To investigate the effect of fast food consumption on mean population body mass index (BMI) and explore the possible influence of market deregulation on fast food consumption and BMI.
The ...within-country association between fast food consumption and BMI in 25 high-income member countries of the Organisation for Economic Co-operation and Development between 1999 and 2008 was explored through multivariate panel regression models, after adjustment for per capita gross domestic product, urbanization, trade openness, lifestyle indicators and other covariates. The possible mediating effect of annual per capita intake of soft drinks, animal fats and total calories on the association between fast food consumption and BMI was also analysed. Two-stage least squares regression models were conducted, using economic freedom as an instrumental variable, to study the causal effect of fast food consumption on BMI.
After adjustment for covariates, each 1-unit increase in annual fast food transactions per capita was associated with an increase of 0.033 kg/m2 in age-standardized BMI (95% confidence interval, CI: 0.013-0.052). Only the intake of soft drinks--not animal fat or total calories--mediated the observed association (β: 0.030; 95% CI: 0.010-0.050). Economic freedom was an independent predictor of fast food consumption (β: 0.27; 95% CI: 0.16-0.37). When economic freedom was used as an instrumental variable, the association between fast food and BMI weakened but remained significant (β: 0.023; 95% CI: 0.001-0.045).
Fast food consumption is an independent predictor of mean BMI in high-income countries. Market deregulation policies may contribute to the obesity epidemic by facilitating the spread of fast food.
The UN Sustainable Development Goals (SDGs) offer a detailed dashboard of goals, targets and indicators. In this paper we investigate alternative methods to relate the SDGs to overall measures of ...sustainable wellbeing that can motivate and guide the process of global societal change. We describe what a Sustainable Wellbeing Index (SWI) that connects with and complements the SDG dashboard might look like. We first investigate several options for how to construct such an index and then discuss what is needed to build consensus around it. Finally, we propose linking the SDGs and our SWI with a comprehensive systems dynamics model that can track stocks and flows and make projections into the future under different policy scenarios.
The 2008 global financial crisis has been one of the outcomes of more than three decades of neoliberal globalisation policies. These reforms, implemented by the international financial institutions ...such as the International Monetary Fund, the World Bank and the World Trade Organisation, under the pressure of wealthy nations and transnational corporations, have also produced negative health effects. The advent of these economic measures since the late 1970s and early 1980s coincided, in fact, with reduced worldwide gains in both economic growth and life expectancy. They also have generated larger economic and health gaps between and within countries. This article reviews the major bodies of evidence on the multiple links between neoliberal globalisation policies, economic inequalities and health. It also discusses the future prospects for global health in light of contemporary policy responses to the crisis by national governments and the G-20. Adapted from the source document.
This article investigates to what extent the worldwide increase in body mass index (BMI) has been affected by economic globalization and inequality. We used time-series and longitudinal ...cross-national analysis of 127 countries from 1980 to 2008. Data on mean adult BMI were obtained from the Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group. Globalization was measured using the Swiss Economic Institute (KOF) index of economic globalization. Economic inequality between countries was measured with the mean difference in gross domestic product per capita purchasing power parity in international dollars. Economic inequality within countries was measured using the Gini index from the Standardized World Income Inequality Database. Other covariates including poverty, population size, urban population, openness to trade and foreign direct investment were taken from the World Development Indicators (WDI) database. Time-series regression analyses showed that the global increase in BMI is positively associated with both the index of economic globalization and inequality between countries, after adjustment for covariates. Longitudinal panel data analyses showed that the association between economic globalization and BMI is robust after controlling for all covariates and using different estimators. The association between economic inequality within countries and BMI, however, was significant only among high-income nations. More research is needed to study the pathways between economic globalization and BMI. These findings, however, contribute to explaining how contemporary globalization can be reformed to promote better health and control the global obesity epidemic.
