Stretton Health Equity, Stretton Institute, North Tce Campus, University of Adelaide, Adelaide, 5005, Australia.
Health Equity Research Development Unit *HERDU, UNSW Centre for Primary Health Care and Equity (CPHCE), University of New South Wales, Sydney, 2052, Australia.
Global Health. 2022 Sep 9;18(1):80. doi: 10.1186/s12992-022-00870-0.
The practices of transnational corporations (TNCs) affect population health through unhealthy products, shaping social determinants of health, or influencing the regulatory structures governing their activities. There has been limited research on community exposures to TNC policies and practices. The aim of this paper was to adapt existing Health Impact Assessment methods that were previously used for both a fast food and an extractives industry corporation in order to assess Carlton and United Breweries (CUB) operations within Australia. CUB is an Australian alcohol company owned by a large transnational corporation Asahi Group Holdings. Data identifying potential impacts were sourced through document analysis, including corporate literature; media analysis, and 12 semi-structured interviews. The data were mapped against a corporate health impact assessment framework which included CUB's political and business practices; products and marketing; workforce, social, environmental and economic conditions; and consumers' adverse health impacts. We also conducted an ecological study for estimating alcohol attributable fractions and burdens of death due to congestive heart disease, diabetes mellitus, stroke, breast cancer, bowel cancer and injury in Australia. Beer attributable fractions and deaths and CUB's share were also estimated.
We found both positive and adverse findings of the corporation's operations across all domains. CUB engage in a range of business practices which benefit the community, including sustainability goals and corporate philanthropy, but also negative aspects including from taxation arrangements, marketing practices, and political donations and lobbying which are enabled by a neoliberal regulatory environment. We found adverse health impacts including from fetal alcohol spectrum disorder and violence and aggression which disproportionately affect Indigenous and other disadvantaged populations.
Our research indicates that studying a TNC in a rapidly changing global financialised capitalist economy in a world which is increasingly being managed by TNCs poses methodological and conceptual challenges. It highlights the need and opportunity for future research. The different methods revealed sufficient information to recognise that strong regulatory frameworks are needed to help to avoid or to mediate negative health impacts.
跨国公司（TNCs）的做法通过不健康的产品影响人口健康，塑造健康的社会决定因素，或影响管理其活动的监管结构。对于社区接触 TNC 政策和做法的研究有限。本文的目的是调整先前用于快餐和采矿业公司的现有健康影响评估方法，以便评估澳大利亚的卡尔顿联合酿酒厂（CUB）的运营情况。CUB 是一家澳大利亚酒类公司，由大型跨国公司朝日集团控股公司拥有。通过文件分析、媒体分析和 12 次半结构化访谈，从企业文献中获取潜在影响的数据。将这些数据与包括 CUB 的政治和商业实践、产品和营销、劳动力、社会、环境和经济状况以及消费者的不良健康影响在内的企业健康影响评估框架进行了对照。我们还进行了一项生态研究，以估计澳大利亚因充血性心力衰竭、糖尿病、中风、乳腺癌、肠癌和伤害而导致的归因于酒精的部分和负担。还估计了啤酒归因部分和死亡人数以及 CUB 的份额。
我们发现公司在所有领域的运营都有积极和不利的发现。CUB 从事一系列有益于社区的商业实践，包括可持续性目标和企业慈善事业，但也有负面方面，包括税收安排、营销实践以及政治捐赠和游说，这些都是新自由主义监管环境所允许的。我们发现了一些不良健康影响，包括胎儿酒精谱系障碍和暴力与攻击，这些对土著居民和其他弱势群体的影响尤为严重。
我们的研究表明，在一个日益由 TNC 管理的快速变化的全球金融化资本主义经济中研究 TNC，存在方法和概念上的挑战。它强调了未来研究的必要性和机会。不同的方法提供了足够的信息，以认识到需要强有力的监管框架来帮助避免或缓解负面健康影响。
