Public health advocacy to change corporate practices: implications for health education practice and research.

Corporate practices, such as advertising, public relations, lobbying, litigation, and sponsoring scientific research, have a significant impact on the health of the people in the United States. Recently, health professionals and advocates have created a new scope of practice that aims to modify corporate practices that harm health. This article describes how corporate policies influence health and reviews recent health campaigns aimed at changing corporate behavior in six industries selected for their central role in the U.S. economy and their influence on major causes of mortality and morbidity. These are the alcohol, automobile, food, gun, pharmaceutical, and tobacco industries. The article defines corporate disease promotion and illustrates the range of public health activities that have emerged to counter such corporate behaviors. It analyzes the role of health professionals, government, and advocacy groups in these campaigns and assesses the implications of this domain for health education practice and research.     

Compliance to health recommendations: a theoretical overview of message framing

Health care professionals have become increasingly interestedin motivating individuals to comply with health recommendations.One approach to this issue has been to evaluate the impact ofmessage framing on behavior change processes. Three types offraming are described: gain, loss and fear. Theoretical considerationsfrom such theories as the Health Belief Model, Prospect Theory,and Protection Motivation reveal the significance of two dimensions,the perceived value and perceived threat of an outcome. Theperceived value dimension focuses on the importance of definingmessages on the basis of whether or not a valued outcome isacquired, and the perceived threat dimension stresses the importanceof negative outcomes. Perceived value is critical to a manipulationof gain and loss framing, while perceived threat is criticalto a manipulation of fear framing. The assumptions underlyingthe theories relevant to these distinctions are considered,followed by a review of the literature, and speculations aboutthe possible mechanisms which may mediate framing effects.     

Bringing health care advocacy to a public defender's office

Recent arrestees often face barriers to health care access as they move through the judicial process, placing them at significant health risk. The immediate postrelease period generally involves numerous court dates, meetings, and other obligations that can fragment the delivery of care. A residency training program collaborated with public defenders to facilitate medical screenings and referrals for recent arrestees in Bronx County, New York. From May 2005 to June 2007, a medical resident met with 104 arrestees at the public defenders' office to take medical histories, make medical referrals, and make appointments at a primary care clinic. Arrestees' kept-appointment rate at the clinic (66%) exceeded the clinic's overall 2006-2007 kept-appointment rate for first appointments (50%). Collaboration between public defenders and physicians can facilitate arrestees' access to health care.     

The post‐2015 landscape: vested interests,corporate social responsibility and public health advocacy

This paper explores the tensions between UN calls for private sector engagement in the post‐2015 landscape and public health opposition to those ‘harm industries’ that are ‘corporate vectors of disease’ for the mounting global non‐communicable disease burden. The UN's support for public‐private partnership has provided industries with ‘vested interests’ in the propagation of unhealthy behaviours with new opportunities for the strategic alignment of their corporate social responsibility (CSR) endeavours with the post‐2015 sustainable development agenda. This has galvanised public health advocates to place pressure on the World Health Organisation to formalise their ambiguous stance towards private sector involvement in public policy formation and the resultant ‘conflicts of interest’. This paper critically examines the ‘gathering storm’ between this ‘anti‐corporate movement’ and the alcohol industry in the increasingly politicised domain of CSR. Drawing on the example of SABMiller's Tavern Intervention Program, the paper argues that CSR represents a profound threat to the sanctity and moral authority of the public health worldview. Questions therefore need to be asked about whether the public health‐led path of industry non‐association will necessarily result in health improvements or just a further retrenchment of the ideological faultlines explored in the paper.     

Fine-cut tobacco: a priority for public health and consumer advocacy

Objectives

To study whether fine-cut tobacco poses a problem for public health and consumer affairs.

Methods

We analyzed up to 70% of the fine-cut tobacco market in Spain. Regarding public health, the contents of nicotine, tar and carbon monoxide were analyzed and compared with levels in conventional cigarettes. Concerning consumer affairs, the labeling of samples was checked.

Results

The contents of nicotine, tar and carbon monoxide reached values of 70%, 85% and 84%, respectively. These values are higher than those allowed in conventional cigarettes. A total of 67% of the samples analyzed did not show nicotine and tar contents on the labeling. None of the labels showed carbon monoxide contents. The presence of labeling per se did not guarantee sufficient information for consumers.

