文章基本信息

标题：Public Health and the Anticorporate Movement: Rationale and Recommendations
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作者：William H. Wiist
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2006
卷号：96
期号：8
页码：1370-1375
DOI：10.2105/AJPH.2005.072298
语种：English
出版社：American Public Health Association
摘要：Institutions and informal networks have formed a movement that is challenging the growing power and pervasive influence of large corporations. The movement’s analyses show that the historical development and current function of the corporate entity requires production of a profit regardless of consequences to health, society, or the environment. As a result, public health professionals frequently address health problems related to products, services, or practices of corporations. There are possibilities for links between public health and the anticorporate movement. Public health research and the professional preparation curriculum should focus on the corporate entity as a social structural determinant of disease. MANY PUBLIC HEALTH professionals are aware of or have been involved in public health problems and issues related to corporate products, services, or practices. Freudenberg 1 described a wide variety of products and practices of what he termed disease-promoting corporations . Included are products such as tobacco, unsafe and polluting motor vehicles, expensive medications, guns, alcohol, and certain foods. Other issues that have generated public health advocacy and research include consumer product safety, hazardous industrial materials, water and air pollution, food supply safety, nutritional content and marketing, and occupational health and safety. Corporations also influence health services. For example, federal funding for some health services such as Medicaid has decreased while the number of people eligible for services has increased 2 in part because corporations have increased employee contributions to health insurance premiums or they do not provide health insurance. 3 Regulatory agencies have a limited number of employees to conduct inspections of corporations and enforce health and safety regulations. 4 Also, efforts to prevent or minimize damage from corporate practices or products face opposition from large, well-funded, organized corporate opposition, 1 for example, the tobacco settlement 5 and the automobile industry position on safety and fuel efficiency. 4 Typically, the field of public health has addressed issues such as these as singular issues, as a specific product, or as a single company or a particular type of industry. Public health could do more along those lines, but as egregious as the harm from some products, services, and practices may seem, the prevention or amelioration of the harmful effects in and of themselves does not address the fundamental structure and function common to all corporations. Rather than expending efforts and resources to confront a particular type of industry or a single health issue, the field of public health might be more effective with a research agenda and a professional preparation curriculum that focus on the corporation as a societal structural factor in disease. Such an approach is consistent with the historical and contemporary mission of public health. Over the past decade there has been a movement to return public health to its social justice roots, to a focus on the social determinants of health. 6 ^, 7 There has been a call for a third public health revolution that focuses on the distal causative factors of disease. 8 Public health ethics, values, and beliefs identify public health’s primary role as that of addressing the fundamental societal structural causes of disease. 9 Public health is increasingly focusing on distal structural factors related to inequities in health, 10 income inequality, economic growth and instability, 11 social relationships, 12 the built environment, 13 and trade regulations. 14 ^, 15 Public health could benefit in several ways from a focus on the corporation as a distal, societal structural factor. Because corporate products, services, and practices provide tangible targets for advocacy and research, such an approach could be more useful than focusing on concepts such as free market fundamentalism or extreme capitalism. Research could examine the influence of the corporate entity on indicators of health status. Academic programs could prepare practitioners to address the corporate role in disease and injury. Public health advocacy activities related to the corporate products already noted 1 could link to the anticorporate movement. Focusing on the corporation as a societal structural factor might also suggest ways to address issues such as race/ethnicity, gender, age, socioeconomic status, and disability that are often manifest in a corporate setting. An anticorporate movement’s perspective of the corporate entity as a societal structural factor is instructive for public health. Review of that perspective points out the mutual interests in social justice, ethics, and the social determinants of health that public health has with the anticorporate movement.