Abstract
Background
Transnational Corporations (TNCs) exercise considerable sway over population health. They now comprise 157 of the 200 largest economies in the world and shape our food choices and degree of exploitation of our natural environment. This paper will analyse data from two corporate health impact assessments exercise (food and extractive industries) to determine what government and international agency regulatory actions are required to minimize the health harm causes by the actions of TNCs.
Methods
We used a Corporate Health Impact Assessment (CHIA) framework, data sourced through document and media analyses, and semi-structured interviews to examine the practices of McDonalds in Australia and Rio Tinto in Australia and South Africa. Data were mapped against the CHIA framework's three sections which are: i) the impact of regulatory environments ii) How TNC practices and products impact on health and equity ii) the direct impact of TNCs practices on daily living conditions.
Results
The CHIA exercise indicated an absence of effective international regulation on the actions of TNCs and that national regulatory regimes can encourage more responsible behavior from TNCs, for example in occupational health and safety. We identified the need for a much higher level of global and national regulation to: i) prevent the many conflicts of interest we found ii) reduce the extent to which TNC products are unhealthy iii) enforce healthy employment practices iv) prevent externalization of the costs of TNCs v) prevent taxation minimization.
Conclusions
The study highlighted the ways in which TNCs can use their power and size to maintain a de-regulated environment. Concerted global and national action is required to regulate in favour of human health and safety and that of the environment. Our findings support the need for an enforceable international treaty.
Key messages
Transnational corporations have a massive impact on population health. A health impact assessment can identify the pathways of impact and be used to inform regulatory action to promote health.
Epidemiology, Population Health, and Health Impact Assessment
