacks G. A proposed approach to systematically identify and monitor the corporate political activity of the food industry with respect to public health using publicly available information. Obes Rev. 2015;16(7):519-530. doi:10.1111/obr.12289
  66. Ulucanlar S, Fooks GJ, Gilmore AB. The policy dystopia model: an interpretive analysis of tobacco industry political activity. PLoS Med. 2016;13(9):e1002125. doi:10.1371/journal.pmed.1002125
  67. Jahiel RI. Corporation-induced diseases, upstream epidemiologic surveillance, and urban health. J Urban Health. 2008;85(4):517-531. doi:10.1007/s11524-008-9283-x
  68. London L. The 'dop' system, alcohol abuse and social control amongst farm workers in South Africa: a public health challenge. Soc Sci Med. 1999;48(10):1407-1414. doi:10.1016/s0277-9536(98)00445-6
  69. Nelson RR, Nelson K. Technology, institutions, and innovation systems. Res Policy. 2002;31(2):265-272. doi:10.1016/s0048-7333(01)00140-8
  70. Gereffi G, Fernandez-Stark K. Global Value Chain Analysis: A Primer. Duke University, North Carolina, USA: Center on Globalization, Governance & Competitiveness (CGGC); 2011.
  71. Friel S, Jamieson L. Political economy, trade relations and health inequalities: lessons from general health. Community Dent Health. 2019;36(2):152-156. doi:10.1922/CDH_SpecialIssueFrielJamieson05
  72. OECD. Oligopoly Markets. http://www.oecd.org/daf/competition/oligopoly-markets.htm.  Accessed June 4, 2020. Published 2015.
  73. Galea S. Macrosocial Determinants of Population Health. New York: Springer; 2007.
  74. Biely K, Maes D, Van Passel S. Market power extended: from Foucault to Meadows. Sustainability. 2018;10(8):2843. doi:10.3390/su10082843
  75. Savell E, Gilmore AB, Fooks G. How does the tobacco industry attempt to influence marketing regulations? a systematic review. PLoS One. 2014;9(2):e87389. doi:10.1371/journal.pone.0087389
  76. Savell E, Fooks G, Gilmore AB. How does the alcohol industry attempt to influence marketing regulations? a systematic review. Addiction. 2016;111(1):18-32. doi:10.1111/add.13048
  77. Mialon M, Swinburn B, Sacks G. A proposed approach to systematically identify and monitor the corporate political activity of the food industry with respect to public health using publicly available information. Obes Rev. 2015;16(7):519-530. doi:10.1111/obr.12289
  78. de Lacy-Vawdon C, Livingstone C. Defining the commercial determinants of health: a systematic review. BMC Public Health. 2020;20(1):1022. doi:10.1186/s12889-020-09126-1
  79. Mialon M. An overview of the commercial determinants of health. Global Health. 2020;16(1):74. doi:10.1186/s12992-020-00607-x
  80. Walls H, Nisbett N, Laar A, Drimie S, Zaidi S, Harris J. Addressing malnutrition: the importance of political economy analysis of power. Int J Health Policy Manag. 2020; In Press. doi:10.34172/ijhpm.2020.250
  81. Levy DL, Newell PJ. Business strategy and international environmental governance: toward a neo-Gramscian synthesis. Glob Environ Polit. 2002;2(4):84-101. doi:10.1162/152638002320980632
  82. Levy DL, Egan D. A neo‐Gramscian approach to corporate political strategy: conflict and accommodation in the climate change negotiations. J Manag Stud. 2003;40(4):803-829. doi:10.1111/1467-6486.00361
  83. Baines J. Food price inflation as redistribution: towards a new analysis of corporate power in the world food system. New Political Econ. 2014;19(1):79-112. doi:10.1080/13563467.2013.768611
  84. Nitzan J, Bichler S. Capital as Power: A Study of Order and Creorder. Routledge; 2009.
  85. Bain JS. Industrial Organization. New York: John Wiley & Sons; 1968.
  86. Bresnahan TF. Chapter 17 Empirical studies of industries with market power. In: Handbook of Industrial Organization. Vol 2. Elsevier; 1989:1011-1057. doi:10.1016/s1573-448x(89)02005-4
  87. Miller D, Harkins C. Corporate strategy, corporate capture: food and alcohol industry lobbying and public health. Crit Soc Policy. 2010;30(4):564-589. doi:10.1177/0261018310376805
  88. Baron DP. Integrated strategy: market and nonmarket components. Calif Manage Rev. 1995;37(2):47-65.
  89. Applbaum K. Getting to yes: corporate power and the creation of a psychopharmaceutical blockbuster. Cult Med Psychiatry. 2009;33(2):185-215. doi:10.1007/s11013-009-9129-3
International Journal of Health Policy and Management
Volume 11, Issue 8
August 2022
Pages 1251-1261

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History

  • Receive Date: 07 August 2020
  • Revise Date: 08 January 2021
  • Accept Date: 16 January 2021
  • First Publish Date: 25 January 2021

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