Mapping the Lobbying Footprint of Harmful Industries: 23 Years of Data From OpenSecrets.

Policy Points Our research reveals the similarities and differences among the lobbying activities of tobacco, alcohol, gambling, and ultraprocessed food industries, which are often a barrier to the implementation of public health policies. Over 23 years, we found that just six organizations dominated lobbying expenses in the tobacco and alcohol sectors, whereas the gambling sector outsourced most of their lobbying to professional firms. Databases like OpenSecrets are a useful resource to monitor the commercial determinants of health. CONTEXT: Commercial lobbying is often a barrier to the development and implementation of public health policies. Yet, little is known about the similarities and differences in the lobbying practices of different industry sectors or types of commercial actors. This study compares the lobbying practices of four industry sectors that have been the focus of much public health research and advocacy: tobacco, alcohol, gambling, and ultraprocessed foods. METHODS: Data on lobbying expenditures and lobbyist backgrounds were sourced from the OpenSecrets database, which monitors lobbying in the United States. Lobbying expenditure data were analyzed for the 1998-2020 period. We classified commercial actors as companies or trade associations. We used Power BI software to link, analyze, and visualize data sets. FINDINGS: We found that the ultraprocessed food industry spent the most on lobbying ($1.15 billion), followed by gambling ($817 million), tobacco ($755 million), and alcohol ($541 million). Overall, companies were more active than trade associations, with associations being least active in the tobacco industry. Spending was often highly concentrated, with two organizations accounting for almost 60% of tobacco spending and four organizations accounting for more than half of alcohol spending. Lobbyists that had formerly worked in government were mainly employed by third-party lobby firms. CONCLUSIONS: Our study shows how comparing the lobbying practices of different industry sectors offers a deeper appreciation of the diversity and similarities of commercial actors. Understanding these patterns can help public health actors to develop effective counterstrategies.

Corrigendum: Taking on the Commercial Determinants of Health at the level of actors, practices and systems.

[This corrects the article DOI: 10.3389/fpubh.2022.981039.].

Lobbying by omission: what is known and unknown about harmful industry lobbyists in Australia.

What is unknown about commercial lobbying is far greater than what is known. These omissions distort our understanding of the extent and nature of business influence on politics. Especially when businesses engage in practices that harm health, it is crucial for public health advocates to understand corporate lobbying to counter its influence. Our study proceeded in three phases. First, based on an international audit, we developed a list of the categories of information about lobbying that could be disclosed under four groups (lobby firms, lobbyists, organizations and activities) and benchmarked Australian lobbyist registers against this list. Second, we manually extracted data from lobbyist registers in eight jurisdictions, cleaned the data and created a relational model for analysis. Finally, we classified a sample of organizations as public health organizations or harmful industries to compare their activities. We identified 61 possible categories of information about lobbying in international lobbyist registers. When applied to Australian lobbyist registers, Queensland covered the widest range of categories (13, 21%), though many lacked detail and completeness. Australian lobbyist registers provided data on 462 third-party lobby firms across Australia, currently employing 1036 lobbyists and representing 4101 organizations. Several of these represented harmful industries, with gambling interests hiring the most third-party lobby firms. Ultimately, Australian lobbyist registers do not provide enough information to understand the full extent of lobbying activities taking place. Political transparency is important for public health actors to be able to monitor corporate political activity and to protect policy-making from vested interests.

Corporate Harm Minimisation: Promises and Perils Comment on "Understanding Marketing Responses to a Tax on Sugary Drinks: A Qualitative Interview Study in the United Kingdom, 2019".

Taxes on sugary drinks are often used to encourage companies to reformulate their products to reduce the sugar content. This comment discusses how product reformulation can strengthen the market and political power of the food industry, and questions whether these political risks outweigh the public health benefits. It proposes the term 'corporate harm minimisation' to describe the strategic adaptation of a public health harm reduction strategy to align with company or industry goals. It concludes by reflecting on the other ways that corporations influence health beyond the production and marketing of 'unhealthy commodities,' and why public health actors must explore other strategies to challenge powerful corporations.

