Online Program

Multinational corporations and addictive disorders: Analytic framework and sites for public health intervention

Monday, November 4, 2013 : 2:30 p.m. - 2:45 p.m.

Rene Jahiel, MD, PhD, Community Medicine, University of Connecticut School of Medicine, Farmington, CT
After a brief review of addictive mechanisms common to different diseases and disorders, this presentation will focus on multi-national corporations that derive profits from domestic and worldwide sales of products to which consumers become addicted. To increase profits and overcome competitors, corporations use various inducements to sell their products, including product modification to strengthen addictive properties and environmental modifications to elicit potential consumers' knowledge of, interest in, and attractiveness to the products. I demonstrate a cyclic epidemiologic cascade framework, ECF, whose main features apply to diverse potentially addictive products. The framework includes two bow-tie knots (sites, where inputs converge leading to divergent outputs), at the corporate and consumer levels, respectively, and three zones. In Zone A, outputs from the corporation cascade through conduits along five sectors to reach the consumer; Zone B contains inputs and outputs between corporation and governments along the same five sectors; in Zone C, outputs of product sales, consumer health and behavioral effects, and public and professional actions emerge and return as inputs to the corporation to start a new cycle. Notably, the government does not act as a bow-tie knot. I shall present various public health policy interventions for addiction related disorders and diseases that can be conducted within each Zone.

Learning Areas:

Chronic disease management and prevention
Public health or related public policy
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Explain with the epidemiologic cascade and bow-tie frameworks how relations among corporations, government, consumers of corporate products, and professional groups have an impact on addiction to corporate products. Show how the epidemiologic cascade and bow-tie knot frameworks can instruct the epidemiology of addictive disorders and guide selection of preventive measures . Give one example each of public health interventions that a) can be conducted within existing policies; b) require a change in policies; and c) require a systemic change in the relations of the corporations.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have done research and teaching on health care systems for the past three decades. During the past 7 years I have done research and published on corporation-induced diseases and disorders (e.g. Journal of Urban Health 2008),public health infrastructure (e.g. chapter in the book The Bottom Line and Public Health, Oxford University Press, 2010), and developed the concept of Epidemiologic Cascade Framework (last presented at the APHA annual meeting in 2012).
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.