Public Health Business and Corporate Practices
by
Nicholas Freudenberg
  • LAST REVIEWED: 15 June 2015
  • LAST MODIFIED: 23 February 2011
  • DOI: 10.1093/obo/9780199756797-0130

Introduction

Public health professionals and researchers have often focused on the role of civil society and government in influencing population health, but the business sector also plays a powerful role in shaping patterns of health and disease. The products that businesses make, their production and distribution practices, their employment policies, and their involvement in the political process can promote or undermine the health of populations. By the early 21st century, the free market system, in several variants, had become the dominant economic paradigm around the world, and most businesses operate within this framework. This entry considers the growing and interdisciplinary literatures that examine the health consequences, history, and changing dynamics of the influence of business practices on health. The focus is on corporations, the principal unit of business today, and a key topic of interest is the role of public health in promoting health-enhancing business practices and reducing health-damaging practices. Although citations reflect the range of literature on the topic, empirical studies that assess the health impact of various specific practices are favored over more theoretical perspectives. For at least two reasons, more has been written on the harmful effects than on the health-enhancing effects of business practices. First, public health researchers often focus on problems rather than successes to fulfill their mission of improving and protecting population health. Second, most proponents of free market systems assume its benefits, especially since alternative models (e.g., state socialism) have collapsed. As a result, these supporters have little motivation to analyze the health impact of markets. However, this absence of a literature documenting the beneficial health effects of corporations should not lead researchers to conclude that such benefits do not exist. Conversely, studies of the harmful effects should be evaluated on their merits, not dismissed because they represent only one side of the picture.

General Overviews

Several works provide readers with an overview of current directions in public health research on the health effects of business practices. In a work that contributed to renewed interest in the topic, the economist Majnoni d’Intignano 1995 defined “industrial epidemics” as preventable illnesses or deaths caused by the legal or illegal products of powerful international businesses that use coherent, long-term strategies to promote their products. In a provocative essay, Levins 2000, a Harvard biologist, argues that “free market capitalism” undermines health by creating social and economic arrangements that put profit ahead of human need. Bohme, et al. 2005 describes the range of tactics that corporations use to obscure the fact that their products are harmful to health. Dauvergne 2008 focuses on the adverse health and environmental effects of the over-consumption of products created and distributed to maximize profits. Freudenberg and Galea 2008 describes business practices as a modifiable social determinant of health, while Manno 2010 (see Other Disciplinary Perspectives) takes a systemic approach to analyze the consequences of treating a growing number of products as commodities. Wiist 2006 examines the emergence of a social movement that challenges the health practices of corporations. From a different perspective, Institute of Medicine, Board on Health Promotion and Disease Prevention 2003 summarizes why and how businesses should support public health, and Simon and Fielding 2006 describes the benefits of collaboration between businesses and public health organizations.

  • Institute of Medicine, Board on Health Promotion and Disease Prevention. 2003. Employers and business. In The Future of the Public’s Health in the 21st Century. By Institute of Medicine, Board on Health Promotion and Disease Prevention, 268–306. Washington, DC: National Academies Press.

    E-mail Citation »

    Reviews the ways that employers and companies can promote the health of their workers and the population as a whole. Focus is on role of business in health care, but additionally wider efforts are considered. Presented in the context of arguing for refocus of US public health enterprises to focus on threats of the 21st century.

  • Bohme, Suzanna Rankin, John Zorabedian, and David S. Egilman. 2005. Maximizing profit and endangering health: Corporate strategies to avoid litigation and regulation. International Journal of Occupational and Environmental Health 11.4:338–348.

    E-mail Citation »

    Describes tactics that corporations and industries use to obscure the fact that their products are dangerous or deadly. Suggests how public health professionals can effectively build scientific and public opinion that makes both good science and public health priorities.

  • Dauvergne, Peter. 2008. The shadows of consumption: Consequences for the global environment. Cambridge, MA: MIT Press.

    E-mail Citation »

    Analyzes the costs of patterns of consumption encouraged by corporations seeking to maximize profits. Traces the environmental and health consequences of five commodities: automobiles, gasoline, refrigerators, beef, and harp seals. Suggests reforms in the global political economy to reduce the inequalities of consumption and correct the imbalance between growing economies and environmental sustainability.

  • Freudenberg, Nicholas, and Sandro Galea. 2008. The impact of corporate practices on health: Implications for health policy. Journal of Public Health Policy 29.1: 86–104.

    DOI: 10.1057/palgrave.jphp.3200158E-mail Citation »

    Considers corporate practices as a social determinant of health. Presents case studies of trans fats (a food additive); rofecoxib (a painkiller), and sports utility vehicles to illustrate the role of corporate practices in the production of health and disease. Suggests strategies that can guide the development of health policies that discourage harmful corporate practices.

  • Levins, Richard. 2000. Is capitalism a disease? Monthly Review 52.4: 8–33.

    E-mail Citation »

    Analyzes failures and successes of public health using a bio-ecological perspective that views capitalism as key driver of change. Suggests that growing income inequalities and new technologies impose new burdens on population health. Attributes continued global health inequalities to dynamics of global capitalism and argues that improvements in health require struggles for more equitable allocation of the necessities of life.

  • Majnoni d’Intignano, Béatrice. 1995. Epidémies industrielles. Commentaire 71:557–565.

    E-mail Citation »

    Proposes that “industrial epidemics” have become major determinants of premature morbidity and mortality and are caused by powerful industries such as tobacco, alcohol, and pharmaceutical sectors that launch coherent and long-term strategies to advance their business interests.

  • Simon, Paul A., and Jonathan Fielding. 2006. Public health and business: A partnership that makes cents. Health Aff (Millwood) 25.4: 1029–1039.

    DOI: 10.1377/hlthaff.25.4.1029E-mail Citation »

    Highlights shared interests of business and public health in ensuring a healthy population. Makes the case that businesses have a financial interest in supporting organized public health efforts and that business partnerships can increase the reach and effectiveness of public health. Suggests opportunities for future collaboration to improve the public’s health.

  • Wiist, William H. 2006. Public health and the anticorporate movement: rationale and recommendations. American Journal of Public Health 96:1370–1375.

    DOI: 10.2105/AJPH.2005.072298E-mail Citation »

    Describes an emerging movement that challenges the growing power and pervasive influence of large corporations that are seen as pursuing profit regardless of consequences to health, society, or the environment. Suggests that public health research and the professional preparation should focus on the corporate entity as a social structural determinant of disease.

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