Commercial lobbying and political contributions: an Australian scoping review.

OBJECTIVE: Many of the most effective and equitable policies to reduce the burden of non-communicable diseases threaten the interests of powerful corporations. A first step for public health advocates seeking to challenge powerful corporate interests is to understand the nature and extent of corporate political practices. This scoping review explored public health research on two political practices in Australia: lobbying and political donations. METHODS: We searched six databases, two Google Advanced searches and 11 Australian public health websites. We screened 2866 documents in total, and extracted information about political practices, industry actors and datasets. RESULTS: 62 studies published between 1980 and 2021 were identified, analysing public health advocacy, policy submissions, direct engagement with government representatives and political donations. We extracted data from 14 studies that focused on direct engagement and/or political donations. Most focused on 'unhealthy commodity industries.' CONCLUSIONS: Analysis of lobbying and political contributions in Australia is a nascent but expanding area of public health research. We discuss opportunities for future research to strengthen the evidence base and support public health advocacy to counter harmful corporate practices and promote and protect population health. IMPLICATIONS FOR PUBLIC HEALTH: Countering powerful commercial interests requires greater investment in understanding corporate political activities.

Aiding empirical research on the commercial determinants of health: a scoping review of datasets and methods about lobbying.

BACKGROUND: To support public health researchers and advocates seeking to challenge the influence of powerful commercial actors on health, it is necessary to develop a deeper understanding of corporate political activities. This project explores political science scholarship analysing lobbying to identify new datasets and research methods that can be applied to public health and stimulate further research and advocacy. METHODS: We undertook a systematic scoping review of peer-reviewed and grey literature reports analysing the practice of lobbying. Titles and abstracts of 4533 peer-reviewed and 285 grey literature reports were screened, with 233 peer-reviewed and 280 grey literature reports assessed for eligibility. We used a two-stage process for data extraction. In stage 1, we collected two pieces of information from all included studies: data sources and indicators used to measure lobbying. For the second stage, data extraction was limited to 15 studies that focused on meetings. RESULTS: The most common indicators used to measure lobbying activity were: registrations of active lobbyists; expenditure on lobbying; meetings; written comments and submissions made to government consultations; bills; and committee participation. A range of different data sources were used to analyse lobbying, including from governments, not-for-profits and commercial sources. All 15 studies analysing lobbyist meetings were from high-income contexts. The studies analysed three key variables: the types of government actors targeted by lobbying; the policies of interest; and the lobbyists and/or their clients. The studies used a range of taxonomies to classify policy issues and the types of actors engaged in lobbying. All studies discussed challenges with accessing and analysing lobbying data. CONCLUSIONS: There is enormous potential for public health research and advocacy concerned with commercial lobbying to learn from political science scholarship. This includes both conceptual frameworks and sources of empirical data. Moreover, the absence of good quality transparency internationally emphasises the importance of advocacy to support policy change to improve the quality of political transparency to make it easier to monitor commercial lobbying.

Conceptualising commercial entities in public health: beyond unhealthy commodities and transnational corporations.

Most public health research on the commercial determinants of health (CDOH) to date has focused on a narrow segment of commercial actors. These actors are generally the transnational corporations producing so-called unhealthy commodities such as tobacco, alcohol, and ultra-processed foods. Furthermore, as public health researchers, we often discuss the CDOH using sweeping terms such as private sector, industry, or business that lump together diverse entities whose only shared characteristic is their engagement in commerce. The absence of clear frameworks for differentiating among commercial entities, and for understanding how they might promote or harm health, hinders the governance of commercial interests in public health. Moving forward, it is necessary to develop a nuanced understanding of commercial entities that goes beyond this narrow focus, enabling the consideration of a fuller range of commercial entities and the features that characterise and distinguish them. In this paper, which is the second of three papers in a Series on commercial determinants of health, we develop a framework that enables meaningful distinctions among diverse commercial entities through consideration of their practices, portfolios, resources, organisation, and transparency. The framework that we develop permits fuller consideration of whether, how, and to what extent a commercial actor might influence health outcomes. We discuss possible applications for decision making about engagement; managing and mitigating conflicts of interest; investment and divestment; monitoring; and further research on the CDOH. Improved differentiation among commercial actors strengthens the capacity of practitioners, advocates, academics, regulators, and policy makers to make decisions about, to better understand, and to respond to the CDOH through research, engagement, disengagement, regulation, and strategic opposition.

