Nicholas Freudenberg City University of New York School of Public Health and Hunter College

1. Reducing the Influence of the Alcohol, Food and Beverage and Tobacco Industries on Health Education:Lessons from Local, National and Global Campaigns Nicholas Freudenberg City University of New York School of Public Health and Hunter College

2. The Wrap Up • Why are the practices of the global tobacco, food and alcohol corporations important for public health? • What are the common practices of these three industries that have an impact on health education? • What can health educators do to reduce the harmful impact of tobacco, food and alcohol corporations on global premature death, preventable illnesses and injuries?

3. The Global Burden of Chronic Disease In 2008, 36 million of 57 million deaths chronic conditions Nearly 80 percent of those deaths occur in developing countries and 25% among people < 60 years old By 2030, they will cause > 75% of global deaths Cost to the world economy over the next two decades is estimated at $47 trillion Bloom DE, Cafiero ET, Jané-Llopis E, et al. The Global Economic Burden of Noncommunicable Diseases. Geneva: World Economic Forum. 2011.

4. World Health Organization on primary causes of increase in non-communicable diseases Leading drivers of increasing NCDs: • Tobacco use • Alcohol use • Foods high in fat, sugar, salt and calories • Physical inactivity Are we willing to sacrifice another generation to NCDs?

5. Unweighted Trends in Unhealthy Commodities, by Geographic Region, 2000-2010 Stuckler D, McKee M, Ebrahim S, Basu S (2012) Manufacturing Epidemics: The Role of Global Producers in Increased Consumption of Unhealthy Commodities Including Processed Foods, Alcohol, and Tobacco. PLoS Med 9(6): e1001235. doi:10.1371/journal.pmed.1001235

7. Marketing Tobacco, Food and Alcohol United States annual expenditures on advertising : • Cigarette companies $8.37 billion (2011) • Alcohol industry $4 billion • $6.6 billion for food and candy advertising and $6.2 billion for restaurants (2012) $1.8 billion on food marketing to children About $25 billion per year, About $68 million per day, About $80 per person per year CDC: budget in 2011 about $11 billion In US we spend about 2.3 times as much on advertising tobacco, alcohol and food as on federal public health efforts

8. How corporate practices get inside our head Practices Advertising Ubiquitous availability Misinformation Appeals to fears, insecurities or biological vulnerabilities Manufacture of scientific doubt Campaign contributions & lobbying Philanthropy Pathways Physical environments Social environments Social and peer norms Political climate Dominant ideology Political power

9. The Problem Credit: newsjunkiepost.com Hyperconsumption -- an ideology that promotes behaviors, lifestyles, values, physical and social environments and policies that contribute to premature deaths and preventable illnesses and injuries

10. The Corporate Consumption Complex

11. The Remedy Create a counter-ideology that can engage people in creating healthy, sustainable, joyful lifestyles Contest the appropriation of science and politics to promote hyperconsumption Over time, dismantle the corporate consumption complex, a threat to health, democracy and the environment

12. Health educators have hit a fork in the road

13. Path 1 Path 2 Business as usual Professional organizations and academic institutions always find rationale to partner with alcohol, food and tobacco industries Health departments step back from confronting industry disease promotion activities Corporations increasingly become America’s health educators Bottom line is health Health educators reclaim responsibility for educating about health Contesting disease promotion becomes a priority Partnerships judged by their outcome, not the good will they generate Professional organizations and universities refuse to be coopted

14. What roles for health educators in Path 2? Health educators aim to : • Engage people’s minds and emotions in creating healthy, sustainable lifestyles • Reclaim public space for public rather than commercial activities • Contest use of science and technology to profit at expense of human well-being • Act to require corporations to accept responsibility for the costs of the diseases they promote • Make moral and economic arguments against institutions that promote unhealthy behavior, lifestyle and environments • Join campaigns to remove corporate money from our political life

15. For more information Nicholas Freudenberg nfreuden@hunter.cuny.edu Corporations and Health Watch www.corporationsandhealth.org Healthy Public Policy -- research workgroup www.healthypublicpolicy.org