Conclusions

Fine-cut tobacco is a problem in both public health and consumer affairs. Solutions are required to resolve both problems.     

More schools of public health: a worldwide need

This article asserts an urgent need for more schools of public health to produce an adequate supply of personnel capable of dealing with the health problems of the world population. Although there is a need for 450 schools of public health worldwide (1 for every 10 million population), there are currently fewer than 100 independent schools, with 23 concentrated in the United States alone. The benefits of independence from medical schools are stressed. The academic environment of patient-oriented clinical medicine is posited not to be conducive to the growth of the community-oriented public health discipline. The need for expansion exists in both developing and industrialized countries, although shortages are greater in less developed areas. Effective schools of public health should welcome students from a variety of backgrounds and serve as centers for the research and evaluation of national health systems.     

Evolving views of disability and public health: the roles of advocacy and public health

Promoting health, quality of life, and participation of persons with disabilities is a relatively recent development in public health. Its brief history reflects three distinct public health perspectives toward disability-a traditional approach that focuses on preventing disability, a contemporary approach that regards disability as a minority group experiencing disparities relative to people without disabilities, and an emerging perspective where disability status is considered one of multiple determinants of health. The field of disability and health has been influenced by the interaction of disability advocacy with the public health process of surveillance, epidemiology research, and intervention. Advocacy draws on political and legal arguments to press for action on issues such as health care access, control of services, and choice of residence. Public health uses surveillance to document magnitude of problems; epidemiology to identify specific groups, develop measures, and apply rigorous research methods; and intervention to improve health behaviors and health outcomes. The field of disability and public health, however, has lagged in addressing the role of environmental factors in the disabling process, in moving to societal participation as an outcome, and in implementing population scale interventions.     

The impact of corporate practices on health: implications for health policy

Although corporate practices play a substantial role in shaping health and health behavior, public health researchers have rarely systematically studied these practices as a social determinant of health. We consider case studies of three products - trans fat, a food additive and a preservative; Vioxx, a pain killer; and sports utility vehicles - to illustrate the role of corporate policies and practices in the production of health and disease and the implications for health policy. In recent years, public health advocates, researchers, and lawyers have used strategies to reduce the adverse health impact of corporate practices. Systematic analysis of these experiences yields insights that can guide the development of health policies that increase opportunities for primary prevention by discouraging harmful corporate practices.     

Designing messages for fluorosis mitigation behavior change: Role of message framing and perceived risk

This article describes the research to develop message for fluorosis behavior change communication campaign. Using a posttest only with control experiment the study investigates the impact of perceived risk associated with advocated behavior (RISK-AB) and perceived risk associated with existing behavior (RISK-EB) on the effectiveness of framed fluorosis messages. Findings suggest that positive-frame is more appropriate when RISK-AB is high and RISK-EB is low or RISK-AB is low and RISK-EB is high or both RISK-AB and RISK-EB are low. And negative-frame is more persuasive when both RISK-AB and RISK-EB are high. Marketing implications are discussed.     

Tobacco industry issues management organizations: Creating a global corporate network to undermine public health

Background  

The global tobacco epidemic claims 5 million lives each year, facilitated by the ability of transnational tobacco companies to delay or thwart meaningful tobacco control worldwide. A series of cross-company tobacco industry "issues management organizations" has played an important role in coordinating and implementing common strategies to defeat tobacco control efforts at international, national, and regional levels. This study examines the development and enumerates the activities of these organizations and explores the implications of continuing industry cooperation for global public health.     

Communicating ALS to the public: The message effectiveness of social-media-based health campaign

Celebrity endorsement has been proved to be a very powerful tool in health campaigns. This study examined how celebrity–issue matchup presented in utilitarian and hedonic appeals influences attitude toward the video, perceived issue severity, and behavioral intentions in the context of ALS communication. The findings showed that celebrity–issue matchup condition outperformed nonmatchup condition in generating positive attitude and behavioral intentions. The results also indicated that utilitarian appeal with matchup condition triggered significantly greater behavioral intention than that with nonmatchup condition. However, no difference was found in hedonic appeal between matchup and nonmatchup conditions. Theoretical and practical implications are also discussed.