In the study of factors that influence health, in addition to biological conditioners (such as genetics), social determinants are increasingly taken into account: gender, occupation, class, economic level, place of residence, education, ethnicity… In fact, they are of great importance in well-being and diseases, whether infectious (produced by pathogens) or not.
COVID-19 has left us clear examples. For example, older adults had a higher risk of dying than young people in case of infection (biological conditioning). On the other hand, women have had a higher risk of infection, as they are usually in charge of patient care, both for their profession and their role (social conditioning).
Now, the WHO has focused on other kinds of constraints: commercial. The head of the WHO, Tedros Adhanom Ghebreyesus, has warned in The Lancet that certain products and practices of powerful international industries cause serious damage to public health and also increase use and other discrimination.
In addition to the words of the director of the WHO, the journal has published a series of articles on the subject. Just the data in one of the articles to see how trade constraints influence: four industries – alcohol, tobacco, ultra-processed foods and fossil fuels – account for at least one third of the world’s deaths each year.
The journal also cites other powerful industries, such as pharmaceutical companies, gambling, mining, new technologies, cars… and their concern for social differences. For example, they denounce that the tobacco and food industries perpetuate colonialism and racism. They have also stressed that certain consumer habits and products reinforce consumption stereotypes and recall that children's product manufacturers use deceit for sale.
It is clear that many public health campaigns remain upside down, without recognizing or limiting the power of these industries. Therefore, they propose a change of focus in the journal: to leave aside the gross domestic product and discuss how the economy of well-being is measured; to face the imbalance of power and analyze new socioeconomic models; to invest in the commons for health... In short, a revolution so that lives are above economic benefits.
Although they are ambitious objectives, there are examples in this direction. For example, since last year, in New Zealand, those born from 2009 have been banned from buying tobacco and tobacco companies have had to reduce the proportion of nicotine in cigarettes and close 90% of establishments. In Europe, this year’s obesity conference had to give up the support of Nestle, due to pressure from research groups through the British Medical Journal.