The case for developing a cohesive systems approach to research across unhealthy commodity industries

Knai, Cécile; Petticrew, Mark; Capewell, Simon; Cassidy, Rebecca; Collin, Jeff; Cummins, Steven; Eastmure, Elizabeth; Fafard, Patrick; Fitzgerald, Niamh; Gilmore, Anna B; Hawkins, Ben; Jensen, Jørgen Dejgård; Katikireddi, Srinivasa Vittal; Maani, Nason; Mays, Nicholas; Mwatsama, Modi; Nakkash, Rima; Orford, Jim F; Rutter, Harry; Savona, Natalie; van Schalkwyk, May C I and Weishaar, Heide. 2023. The case for developing a cohesive systems approach to research across unhealthy commodity industries. BMJ Global Health, 6(2), e003543. ISSN 2059-7908 [Article]

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Abstract or Description

Objectives Most non-communicable diseases are preventable and largely driven by the consumption of harmful products, such as tobacco, alcohol, gambling and ultra-processed food and drink products, collectively termed unhealthy commodities. This paper explores the links between unhealthy commodity industries (UCIs), analyses the extent of alignment across their corporate political strategies, and proposes a cohesive systems approach to research across UCIs.

Methods We held an expert consultation on analysing the involvement of UCIs in public health policy, conducted an analysis of business links across UCIs, and employed taxonomies of corporate political activity to collate, compare and illustrate strategies employed by the alcohol, ultra-processed food and drink products, tobacco and gambling industries.

Results There are clear commonalities across UCIs’ strategies in shaping evidence, employing narratives and framing techniques, constituency building and policy substitution. There is also consistent evidence of business links between UCIs, as well as complex relationships with government agencies, often allowing UCIs to engage in policy-making forums. This knowledge indicates that the role of all UCIs in public health policy would benefit from a common approach to analysis. This enables the development of a theoretical framework for understanding how UCIs influence the policy process. It highlights the need for a deeper and broader understanding of conflicts of interests and how to avoid them; and a broader conception of what constitutes strong evidence generated by a wider range of research types.

Conclusion UCIs employ shared strategies to shape public health policy, protecting business interests, and thereby contributing to the perpetuation of non-communicable diseases. A cohesive systems approach to research across UCIs is required to deepen shared understanding of this complex and interconnected area and also to inform a more effective and coherent response.

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Funding: The 2016 international meeting of researchers was funded by a Wellcome Trust Small Grant in Humanities and Social Sciences (PI CK). JC, ABG, CK, MP and NF are supported by the UK Prevention Research Partnership (MR/S037519/1), which is funded by the British Heart Foundation, Cancer Research UK, Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Health and Social Care Research and Development Division (Welsh Government), Medical Research Council, National Institute for Health Research, Natural Environment Research Council, Public Health Agency (Northern Ireland), The Health Foundation and Wellcome. NM is supported by a Harkness Fellowship from the Commonwealth Fund. SVK is funded by an NRS Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_12017/13) and Scottish Government Chief Scientist Office (SPHSU13). MCIVS is funded by an NIHR Doctoral Fellowship (Ref NIHR300156).

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11 November 2020Accepted
16 February 2021Published Online
4 May 2023Published

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Date Deposited:

13 Jun 2024 08:58

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13 Jun 2024 08:58

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Yes, this version has been peer-reviewed.


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