Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
J Epidemiol Community Health. 2017 Nov;71(11):1078-1083. doi: 10.1136/jech-2017-209710. Epub 2017 Oct 4.
Corporations use a range of strategies to dispute their role in causing public health harms and to limit the scope of effective public health interventions. This is well documented in relation to the activities of the tobacco industry, but research on other industries is less well developed. We therefore analysed public statements and documents from four unhealthy commodity industries to investigate whether and how they used arguments about complexity in this way.
We analysed alcohol, food, soda and gambling industry documents and websites and minutes of reports of relevant health select committees, using standard document analysis methods.
Two main framings were identified: (i) these industries argue that aetiology is complex, so individual products cannot be blamed; and (ii) they argue that population health measures are 'too simple' to address complex public health problems. However, in this second framing, there are inherent contradictions in how industry used 'complexity', as their alternative solutions are generally not, in themselves, complex.
The concept of complexity, as commonly used in public health, is also widely employed by unhealthy commodity industries to influence how the public and policymakers understand health issues. It is frequently used in response to policy announcements and in response to new scientific evidence (particularly evidence on obesity and alcohol harms). The arguments and language may reflect the existence of a cross-industry 'playbook', whose use results in the undermining of effective public health policies - in particular the undermining of effective regulation of profitable industry activities that are harmful to the public's health.
企业采用多种策略来质疑自身在造成公共健康危害方面的作用,并限制有效的公共卫生干预措施的范围。这在烟草行业的活动中已有充分记录,但对其他行业的研究则不太完善。因此,我们分析了四个不健康商品行业的公开声明和文件,以调查它们是否以及如何以这种方式利用复杂性论点。
我们使用标准的文件分析方法,分析了酒精、食品、苏打水和赌博行业的文件和网站以及相关健康专门委员会报告的记录。
确定了两种主要的框架:(i)这些行业争辩说病因复杂,因此不能归咎于个别产品;(ii)他们认为,针对人口健康的措施“过于简单”,无法解决复杂的公共健康问题。但是,在第二种框架中,行业如何使用“复杂性”存在内在矛盾,因为他们的替代解决方案本身并不复杂。
公共卫生中常用的复杂性概念也被不健康商品行业广泛用于影响公众和政策制定者对健康问题的理解。它经常被用于回应政策公告和新的科学证据(特别是关于肥胖和酒精危害的证据)。这些论点和语言可能反映出跨行业“剧本”的存在,其使用导致有效的公共卫生政策被破坏——特别是对有害公众健康的有利可图的行业活动进行有效监管的破坏。