1. Changing the Practices of the Tobacco, Alcohol, Automotive, and Food Industries to Prevent Noncommunicable Diseases
Nicholas Freudenberg
City University of New York School of Public Health, September 25, 2014

2. Non-communicable diseases
21st Century Killers
Non-communicable diseases
36 million deaths in 2011
52 million in 2030
Source: World Health Organization

3. Possible Explanations for Changes in Global Mortality
You gotta die of something
Population aging
Collateral damage from economic development
(Genetic factors)
Unhealthy lifestyles
What are limits of these explanations?

4. Another view: Analyzing the cause of the causes for changes in lifestyle
The business and political practices of corporations are a primary modifiable determinant of health behaviors, lifestyle, social environments and health policies.
Most health problems are “not, strictly speaking public health problems at all but questions of individual lifestyle—obesity, smoking, alcohol abuse, diabetes, sexually transmitted disease. These are not epidemics in the epidemiological sense—they are the result of millions of individual decisions at millions of points in time.”
Tony Blair or

5. Corporate Practices Business practices Product design Marketing
Retail distribution
Pricing
Political practices
Lobbying
Campaign contributions
Public relations
Sponsored scientific research
Philanthropy

6. Annual U.S. and Global Deaths Attributable to Products and Practices of Selected Consumer Industries
Industry
Main Health Conditions Related to Products and Practices
Estimated Global Annual Deaths,2010
Tobacco
Heart disease, lung and other cancers, respiratory diseases
6,297,287
(includes exposure to second-hand smoke)
Food and beverages
Obesity, diabetes, heart disease, some cancers
3,371,232
(attributed to high Body Mass Index)
Alcohol
Accidents, homicides, liver cancer , cirrhosis
4,860,168
Motor vehicles
Injuries , respiratory diseases including cancer, heart disease
1,300,000(from collision injuries)
3,223,540 (from particulate matter air pollution, of which motor vehicles are largest contributor)
Firearms
Homicide, suicide, unintended injuries
500,000, of which 300,000 are conflict-related and 200,000 homicides, suicides and accidents (2000)
Pharmaceuticals
Over and under medication
Not available
Sources: Lancet review, 2013

7. Top 20 Causes of Death Brasil 2011 Rate Deaths Industries 1.
Coronary Heart Disease
81.18
133,992
Tobacco, Alcohol, Food, Automobile 2.
Stroke
74.03
123,034
Food, Tobacco 3.
Diabetes Mellitus
37.71
61,987 4.
Influenza & Pneumonia
35.84
60,951 5.
Hypertension
32.15
53,466
Food, Tobacco, Automobile 6.
Violence
28.45
56,841
Firearms, Alcohol 7.
Lung Disease
26.52
43,373
Tobacco, Automobile 8.
Road Traffic Accidents
22.11
42,071
Automobile, Alcohol 9.
Lung Cancers
13.96
22,747
10.
Breast Cancer
13.65
Food
11.
Liver Disease
12.95
22,731
Alcohol
12.
Inflammatory/Heart
11.41
19,315
13.
Stomach Cancer
10.21
16,832
14.
Kidney Disease
9.10
15,350
15.
Prostate Cancer
9.00
14,428
16.
Other Injuries
8.23
15,023
17.
Alzheimers/Dementia
8.21
13,818
18.
Endocrine Disorders
8.12
14,081
19.
HIV/AIDS
7.49
14,361
20.
Colon-Rectum Cancers
7.09
11,763
Top 20 Causes of Death
Brasil 2011

8. The rise of the corporate consumption complex
The network of consumer corporations, financial institutions, advertising agencies, law firms, lobbying groups and the politicians, scientists and others they support

9. Hyperconsumption – the ideology of the corporate consumption complex
Hyperconsumption: health behaviors and lifestyles that contribute to premature death and preventable illnesses and injuries
1,420 calories and 107 grams of fat
Audacity on a bun

10. Diageo— bringing hard liquor to girls and women– and guys.
John Travolta teaches dance moves to Brazilian guys for Diageo

11. The Corporate Consumption Ideology
Lifestyle is the main influence on health.
Companies produce what customers want.
Advertising provides consumers with the information they need to choose wisely.
Government shouldn’t tell people or companies what to do.
Free trade is good for everyone
7. Criticizing big business is un-American.
8. Promoting consumption is essential for economic growth and prosperity.
The Corporate Consumption Ideology
Lifestyle is the main influence on health.
Companies produce what customers want.
Advertising helps consumers choose wisely.
Government shouldn’t tell people or companies what to do.
Free trade is good for everyone
Criticizing big business is un-American.
Promoting consumption is essential for economic growth and prosperity.

12. 10 ways consumer industries harm health
Make disease promoting products ubiquitous
Encourage retailers to promote their products
Supersize products
Target marketing to vulnerable populations
Price unhealthy products to promote sale and use
Create monopolies that reduce bargaining power of consumers and government
Support candidates who oppose public health policies and lobby against laws that protect public health
Sow doubt about scientific evidence that jeopardizes profits by documenting harms
Threaten to take jobs out of communities that oppose their policies
Organize Astroturf groups to oppose public health policies

13. Four “Impossible” Tasks for a Movement for a Healthier Future
1. Extract practical lessons from past campaigns to change corporate practices to guide creation of a more powerful, cohesive, and successful movement
2. Construct and popularize an ideology of health and democracy that can challenge corporate consumption complex’s prescription of hyperconsumption
3. Weaken, then dismantle, the corporate consumption complex
4. Forge a practical policy agenda that offers a vision of a healthier, more democratic future

14. Extract lessons

15. Construct an alternative ideology
Frames for Movements to Change Health Damaging Corporate Practices
The necessities for health -- clean air, healthy food, safe consumer products—should
be rights, not privileges.
Public policy should make healthy choices easy choices, not privilege private gain at the expense of health.
A decent society protects children and other vulnerable populations from those who seek to profit by encouraging unhealthy behavior or lifestyles.
Only government has the resources and mandate to protect public health from market forces.
Diminishing the power of government may give corporations more power.
Protecting and expanding democratic rights gives people more opportunities to shape decisions that affect their lives; diminishing these rights reduces this capacity.

16. Dismantle the corporation consumption complex
Evicting corporations from our minds
Evicting corporations from our institutions and communities
Evicting corporations from our political system

17. Forge a practical agenda
A Policy Agenda for a Movement for a Healthier Future
The movement for a healthier, more sustainable future supports policies that will:
Expand people’s right to know and corporations’ duty to disclose health consequences of corporate practices and products.
Require corporations to pay for health and environmental consequences of products and practices.
Establish global health standards for product design and marketing.
Protect science and universities from corporate intrusion.
Restore the visible hand of government in public health protection.
Prevent corporations from using money and power to manipulate democratic processes. .

18. Reject the view that there is no alternative, insist another world is possible. 

19. For more info
Corporations and Health Watch
Lethal and Legal available from Amazon, Barnes and Noble, Oxford University Press and bookstores