Defining and conceptualising the commercial determinants of health.

Although commercial entities can contribute positively to health and society there is growing evidence that the products and practices of some commercial actors-notably the largest transnational corporations-are responsible for escalating rates of avoidable ill health, planetary damage, and social and health inequity; these problems are increasingly referred to as the commercial determinants of health. The climate emergency, the non-communicable disease epidemic, and that just four industry sectors (ie, tobacco, ultra-processed food, fossil fuel, and alcohol) already account for at least a third of global deaths illustrate the scale and huge economic cost of the problem. This paper, the first in a Series on the commercial determinants of health, explains how the shift towards market fundamentalism and increasingly powerful transnational corporations has created a pathological system in which commercial actors are increasingly enabled to cause harm and externalise the costs of doing so. Consequently, as harms to human and planetary health increase, commercial sector wealth and power increase, whereas the countervailing forces having to meet these costs (notably individuals, governments, and civil society organisations) become correspondingly impoverished and disempowered or captured by commercial interests. This power imbalance leads to policy inertia; although many policy solutions are available, they are not being implemented. Health harms are escalating, leaving health-care systems increasingly unable to cope. Governments can and must act to improve, rather than continue to threaten, the wellbeing of future generations, development, and economic growth.

A proposal for systematic monitoring of the commercial determinants of health: a pilot study assessing the feasibility of monitoring lobbying and political donations in Australia.

BACKGROUND: The commercial determinants of health include a range of practices to promote business interests, often at the expense of public health. Corporate political practices, such as lobbying and campaign donations, are used to influence policy makers and foster a political and regulatory environment conducive to business interests. Despite recognition of their public health importance, thus far there are relatively few efforts to systematically monitor commercial political practices. METHODS: A pilot study was conducted to explore the feasibility of systematically monitoring two political practices - lobbying and political contributions - for 'harmful industries' (alcohol, gambling, ultra-processed food and tobacco industries) in Australia. Potential data sources were reviewed to compare data availability and detail. Two publicly available datasets were selected for the pilot: ministerial diaries for New South Wales and annual donor filings from the Australian Electoral Commission. Google Data Studio was used to analyse and visualise findings.  RESULTS: The pilot study resulted in the creation of several interactive charts and dashboards that supported analysis and interrogation of the data. These charts helped to easily convey the volume of lobbying and political donations, as well as changes over time. For example, we found that between July 2014 and December 2020, NSW ministers had 20,607 meetings, of which 634 meetings were with harmful industries. And between 1998 and 2020, a total of $576,519,472 disclosed donations were made to political parties and other entities, of which $35,823,937 were from harmful industries. CONCLUSIONS: Opportunities to develop a program to monitor commercial political practices face several challenges including access barriers arising from poor availability and detail of data, technical barriers arising from the format of data disclosures and coding challenges arising from the diverse nature of the commercial sector. Despite these challenges, our pilot study demonstrates the potential to implement a monitoring program and to expand its scope to other commercial determinants of health.

Taking on the Corporate Determinants of Ill-health and Health Inequity: A Scoping Review of Actions to Address Excessive Corporate Power to Protect and Promote the Public's Health.

