The Commercial Determinants of Health - How Big Businesses Keep Us Sick

TLDR: The Commercial Determinants of Health - The Overlooked Social Justice Issue

This article explores how large corporations influence health outcomes. Key points include:

1. The role of powerful industries in driving preventable diseases

2. How corporate wealth translates to political power

3. The strategies companies use to shape health behaviors and policies

Key takeaways:

• Just four industries (ultra-processed food, tobacco, alcohol, fossil fuels) account for a third of global deaths

• As corporations profit from harmful products, they gain more power to resist regulation

• Companies use sophisticated strategies to shape what society considers "normal"

• Healthcare systems and governments have become increasingly unable to address these problems

Wise Mind Nutrition’s stance:

• Recognizes the need to address systemic causes of poor health, not just individual choices

• Acknowledges how corporate strategies influence eating behaviors and mental health

• Promotes awareness of how industry shapes our food environment

• Supports evidence-based policy changes to protect public health

• Emphasizes the importance of understanding corporate influence while making personal health decisions

The article concludes by offering practical ways individuals can protect their health while supporting broader systemic change. It emphasizes that while solutions exist, implementation requires collective action to overcome corporate resistance.

[Read the full article for a detailed discussion of corporate strategies, health impacts, and paths to change]

The Commercial Determinants of Health: Following the Money Trail to Poor Health

As a mental health nutritionist who has spent years challenging the status quo, I've observed firsthand how commercial interests shape our health outcomes. Today, I want to pull back the curtain on what public health experts call "the commercial determinants of health," a fancy way of saying how big business impacts our well-being, often in hidden ways.

The Elephant in the Room

Imagine a game where the players who cause the most damage get the most power to keep playing. Sounds absurd, right? Yet this is precisely what's happening with our health. The companies producing the products that harm us most–ultra-processed foods, tobacco, alcohol, and fossil fuels–are also becoming increasingly wealthy and influential while the rest of us pay the price.

The Big Four

Just four industry sectors are responsible for at least one-third of deaths globally:

1. Ultra-Processed Food Industry: Creating products engineered to override our natural satiety signals

2. Tobacco Industry: Despite decades of evidence of harm

3. Alcohol Industry: Marketing addiction as a lifestyle

4. Fossil Fuel Industry: Impacting both planetary and human health

   
   

The Food Industry: A Closer Look

As someone specializing in nutrition and mental health, I'm particularly concerned about the food industry's role. Here's what we're seeing:

• Creation of ultra-processed foods designed for maximum palatability and profit, not health

• Aggressive marketing to children and vulnerable populations

• Lobbying against public health measures

• Funding research that downplays their products' harmful effects

• Creating confusion about nutrition science

  
  

The Vicious Cycle

Here's the troubling pattern:

1. Companies create harmful products

2. They make enormous profits

3. They use these profits to gain more influence

4. This influence helps them avoid regulation

5. The cycle continues while public health deteriorates

   
   

The Corporate Playbook: Shaping What We Think is "Normal"

One of the most powerful yet subtle ways corporations influence our health is through "norm-shaping," strategically manipulating what society considers standard, acceptable, or desirable. Here's how they do it:

1. Manufacturing Doubt

• Funding studies that create uncertainty about health impacts

• Using phrases like "more research is needed" to delay action

• Attacking scientists and health advocates who speak out

• Creating front groups that appear independent but serve industry interests

  
  

2. Controlling the Narrative

• Promoting individual responsibility while downplaying corporate accountability

• Using terms like "balance" and "moderation" to normalize harmful products

• Sponsoring health organizations to gain credibility

• Positioning themselves as part of the solution rather than the problem

  
  

3. Stigmatizing Critics

• Labeling health advocates as "food police" or "nanny state" proponents

• Dismissing concerns about ultra-processed foods as "fearmongering"

• Portraying public health measures as attacks on personal freedom

• Using social media influencers to mock health-conscious choices

  
  

4. Creating False Equivalencies

• Equating industry-funded research with independent studies

• Suggesting all foods should be part of a healthy diet

• Comparing naturally occurring sugars with added sugars

• Positioning exercise as an equal counterbalance to a poor diet

  
  

5. Capturing Professional Organizations

• Funding nutrition organizations and conferences

• Influencing dietary guidelines through lobbying

• Creating educational materials for schools

• Sponsoring continuing education for health professionals

  
  

Why Can't We Stop This?

