How Industry Opposes Health Measures – Health

When discussing the regulation of unhealthy products, objections are often raised that come from standard industry repertoire. The most common statements – and what to think of them.

“What the citizen consumes is none of the state’s business”

At first it sounds plausible: what citizens spend their hard-earned money on is their own business. But what is overlooked is that what the individual consumes “is already largely the concern of others,” says Nason Maani, public health researcher at the University of Edinburgh. After all, the options from which citizens choose – the products, their prices and availability, and the social norms that influence their consumption – have shaped commercial companies.

“If you say ‘what the citizen consumes is none of the government’s business’, then that’s not simply an argument for individual freedom,” says Maani. “Rather, the state should sit back and let other powerful actors shape citizens’ choices. And not in a way that necessarily benefits citizens, but in a way that benefits these powerful actors. In my opinion, it is This is not an argument for individual liberty, for the citizen, or for the public good.”

In addition, the state pays for part of the health consequences of consumption. Keeping these costs low is therefore also necessary from an economic point of view. Maani also points out that manufacturers of harmful products also receive government subsidies. For example, global fossil fuel subsidies in 2020 were $5.9 trillion. The same applies here, says Maani: “What these companies produce and what is consumed is something that concerns the state, because it is paid for by the taxpayer.”

“You want to ban the citizens more and more”

There is always talk of prohibition policy, but in fact it is almost never about prohibiting something. The recommendations from institutions such as the WHO and from various scientific networks are aimed at reducing, not eliminating, certain commodities or ingredients.

So there is in that Catalog of measures presented by the WHO to combat lifestyle diseases, only one product to disappear: industrial trans fats, found in processed foods and increasing the risk of cardiovascular disease more than other fats. In Germany, on the other hand, not even this is up for debate. With this ban, the consumer would only be deprived of something that he does not even know what it contains: trans fats do not have to be declared in Germany. It is unlikely that consumers would miss them. There are also bans on smoking in some places and advertising some products. But here, too, it is questionable whether people seriously miss this advertising.

“Political regulations are massively damaging to the economy”

It is possible that falling consumption of unhealthy products will lead to losses for their manufacturers and suppliers. But don’t customers spend the money saved on these products on other things? This is what Martin McKee, Professor of European Public Health at the London School of Hygiene and Tropical Medicine, writes in the book “Commercial Determinants of Health”. If the alternative products came from domestic production, the economy as a whole could even benefit, argues McKee, using the example of cigarettes, which are imported in many places and often only offer small profit margins for retailers.

A well-studied example of government intervention not having a large economic impact is the ban on smoking in restaurants. Two comprehensive review article showed that hosts did not suffer any significant economic disadvantages.

Behind the argument is an industry-carried narrative that health and business are in a trade-off, so politicians must choose between the two, writes McKee. In fact, it has been shown many times that health is an important factor for economic growth. So revealed a Overview article from the past yearthat an increase in average life expectancy by one year goes hand in hand with economic growth of 2.4 percent.

“You have to involve the industry”

Don’t regulate the corporations, just give them a hand? Trust them to be responsible and prevent particularly harmful effects of their products? Governments have often tried to do this and still do. But the results do not suggest that this strategy is promising.

To name just a few examples: According to consumer advice centers, the Nutriscore, which was introduced in Germany on a voluntary basis, is only found on about 40 percent of the foods they examine. The soft drinks industry in Germany has committed to reducing the sugar content of its products by a meager 15 percent by 2025. So far, however, it has only fallen by about two percent.

The currently discussed ban on advertising unhealthy children’s food was also preceded by a long voluntary phase. In 2007, Europe’s largest food companies committed themselves not to advertise foods high in sugar, fat and calories in commercials for children. An analysis of Consumer organization Foodwatch showed However, in 2021, 86 percent of the advertised children’s foods examined still contained too much sugar, fat and calories when measured against WHO recommendations.

Ultimately, voluntary commitments by industry led to a classic prisoner’s dilemma, said Stefan Lhachimi, Professor of Public Health at Neubrandenburg University of Applied Sciences recently to the SZ. Even if the individual company were actually willing to change products or marketing, the mere assumption that other companies would not do so could thwart the plan.

“There is insufficient evidence”

Population-wide measures often cannot be checked according to the gold standard of medical research – that’s true. Studies in which individuals or groups are randomized, i.e. randomly assigned either the measure or an alternative, are often neither politically nor practically feasible. “Think of a randomized introduction of a tax on sugary drinks. The federal states would hardly agree that eight states implement this tax while the other eight do not – or only a year later,” says Eva Rehfuess, who holds the chair for public health and health services research at the Ludwig-Maximilians-University in Munich.

However, there are now epidemiological study designs and statistical approaches that provide causal findings that are almost as reliable, says Rehfuess. This includes, for example, the family of so-called “Natural Experiments Studies”, in which researchers do not initiate an experiment themselves, but evaluate developments that occur without their involvement. This also applies to measures taken by governments. For example, the Scottish government decided to introduce a minimum price on alcohol in order to limit the consumption of cheap alcohol. Researchers have since observed the health consequences – and theirs Results published a few days ago. According to this, the number of alcohol-related deaths has fallen by 13 percent since its introduction.

There is already very solid evidence from various countries, says Eva Rehfuess: “I would say: implement, evaluate and check after five years whether and how it needs to be readjusted.” She refers to the British epidemiologist and statistician Austin Bradford Hill, who is considered the pioneer of randomized clinical trials and yet said: “Every scientific work is incomplete – whether it is observation or experiment. Every scientific work can be improved by the advance of knowledge be shaken or changed. This does not give us the freedom to ignore the knowledge we already have or to postpone the actions that seem necessary at the time.”

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