BACKGROUND: In many sectors of the economy, for-profit business corporations hold excessive power relative to some governments and civil society. These power imbalances have been recognised as important contributors to many pressing and complex societal challenges, including unhealthy diets, climate change, and widening socio-economic inequalities, and thus pose a major barrier to efforts to improve public health and health equity. In this paper, we reviewed potential actions for addressing excessive corporate power. METHODS: We conducted a scoping review of diverse literature (using Scopus, Web of Science, HeinOnline, and EBSCO databases), along with expanded searches, to identify state and collective actions with the potential to address excessive corporate power. Actions were thematically classified into overarching strategic objectives, guided by Meagher's '3Ds' heuristic, which classifies actions to curb corporate power into three groups: dispersion, democratisation, and dissolution. Based on the actions identified, we proposed two additional strategic objectives: reform and democratise the global governance of corporations, and strengthen countervailing power structures. RESULTS: We identified 178 documents that collectively cover a broad range of actions to address excessive corporate power. In total, 18 interrelated strategies were identified, along with several examples in which aspects of these strategies have been implemented. CONCLUSION: The proposed framework sheds light on how a diverse set of strategies and actions that seek to address excessive corporate power can work synergistically to change the regulatory context in which corporations operate, so that broader societal goals, including health and equity, are given much greater prominence and consideration vis-à-vis powerful corporate interests.

Interdisciplinary insights on the future of food systems research: perspectives from the next generation of research leaders.

Our dominant food system is a primary driver of worsening human and planetary health. Held in March 2022, the Public Health Association of Australia's Food Futures Conference was an opportunity for people working across the food system to connect and advocate for a comprehensive, intersectoral, whole-of-society food and nutrition policy in Australia to attenuate these issues. Conference themes included food systems for local and global good; ecological nutrition; social mobilisation for planetary and public good; food sovereignty and food equity. Students and young professionals are integral in transforming food systems, yet they are under-represented in the academic workforce, across publishing, scientific societies and conference plenaries. A satellite event was held to platform initiatives from early career researchers (ECR) in areas integral for improving planetary and public good. The research topics discussed in this commentary reflect sub-themes of the conference under investigation by ECR: food systems governance and regulation; local food policies; commercial determinants of health; sustainable healthy diets; and food equity and sovereignty.

The public health playbook: ideas for challenging the corporate playbook.

Many commercial actors use a range of coordinated and sophisticated strategies to protect business interests-their corporate playbook-but many of these strategies come at the expense of public health. To counter this corporate playbook and advance health and wellbeing, public health actors need to develop, refine, and modernise their own set of strategies, to create a public health playbook. In this Viewpoint, we seek to consolidate thinking around how public health can counter and proactively minimise powerful commercial influences. We propose an initial eight strategies for this public health playbook: expand public health training and coalitions, increase public sector resources, link with and learn from social movements to foster collective solidarity, protect public health advocates from industry threats, develop and implement rigorous conflict of interest safeguards, monitor and expose corporate activities, debunk corporate arguments, and leverage diverse commercial interests. This set of strategies seeks to amplify inherent assets of the public health community and create opportunities to explicitly counter the corporate playbook. These strategies are not exhaustive, and our aim is to provoke further discussion on and exploration of this topic. TRANSLATION: For the Spanish translation of this paper see Supplementary Materials section.

Corporations and Health: The Need to Combine Forces to Improve Population Health.

The recent concerns raised about commercial determinants of health (CDoH) are not new. Numerous organizations around the world are working on these issues. These groups have emerged in response to specific issues and contexts and bring with them a diversity of interests, worldviews and strategies for change. In creating the 'Governance, Ethics and Conflicts of Interest in Public Health' network in 2018, our hope was to broaden our engagement with other actors advocating for change and strengthen our collective efforts. For academics, this requires moving further beyond the collective comfort zone of peer-reviewed publications, working with the media and those with political expertise, and learning from and supporting other stakeholders with a common vision.

Representations of Ultra-Processed Foods: A Global Analysis of How Dietary Guidelines Refer to Levels of Food Processing.

