There has been a lot written about capitalism. Karl Marx,
for example, wrote a multi-volume study of it just about 150 years ago, and
since then a lot of the writing has been about what he wrote, supportive and
critical. There is no question that it has remained the dominant economic
system in the world; it is the linchpin not only of Western “democracies” and
totalitarian fascist states but also ostensibly Marxist governments like China.
While capitalism has both its defenders and detractors, it is interesting to me
that the defenders spend little time defending the amazingly deleterious
effects that it has on the quality of life (and even existence of life!) of
people, the environment, war, and (to the point of this blog) health.
The problem is that, in pursuit of profit, industries will
do and have done almost anything, with no moral compass or conscience, and,
worse, with no concern for future generations or the planet. Some of the most
obvious and egregious examples in the US at this time include their (largely
successful) lobbying of the current administration to roll back on rules to
ensure clean air and water and the overall environment so that they (in this
case, extraction industries like oil and mining) can further increase their
unconscionable profits without worrying about the damage it does. So we have
mining and extraction in and near our national parks (“near” is important; air
and water do not respect boundaries!), scaling back of national monuments so
extraction can take place, poisoning of the water through leaks in oil
pipelines (such as Keystone), and poisoning of the air we breathe when fossil
fuels are burned. Oh yeah, and the increase in global warming which has already
permanently altered the climate and will eventually wipe out life on earth
(starting with the lowest lying areas) if nuclear war doesn’t first.
Our health and safety is also constantly at risk from
aggressive efforts by corporations to increase their profits. This can take the
form of producing unsafe products either because it saves money (e.g., dangerous
child toys) or costs a lot to not do (e.g., not having lead in our water or asbestos
in talcum powder), or by making important and beneficial (and hopefully safe)
medications unavailable to many people because of incredible price increases
(for the tip of the iceberg, see “Epi-Pen®
and Predatory Pricing: You thought our health system was designed for people’s
health?, September 3, 2016). We of course know about the ongoing –
and largely successful efforts – of the tobacco industry to increase their
profits by promoting a product that kills 400,000 people a year in just the US
(mainly from cancer and heart disease), including through promoting it to
children (e.g., the cartoon character “Joe Camel” – see Fischer et al, “Brand Logo
Recognition by Children Aged 3 to 6 Years: Mickey Mouse and Old Joe the Camel”, JAMA 1991;266(22):3145-3148, December 11, 1991).
One of the most vicious and insidious efforts to compromise
our health in the interest of profit has been carried
on for more than a half-century by the sugar industry. For decades, under
the table, sugar producers funded scientific research into the negative effects
of a high-fat diet while ignoring the almost-certainly more detrimental effects
of a high-carbohydrate, especially simple carbohydrate – sugar – based diet.
Soda pop became the national beverage with incredible impact on the rate of
obesity, in the US and internationally. A 12-oz can of Coca-Cola® has 140
calories, so what about that 40oz fountain drink at the convenience store? A
2-liter bottle has 812 calories. That’s a lot. So most health professionals,
like doctors, tell people to not drink it, or not very much of it. This is,
however, competing against the messaging of the industry, which pushes it a
lot, and gets the cooperation of many nutritionists through the use of – wait for
it – money! I have written about the corruption (or conflict of interest, to
put it nicely) of health organizations like the American Academy of Dietetics
and Nutrition (AADN) and the American Academy of Family Physicians being funded
by Coca-Cola® and other sugar purveyors and having their ads on their websites (The
AAFP, Coca-Cola, and Ethics: Serving the public interest?, August
20, 2010). The ads are no longer there, but you can read about the AADN at the fooducate
blog, and if you search sugar on the current
AADN website, you will find some pieces on limiting sugar, but as many on
the potential risks of artificial sweeteners (which, whatever your beliefs, the FDA rules as safe) and fats.
Of course, as with the case of tobacco, efforts to limit the
sugar market in the US (such as Mayor Michael Bloomberg’s failed attempt to
limit the size of sugary sodas in NYC), have led the industry to branch out and
increase its efforts to profit in the rest of the world, particularly the
developing world. While many countries can be targeted, the biggest markets,
China, India, and Mexico, have received special attention. The NY Times has an important exposé on January 9, 2019, ‘Research
details how junk food companies influence China’s nutrition policy”, citing
work published in BMJ (“Making China safe for Coke:
how Coca-Cola shaped obesity science and policy in China”) and the Journal of Public Health Policy (“Soda industry influence on obesity science
and policy in China”) on the role of the International
Life Sciences Institute (ILSI):
…a worldwide organization with a Washington
headquarters, funded by many of the biggest names in snack foods, including
Nestlé, McDonald’s, Pepsi Co. and Yum! Brands as well as Coca-Cola. It has 17
branches, most of them in emerging economies like Mexico, India, South Africa
and Brazil, and promotes itself as a bridge between scientists, government
officials and multinational food companies.
But in China ILSI
is so well-placed that it runs
its operations from inside the government’s Centre for Disease Control and
Prevention in Beijing. In fact, when asked to comment on the studies, the
ministry emailed a statement not from a government official but from ILSI’s
China director.
Thus China’s health
policy, which almost entirely focuses on exercise like “Happy 10 minutes” (good
for you!) and ignores the dangers of high-calorie sugar-laden foods for obesity
(and there is excellent evidence that diet is probably about 80% of the issue,
with exercise critical for the other 20%).
There are those who
will argue that it is not capitalism itself, but “unfettered capitalism” that
is the problem. There is a lot of truth to that. The blind pursuit of maximal
profit with no attention at all to the negative impacts on the world around
them is not a necessary part of any profit making endeavor. Indeed, the “Wealth
of Nations” by Adam Smith cautions strongly against this sort of excess, and “the
only responsibility of business is to make profit for its stockholders” guru
Milton Friedman sort of assumed that they wouldn’t do it.
But they do, and “unfettered”
– or corporate gangster capitalism – is what is running the world. And it is
not good for our health.
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