Let's talk about corporate tax, not philanthropy
Inequalities and the social determinants of health
[Image: J. Peacock - Unsplash]
A recent news article[1]criticised the UK government’s austerity policies for quite literally shortening life expectancies. National statistics showed that austerity policies, deemed “inequality by stealth” and “fiscal misogyny,” have widened the gap between the wealthy and the poor, especially poor women.
Solutions to health inequalities often focus on individual behaviour change—educating people to make better choices. This approach is fundamentally flawed. The mantra of “personal responsibility” ignores the broader circumstances in which people are born, live and die—circumstances largely outside of personal control. These circumstances—legal systems, colonization, discrimination and prejudice, access to health care, housing vulnerability, racism, exposure to violence—are referred to as the Social Determinants of Health(or SDoH).[2]
A new kid on the SDoH block is transnational corporations. Corporations influence health. The most obvious method is by manufacturing and marketing products that cause disease—tobacco, alcohol, ultra-processed foods, asbestos—the list goes on. Corporations also influence health in less visible ways through political strategies.
As economist Milton Freedman argued 50 years ago, the role of corporations is to increase profits.[3]This is not inherently problematic—businesses employ people, provide necessary goods and services, grow the economy, foster innovation, and contribute to government budgets through the taxes they pay. Job security and work environments play a significant role in public health and welfare—not to mention mental health. Making money is not inherently wrong.
But. Over the past several decades, corporations have grown in size, in global reach and in political influence. They have merged with their competitors and acquired the businesses in their supply chain. This consolidation has led to a small number of corporations exercising disproportionate influence over markets. The power of these companies is vividly illustrated in the World Bank’s[4]ranking of the largest global economies. Coming in at number 10 is Walmart—a US based supermarket that boasts an annual revenue larger than Australia and 11,300 stores in 27 countries.[5]When corporate revenue exceeds national GDPs it necessitates scrutiny.
With market power comes political power. Corporations fund political campaigns. They lobby politicians. They sit on policy committees or employ former regulators. They fund their own research to show that their products or services are benign or healthful (cough, Coca-Cola[6], Monsanto[7]). In addition to marketing their products, they develop elaborate corporate responsibility campaigns to showcase the beneficial actions the company is taking and distract from the less savoury strategies that also occur.
Food companies exercise political power to ensure that government policies are favourable to their interests. A vivid example of this is how food insecurity is understood and addressed. Food insecurity is often thought to be an issue for less wealthy nations, but a significant (and disgracefully large) percent of Australians are food insecure. This group includes the homeless, women, immigrants, and the elderly. The dominant solution to food insecurity is food charity. In 2018, Food bank Australia distributed more than 20 million meals.[8]On one hand, this is an impressive feat and has quite literally saved people from hunger. On the other hand, food charity is a band aid. It provides an emergency response to a chronic problem. It rarely does anything to address the root causes of food insecurity: poverty.
In Australia,more than half of the people suffering from food insecurity are employed.[9]The qualityand securityof that employment are another matter entirely. Large companies (including food companies) donate food and money to food charities. The is excellent public relations that distracts from the role these companies play in the problem. Social safety nets—welfare, pension, aged care, Medicare—are vital to close the gap between the wealthy and the poor. Yet these social programs are slowly shrinking. The UK’s austerity policies are not an anomaly, but increasingly common. While corporations are making charitable donations to emergency services such as food banks, they are actively opposing policies that would improve the lives of the poorest—increases in minimum wages, the elimination of zero-hour contracts, minimum working conditions and others.
Corporations are working very hard to present themselves as part of the solution to food insecurity, to obesity, to climate change and to a range of other “wicked” problems facing the world. But so long as they continue to hide profits offshore, oppose economic policies designed to improve the lives of the poorest and even threaten countries that develop public health policies (see Philip Morris v. Uganda[10]) that argument is a lie.
A historian at the World Economic Forum in Davos this year perhaps said it best: we’ve got to be talking about taxes. All the rest is bulls**t in my opinion[11].
[1]https://jacobinmag.com/2019/04/britain-life-expectancy-austerity-conservative-party-tories
[2]https://www.who.int/social_determinants/sdh_definition/en/
[3]https://www.nytimes.com/1970/09/13/archives/a-friedman-doctrine-the-social-responsibility-of-business-is-to.html
[4]https://blogs.worldbank.org/publicsphere/world-s-top-100-economies-31-countries-69-corporations
[5]https://corporate.walmart.com/our-story/our-business
[7]https://www.abc.net.au/4corners/the-monsanto-papers/10352384
[8]https://www.foodbank.org.au/wp-content/uploads/2019/01/Foodbank-NSW-ACT-2018-Annual-Review.pdf
[9]https://www.foodbank.org.au/wp-content/uploads/2019/01/Foodbank-NSW-ACT-2018-Annual-Review.pdf
[10]https://www.tobaccofreekids.org/what-we-do/global/legal/trade-and-investment/philip-morris-v-uruguay
[Source: Jennifer Lacy Nichols, Food Systems Tutor and PhD Researcher, University of Melbourne, @JLacyNichols]