BACKGROUND: As evidence grows about negative health impacts of ultra-processed foods (UPFs), nutrient-centred advice is contested, and food-based dietary guidelines are increasingly utilised. Previous analyses of dietary guidelines evaluated their potential impact on health and sustainability, but little research has been conducted to examine how the concept of UPFs is reflected in dietary advice for consumers. This paper systematically analyses whether and how UPFs are represented in dietary guidelines internationally. METHODS: Based on a systematic online search, the consumer-targeted key messages of 106 dietary guidelines were identified and a qualitative content analysis was conducted. A coding framework was developed to classify messages as 'eat more' or 'eat less' according to the language used (eg, 'choose' vs 'avoid') and to differentiate between a focus on nutrients or food processing. Specific foods mentioned in 'eat less' guidelines were classified according to their level of processing using the NOVA framework. RESULTS: 99% of guidelines utilised some type of nutrient-based message, either promoting 'positive' nutrients (eg, vitamins) or discouraging the consumption of 'negative' nutrients (mainly salt, sugar and fat). Explicit references to food processing were present in 45% of 'eat less' guidelines and 5% of 'eat more' guidelines. Implicit references (eg, promoting 'raw' or discouraging 'packaged' foods) were found in 43% of 'eat less' and 75% of 'eat more' guidelines. 53% of the specific foods referred to in 'eat less' advice were UPFs. CONCLUSION: Overall, nutrient-based messages were more common than messages about processing levels. The majority of discouraged foods were UPFs, however some minimally processed foods were discouraged, which points to tensions and contradictions between nutrient- and processing-based dietary advice. As dietary guidelines begin to include advice about food processing, it is important to consider both consumer understanding of the terms used and their capacity to act on the advice.

Taking on the Commercial Determinants of Health at the level of actors, practices and systems.

Tackling the Commercial Determinants of Health (CDoH) is necessary for progress on health equity and will determine whether or not the health-related targets of the SDGs are met. We present a simple visual heuristic of three core aspects of CDoH: commercial actors, commercial practices, and system-level dynamics (which commercial actors influence and perpetuate). We use this heuristic to highlight key research gaps, in particular the need for more voices and evidence on CDoH from the Global South, particularly on what works to curb harmful impacts. We also propose an agenda to address CDoH and actions for different stakeholders. While efforts to curb specific commercial practices are important, far more attention and effort are needed at the systems level, as they can fundamentally shift the way power is distributed in society to improve health equity.

The Political Economy of Healthy and Sustainable Food Systems: An Introduction to a Special Issue.

Today's food systems are contributing to multiple intersecting health and ecological crises. Many are now calling for transformative, or even radical, food systems change. Our starting assumption in this Special Issue is the broad claim that the transformative changes being called for in a global food system in crisis cannot - and ultimately will not - be achieved without intense scrutiny of and changes in the underlying political economies that drive today's food systems. The aim is to draw from diverse disciplinary perspectives to critically evaluate the political economy of food systems, understand key challenges, and inform new thinking and action. We received 19 contributions covering a diversity of country contexts and perspectives, and revealing inter-connected challenges and opportunities for realising the transformation agenda. We find that a number of important changes in food governance and power relations have occurred in recent decades, with a displacement of power in four directions. First, upwards as globalization has given rise to more complex and globally integrated food systems governed increasingly by transnational food corporations (TFCs) and international financial actors. Second, downwards as urbanization and decentralization of authority in many countries gives cities and sub-national actors more prominence in food governance. Third, outwards with a greater role for corporate and civil society actors facilitated by an expansion of food industry power, and increasing preferences for market-orientated and multi-stakeholder forms of governance. Finally, power has also shifted inwards as markets have become increasingly concentrated through corporate strategies to gain market power within and across food supply chain segments. The transformation of food systems will ultimately require greater scrutiny of these challenges. Technical 'problem-solving' and overly-circumscribed policy approaches that depoliticise food systems challenges, are insufficient to generate the change we need, within the narrow time-frame we have. While there will be many paths to transformation, rights-based and commoning approaches hold great promise, based on principles of participation, accountability and non-discrimination, alongside coalition building and social mobilization, including social movements grounded in food sovereignty and agroecology.