Sheffield DPH

  the neoliberal framework in which the thinking around Commercial Determinants of Health sits   this is the second blog in a series on CDOH. There are important limitations of the socio / ecological model (it hopefully goes without saying there are mission critical limitations of orientating public health around individualistic thinking). Taking a line from Rose , the socio-ecological model tends to obscure the locus of power and influence under the general rubric of ‘policy’, and suggests that the actual core of good public health is the intra- and interpersonal factors.   The commercial determinants of health model has the virtue of focusing attention on the most critical structural impediments to optimal public health in a very immediate way. This isnt to demean or cheapen the impact of social and deeper environmental or economic factors. Lenchucha sets out the ‘core tenets’ of the neoliberal paradigm as constituted by a policy agenda of trade liberalisation, priv

  Industry tactics and the playbook around the commercial determinants of health   This is the third in a series of blogs   1      the broad playbook -  The 3 Ds Distortion / Denial or Doubt / Distraction    Tactics are well documented from the fossil fuel industry hiding the environmental impact of fracking to the pharmaceutical industry misleading the medical community about the dangers of opioid use.  The tactics used to avoid regulation include (building on Mark Petticrew’s 3 D’s that policy makers at all levels need to remember in response to industry supplied evidence / those with industry interests – Distortion / Denial / Distraction – especially alternate causation strategies). Often these seek to forestall or delay (“we should avoid restriction until we are sure”), weaken, or disrupt effective public health policy. There are many who have set out the broad playbook. McKee and Stuckler   identified how corporations influence policy through narrative framing, rule-s

  Counter tactics around the commercial determinants of health   This is the fourth blog in a series and focused on strategies to counter and reduce the impact of products that can be framed as CDOH   1             Policies on products into a broader framework A list of target policies not enough. We DO need policies to address fast food, alcohol consumption, tobacco for eg – broadly access, promotion and price AND to explitly focus on the underpinning concept of the tactics of industry (regardless of the nature of the product). Needs wrapping in a set of core principles. Should be focused on industry influence (across many spaces research, treatment, policy and regulation). Whole system not just focus on some aspects of system. Whole of govt and cross govt coordination Framing towards leverage points (see Donella Meadows on leverage points for big changes in any system) Focus on the unit of intervention is the population or the system, not the individuals within it

  Commercial Determinants of Health   This is the first in a series of blogs on the commercial determinants of health. O ther blogs in the series 1.        What is the issue, what is it all about - this one  2.        The neoliberal framework into whichthis fits 3.        Tactics used by industry  within the standard playbook 4.        Counter tactics used by public health  (and anyone else that wants to use)       Firstly … what is it all about   1      What’s it all about Take tobacco as an example – cause of 20% of deaths about 15% of all illness. Other things are rapidly catching up like obesity and alcohol related illness and death. All up non communicable Diseases continue to kill 41 million people world wide and account for 70% of all deaths.   One can argue that at the centre of this toll is the collective of individual lifesely choices made by all of us. Equally one can argue that at the heart of each of these issues are organisations who want to