PRL-IHPS Spotlight: Commercial Determinants of Health

Healthy Beverage Initiative
Laura Schmidt and colleagues conducted the first evidence-based evaluation of UCSF’s ban of sugar-sweetened beverages on campus. The ban was the result of work by Schmidt and colleagues to use workplace procurement to improve health by lessening the health impact of sugar-sweetened beverages, and builds on Schmidt’s work with SugarScience, which provides information to the general public on the health impacts of sugars.
Sugar-sweetened beverages are heavily promoted by the beverage industry. The evaluation done by Schmidt and colleagues showed reductions in waist circumference of campus employees post-sugar-sweetened beverage ban. The evaluation work is now being replicated at other health systems that have instituted their own sugar-sweetened beverage ban, continuing the work initiated by Schmidt and colleagues to translate evidence of industry promotion of unhealthy sugar products to policy.

Industry Documents Library (IDL) at UCSF
The IDL is a digital archive of documents created by industries which influence public health, hosted by the University of California, San Francisco Library--originally established in 2002 to house the millions of documents publicly disclosed in litigation against the tobacco industry in the 1990s. PRL-IHPS faculty have been instrumental in the founding, and now, expansion of the IDL to include documents from the drug, chemical, food, and fossil fuel industries. PRL-IHPS was a co-founder of the IDL Food Industry Documents Archive, which as of June 2021 contains 619,393 pages related to the sugary food and beverage industry’s manufacturing, operations, regulatory activities, and scientific research activities. PRL-IHPS has also recently partnered with the UCSF Library and Johns Hopkins to launch the Opioid Industry Collection in the Drug Industry Archive, which includes documents from government litigation against pharmaceutical companies, including opioid manufacturers and distributors related to their contribution to the opioid epidemic.

Food Industry Documents Research
Cristin Kearns, DDS, MBA, is building on her work identifying collections for the Food Industry Documents Archive by evaluating commercial determinants of oral health, including historical interactions between the sugar industry and the dental profession that may have inhibited dentists’ engagement in policy action on sugar. Kearns is a Commissioner on the recently formed Lancet Commission on Oral Health and serves as the chair of the Commercial Determinants subgroup, which, among other things, is examining conflicts of interest in the global oral health sphere with the sugary food and beverage industry.
Kearns is also participating in a newly developed Food Industry Documents Archive Training, led by PRL-IHPS colleague Laura Schmidt in conjunction with the Global Health Advocacy Institute, to educate global advocates on applying the FIDA to their evidence-based sugary food and beverage policy work, such as the advancement of front-of-package labelling initiatives. Schmidt and Kearns have also researched the impact of transnational sugar-sweetened beverage companies, such as Coca-Cola, on both obesity and water shortages.

Cross-Industry Documents Research – Commercial Determinants of Breast Cancer
Kearns was recently awarded a grant from the California Breast Cancer Research Program to explore internal research and public relations campaigns sponsored by the tobacco, chemical, pharmaceutical, food, and fossil fuel designed to negatively influence public opinion about environmental exposures and breast cancer. Co-investigators include PRL-IHPS colleagues Tracey Woodruff and Robert Hiatt, as well as Pamela Ling in the Center for Tobacco Control Research and Education, Eric Crosbie at the University of Nevada Reno, and community partner Breast Cancer Action. The IDL is a rich, yet underexplored source of data to establish how industries have cast doubt on links between their products and breast cancer. It is expected that the public exposure of these tactics can contribute to a shift in public opinion and new laws and regulations that collectively reduce environmental exposures related to breast cancer.