Introduction
The world has experienced a nutrition transition from mostly plant-based whole foods to industrialized processed foods. The nutrition transition started in Western countries and the concomitant diseases such as Type II diabetes have been labeled Western Diseases. While these Western Diseases continue to take their toll on all walks of life, they have been especially detrimental among lower-income populations who have less access to plant-based whole foods.
Corporate and monied interests who have benefited from this nutrition transition continue to utilize and refine an age-old approach to influence, lobbying.
Topic
Purpose Statement
Lobbying is about influence. The term “lobby” traces back to 1640 when it originally referred to where the general public could go see their members of the English House of Commons but in the nineteenth century lobbying took on its current meaning for political influence by more than constituents (Hansen, 2006). It is important that we remain aware of the influence directed at our political representatives across many subjects, but our focus here is on an especially powerful form of lobbying that has arisen.
What’s Fair?
Citizens have the right to ask their elected representatives for support. It may be a request to sponsor a child into a military academy or help to get a passport renewed and any number of similar requests that elected representatives address as part of constituent services. Elected representatives, after all, are in office at the will of their constituents and they usually want to satisfy their constituents’ expectations as much as possible. This is normal and customary, going back centuries in representative democracies. When corporations and monied interests start to petition elected officials, or lobby, the results can veer from normal and customary constituent services to harmful influence. Those corporations and monied interests have grown so powerful that they no longer are simply lobbying but directly and negatively impact health in order to advance their own interests.
Ways to lobby and influence
Lobbying is sophisticated. There is seldom any direct quid pro quo. Rather, lobbyists use a variety of indirect methods, such as: interfering with legislative priorities, creating front groups that proxy for the lobbyists, simply questioning the validity of opposing viewpoints, and appearing to advance community best interests while ensuring their own agendas (Tangcharoensathien, et al., 2019). When the desires of corporations and monied interests negatively impact others is an important boundary for public policy.
Pareto Optimality
In social sciences, there is the concept of Pareto Optimality which asserts that a course of action is optimal when it makes some people better off but does not make anyone worse off. If a constituent asks for help to renew a passport expeditiously, that constituent is better off once the expedited passport is in hand but no one else is worse off. The courses of action lobbied by corporations and monied interests work against many and benefit very few. And those who are made worse off are growing as the level of power and sophistication by food corporations and monied interests increase. Given the increasing harm to consumers when advancing commercial interests, lobbying has arguably taken on a new form.
Commercial determinants of health
In 2023 The Lancet published a series of articles that addressed a new concept, Commercial Determinants of Health (CDOH). A similar term, Social Determinants of Health (SDOH), has been in use for years. SDOH is focused on the impact of social factors on health such as housing, relationships, and employment status. CDOH builds on the idea that health is impacted by more than conventional health factors, specifically that commercial interests upset Pareto Optimality by powerfully advancing their own agendas at the expense and health of consumers (Gilmore et al., 2023).
Chung et al. (2024) found through an in-depth review of lobbyist activity captured in the nonprofit OpenSecrets that many lobbying activities were obscured. For example, Chung et al. (2024) observed that only about half of large companies (including processed food companies) are active in direct lobbying but the authors could not review many indirect lobbying methods such as grassroots lobbying, funding a think tank, participating in industry associations, and other forms of “dark money” advocacy.
Gilmore et al. (2023) defined CDOH as “the systems, practices, and pathways through which commercial actors drive health and equity”. It is important to note that in this definition CDOH it is no longer about lobbyists simply bending elected representatives to decide in their favor on issues. Rather, in CDOH these commercial actors intentionally drive health outcomes as a result of maximizing profitability and influence to such an extent that approximately 11 million deaths annually are tied to unhealthy diets in general, not just ultra-processed foods (Gilmore et al., 2023).
Wood et al. (2021) drive the same point with an example of how unequal distribution of costs and benefits in these lobbied results, or to use the vernacular “the rich get richer and the poor get poorer.” Looking at a simple example where we can readily see that a sugar-sweetened beverage (SSB) company harms the environment with plastic bottles and harms consumers (usually in more disadvantaged demographics) with nutrition-free SSBs yet the stockholders and executive management (usually the more affluent demographics) of the global SSB company enjoy not the soft drink but the increased share value. The costs of plastic pollution, obesity, Type II Diabetes, cardiovascular diseases, and other Western diseases associated with SSBs are not on the company’s balance sheet (Wood et al., 2021).
Conclusion
Lobbying has a long history and may not be inherently detrimental; however, in a climate of CDOH lobbying exacerbates the rise of processed-food-related Western diseases. CDOH impacts less-privileged demographics the most, further widening the gap between commercial interests that benefit from CDOH and those adversely impacted by it.
References
Chung, H., Cullerton, K., & Lacy-Nichols, J. (2024). Mapping the Lobbying Footprint of Harmful Industries: 23 Years of Data From OpenSecrets. The Milbank quarterly, 10.1111/1468-0009.12686. Advance online publication. https://doi.org/10.1111/1468-0009.12686
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., Abdool Karim, S., Lacy-Nichols, J., de Carvalho, C. M. P., Marten, R., McKee, M., Petticrew, M., Robertson, L., Tangcharoensathien, V., … Thow, A. M. (2023). Defining and conceptualising the commercial determinants of health. Lancet (London, England), 401(10383), 1194–1213. https://doi.org/10.1016/S0140-6736(23)00013-2
Hansen, L. (Host). (2006, January 22). A lobbyist by any other name? NPR. https://www.npr.org/2006/01/22/5167187/a-lobbyist-by-any-other-name
Moodie, R., Stuckler, D., Monteiro, C., Sheron, N., Neal, B., Thamarangsi, T., Lincoln, P., Casswell, S., & Lancet NCD Action Group (2013). Profits and pandemics: prevention of harmful effects of tobacco, alcohol, and ultra-processed food and drink industries. Lancet (London, England), 381(9867), 670–679. https://doi.org/10.1016/S0140-6736(12)62089-3
Tangcharoensathien, V., Chandrasiri, O., Kunpeuk, W., Markchang, K., & Pangkariya, N. (2019). Addressing NCDs: Challenges From Industry Market Promotion and Interferences. International journal of health policy and management, 8(5), 256–260. https://doi.org/10.15171/ijhpm.2019.02
Commercial determinants of health (By The Lancet). (2023, March 23). The Lancet. Retrieved February 13, 2024, from https://www.thelancet.com/series/commercial-determinants-health
Wood, B., Williams, O., Baker, P., Nagarajan, V., & Sacks, G. (2021). The influence of corporate market power on health: exploring the structure-conduct-performance model from a public health perspective. Globalization and health, 17(1), 41. https://doi.org/10.1186/s12992-021-00688-2
