Agenda item

Report of the Director of Public Health.

The Director of Public Health presented the position statement on Commercial Determinants of Health which has been produced by the Association of Directors of Public Health North East.

Board members were informed that Commercial Determinants of Health is a collective term used to describe the activities of private sector industries that impact us both positively and negatively by shaping the environments in which we’re born, grow, live and work.  They include political, scientific, and marketing practices which mainly cause health harm by maximising the use of potentially harmful products, either directly or by enabling corporations to block, delay, or weaken policy and deter litigation.

Information highlighted included that unhealthy commodity industries (UCIs) are for-profit and commercial enterprises/businesses delivering commercial products that lead to significant associated negative health consequences. Key examples include the tobacco, alcohol, gambling and ultra-processed food industries.  The products of these industries are linked to many chronic, non-contagious diseases (non-communicable diseases), as well as other health and social issues.

Common industry tactics used include lobbying and political party donations; manufacturing doubt and shifting blame; aggressive marketing and advertising; and self-regulation and corporate social responsibility.

Industry-sponsored education and awareness raising in schools is also a common occurrence but has been shown to be biased towards industry interests (for example, promoting moderate alcohol consumption, misinformation about risks and use of ambiguous terms such as ‘responsible drinking’.).

Central to the approach is the narrative of the personal responsibility of the individual, without acknowledgement of the influence the UCIs have in shaping our environments and ultimately influencing choices.

The harms driven by the Commercial Determinants of Health occur at an individual and population level and include health, financial and relationship harms alongside significant monetary costs to society.

The following principles (ways of working) were suggested:

(a)       UCIs should not influence health policy, health services or education/awareness-raising initiatives, particularly those aimed at young people.

(b)       Children and young people are a priority group to protect from the tactics of UCIs, particularly those living in our most deprived communities.

(c)       UCI marketing drives harmful consumption and health inequalities and needs to be tackled.

(d)       Reframing the narrative from personal responsibility to the actions of industries and their harmful products is a legitimate intervention.

A Board member expressed their concern that the report is politically motivated and presents a one-sided view with a further member expressing that they do not like the wording of the document.

Discussions held included that in the case of takeaway establishments, it is difficult to refuse a license to these premises with a further point raised that food delivery is available town-wide and not just in areas with the greatest statistic risk or with the lowest life-expectancy.

The question was raised as to what the motivation for the report is with the response that it is a newly emerging area of work but one with a track record in the past (i.e. tobacco control) in which the results are tracked across decades rather than solely on immediate impacts.  Officers added that gambling and smoking have a greatest impact on the most deprived areas where life expectancy is far lower than more affluent areas due to lung / liver illness and that many areas with health detriments are those that have the most takeaways and off-licenses for example.

Awareness that some industries cause harm to people’s health and reducing the impact of this is the key however officers acknowledged that companies do not wish to damage their bottom line.

It was explained to members that at this stage, an agreement on the principals of the report is sought and that further updates would be provided to future meetings.

A “show of hands” was taken with the Chair noting that the results showed that the report met majority, but not unanimous support from the members present.

RESOLVED – That Health and Wellbeing Board Members note the content of the report and position statement on Commercial Determinants of Health and that the Board receive future updates on the regional commercial determinants of health work programme, as it progresses.

REASON – To enable further work to be undertaken considering the responses and questions raised in this meeting.