The system has become what health experts call "pathological," it's designed to make harmful companies more powerful while weakening the forces that could stop them:

• Governments become dependent on corporate tax revenue and lobbying

• Healthcare systems have become overwhelmed treating preventable diseases

• Individuals bear the burden of poor health and increasing healthcare costs

• Civil society organizations struggle to compete with corporate resources

  
  

The Real Cost

While companies privatize the profits, they socialize the costs. We all pay through:

• Skyrocketing healthcare expenses

• Environmental degradation

• Increasing mental health issues

• Widening health inequalities

• Reduced life expectancy

  
  

Breaking the Cycle

Solutions exist, but they require collective action:

1. Awareness: Understanding how commercial interests influence our choices

2. Advocacy: Supporting policies that prioritize public health over profit

3. Action: Making informed choices about what we consume

4. Accountability: Demanding transparency from corporations and governments

   
   

A Personal Note

As a clinician who has treated over 1,000 patients struggling with disordered eating and addiction, I've seen how commercial interests can hijack our natural relationships with food and substances. The solution isn't just about individual choices–it's about changing the system that makes harmful choices accessible and profitable.

Moving Forward

We need a fundamental shift in how we think about business and health. This means:

• Prioritizing public health over corporate profits

• Implementing stronger regulations on harmful industries

• Supporting businesses that contribute positively to health

• Empowering individuals and communities to resist harmful marketing

• Teaching people about value-based eating 

  
  

The Bottom Line

The commercial determinants of health might sound like academic jargon, but it's really about something simple: how money and power influence our well-being. By understanding these forces, we can better protect ourselves and advocate for change.

The good news? Solutions exist. The challenge isn't finding what works–it's finding the collective will to implement these solutions despite corporate resistance. As healthcare providers, citizens, and consumers, we all have a role to play in demanding this change.

Take Action

• Educate yourself about corporate influence on health

• Support organizations advocating for public health

• Vote for politicians who prioritize health over corporate interests

• Make mindful choices about what you consume and who you support

• Download the Wise Mind Nutrition app and start your journey 

Remember: Your health is your wealth. Don't let commercial interests convince you otherwise.

View an hour-long training on the Commercial Determinants of Health.

References

1. Gilmore, A. B., Fabbri, A., Baum, F., Bertscher, A., Bondy, K., Chang, H.-J., Demaio, S., Erzse, A., Freudenberg, N., Friel, S., Hofman, K. J., Johns, P., Karim, S. A., Lacy-Nichols, J., Carvalho, C. M. P. de, Marten, R., McKee, M., Petticrew, M., Robertson, L., … Thow, A. M. (2023). Defining and conceptualising the commercial determinants of health. The Lancet, 401(Milbank Q 98 2020), 1194–1213. https://doi.org/10.1016/s0140-6736(23)00013-2

2. Friel, S., Collin, J., Daube, M., Depoux, A., Freudenberg, N., Gilmore, A. B., Johns, P., Laar, A., Marten, R., McKee, M., & Mialon, M. (2023). Commercial determinants of health: future directions. The Lancet, 401(10383), 1229–1240. https://doi.org/10.1016/s0140-6736(23)00011-9

3. Lacy-Nichols, J., Nandi, S., Mialon, M., McCambridge, J., Lee, K., Jones, A., Gilmore, A. B., Galea, S., Lacy-Vawdon, C. de, Carvalho, C. M. P. de, Baum, F., & Moodie, R. (2023). Conceptualising commercial entities in public health: beyond unhealthy commodities and transnational corporations. The Lancet, 401(10383), 1214–1228. https://doi.org/10.1016/s0140-6736(23)00012-0