Through pricing, marketing, and availability, our food environment has been, for many decades, encouraging to make unhealthy choices. The rise of advertising has led to an increase in obesity and nutrition deficiencies as more people choose to consume unhealthy food.
Each of us has the right to purchase whatever we can afford. Commercial forces may limit our freedom of choice more than we realize. A new study published in The Lancet indicates that commercial entities, with their deep pockets and power to influence people’s choices, are responsible for many of the key causes of poor health. The commercial entities affect the political, economic, and regulatory systems and policies.
Commercial determinants are the ways in which commercial entities influence our food environment to maximize their profits. They create an atmosphere that encourages us to make unhealthy choices.
Three main methods are used to do this.
We have been socialized to believe our adult food choices are the direct result of our free will and freedom of choice. For people with limited money, this “freedom” can be limited by the food and beverage manufacturers and retailers who choose what to sell, market, and produce.
Marketing creates demand. The supermarkets are full of ultra-processed food with added sugars, unhealthy oils, and harmful additives. These products are made to make you want more. The marketing of food and beverages is done in an unethical manner. The companies target children using manipulative images and parents who are stressed with “easy” ways to feed and satisfy their family.
Profits of food and beverage companies increase their political influence. This is particularly true for markets that are underregulated in countries with low and middle incomes. They use their economic strength (employment, taxes) to support corporate lobbying, which weakens government policies.
What can you do?
The Lancet series outlines four ways that governments, businesses, and citizens can curb the power and harm caused by commercial entities.
1. Rethinking the political and economic system
Bhutan, Ecuador, Brazil and other developing countries are paving the way for new frameworks which put people first. Scotland and Wales in the UK have taken important steps.
These frameworks are designed to measure the commercial impact on health and environment and to encourage practices that promote good health. To achieve this, commercial entities must pay their fair share in taxes and be held accountable for all the harm that their products cause to health, the environment, and social welfare.
2. Create an international convention on commercial health determinants.
In practice, that would mean replicating global regulatory frameworks that work and expanding them. The World Health Organization (WHO) Framework Convention on Tobacco Control shows that public health policies are not at the mercy of commercial interests. The convention, which was adopted in 2003, has had a significant impact on public policy changes around the world. The way has provided countries with a framework to develop and implement evidence-based measures that reduce tobacco use and associated harms. Examples include:
Graphic health warnings for tobacco products.
Prohibitions of tobacco advertising and promotion, as well as sponsorship and tax increases.
The Lancet proposes that an “international convention” should be created on commercial determinants to health, with the support of WHO and its members states. The Lancet suggests that leaders in public health and politicians should replicate the tobacco-control convention by requiring countries to adhere to a set or principles. The framework must be sufficiently broad to include all commercial influences on the health. They include gambling, mining, automobiles, pharmaceuticals and technology (as well as the more familiar alcohol and food industries).
3. Comprehensive policies on food and the environment
Public procurement, i.e. how government purchases goods and services, is one type of policy that has been proven to protect and improve the health. The government can influence the food industry through its purchasing power by encouraging healthy food production and distribution and limiting unhealthy food products.
In 2008, the mayor of New York City directed city agencies to adhere to public food procurement standards in order for them to serve over 260,000,000 meals and snacks annually. The standards are applicable to over 3,000 programs at 12 agencies, including schools, shelters, and hospitals. The nutritional requirements include dairy, cereals and meat as well as fruit, vegetables and fruits.
The Brazilian School Food Programme provides another example of an effective national procurement policy that has direct benefits for health. The program provides healthy meals for millions of children in public schools throughout Brazil.
The company is required to buy 30% of its food from family farmers. The program has improved students’ health and well-being as it promotes sustainable and ethical food production. The programme has been successful in regulating the sale and marketing food both inside and outside of school grounds.
This model could be adopted by countries around the world, including South Africa. Despite industry promises not to sell unhealthy food and beverages to schools, these products are still easily available and readily available.
Read more: South Africa must ban sugary drinks sales in schools. Self regulation is failing
4. Social mobilisation.
Citizens, civil societies, activists, public-health practitioners, and academics are able to demand their right of health by requesting government action regarding commercial determinants. You can use a number of different strategies to achieve this. They can use their collective voice to support evidence-based measures of health, expose and oppose harmful effects of commercial factors on health and equity, and insist that governments and commercial actors are held accountable.