This prospective study examines the relationship between aspects of the neighbourhood social environment and subsequent depressive symptoms in over 7,500 participants of the English Longitudinal ...Study of Ageing (ELSA). Neighbourhood social environment at baseline was operationalised using four items capturing social cohesion and three items capturing perceived safety and associations with the Center for Epidemiologic Studies Depression Scale (CES-D) at two-year follow-up were assessed. Friendship quality and personal sense of control were tested as mediators of this relationship using structural equation modelling. Neighbourhood social cohesion was found to be associated with reporting fewer depressive symptoms independent of demographic and socioeconomic factors and baseline depressive symptoms. Friendship quality and sense of control mediated this association. The study highlights that greater personal sense of control, higher quality friendships and fewer depressive symptoms are found in neighbourhoods seen to be characterised by higher social cohesion. Adapted from the source document.
This lecture transcript is divided in four parts. First, I examine the main public-health strategies in managing the COVID-19 pandemic. Although there are numerous factors capable of explaining ...national differences in COVID-19 mortality that are not attributable to merits or demerits of governments, I have identified five lethal errors (lack of preparation, misinformation, medicalisation, a policy approach based on a ‘laissez-faire’ attitude to the virus and social inequity) and four vital actions (testing, tracing, isolating with support, timeliness and immunisation) that best distinguish success or failure in tackling the pandemic. In the second part, I analyse the origin of SARS-CoV-2 and major risk factors for emerging zoonotic diseases (e.g. exploitation of animal wildlife, deforestation, agricultural intensification and climate change) to be addressed to prevent future pandemics. Then, I discuss the interrelationships between the COVID-19 pandemic and the ecological crisis in the context of the so-called neoliberal variant of capitalism. Both crises are largely determined by anthropogenic risk factors influenced by a model of economic development that prioritises infinite economic growth, free trade and a global self-regulating market over any other values of society (including human survival). An alternative economic approach, capable of creating a new balance between the health of humans, animals, and the environment (by modifying their structural drivers), is the most important antidote against new spillovers and climate change. It is the humanitarian immune response we need to protect global health from future pandemics and ecological collapse.
In 2008, the world experienced the worst financial crisis since the Great Depression. The crisis is often described in relation to its proximal risk factors such as the proliferation of risky loans ...and mortgage-based securities, but the root causes of the Great Recession include distal risk factors such as indiscriminate capital flow, excessive financial deregulation, and high concentration of wealth in the top distribution. Ultimately, the crisis is a byproduct of neoliberal policies and the 'self-correcting market' ideology that guided national and global macroeconomic reforms since the 1970s. Evidence indicates that the Great Recession led to increases in unemployment and suicides, especially in Europe and in the US. Estimates based on the effects of previous economic downturns suggest that the crisis produced negative health and nutritional outcomes in developing countries. Data, however, also show that recessions can be characterized by increases in life expectancy at birth. These favorable trends seem associated with policy regimes favoring a more egalitarian distribution of income and stronger social protections that can decouple the link between unemployment and suicides during crises ('healthy de-growth'.). New rules and regulations at the national and global level are needed to prevent future financial crises. The crisis also provides an opportunity to challenge neoliberalism, the ideology of the 'self-correcting market' and envision a new model of economic development where GDP growth is longer the main national policy priority. Governments can achieve a regime of 'healthy de-growth' if they step in with appropriate policy interventions toward a more egalitarian distribution of income and stronger social protections.
Objective To examine the associations between positive and negative affect and subsequent coronary heart disease events independently of established risk factors.Design Prospective cohort study with ...follow-up over 12 years.Setting 20 civil service departments originally located in London.Participants 10 308 civil servants aged 35-55 years at entry into Whitehall II study in 1985.Main outcome measures Fatal coronary heart disease, clinically verified incident non-fatal myocardial infarction, and definite angina (n=619, mean follow-up 12.5 years).Results In Cox regression analysis adjusted for age, sex, ethnicity, and socioeconomic position, positive affect (hazard ratio=1.01, 95% confidence interval 0.82 to 1.24) and the balance between positive and negative affect, referred to as the affect balance score (hazard ratio=0.89, 0.73 to 1.09), were not associated with coronary heart disease. Further adjustment for behaviour related risk factors (smoking, alcohol consumption, daily fruit and vegetable intake, exercise, body mass index), biological risk factors (hypertension, blood cholesterol, diabetes), and psychological stress at work did not change these results. However, participants in the highest third of negative affect had an increased incidence of coronary events (hazard ratio=1.32, 1.09 to 1.60), and this association remained unchanged after adjustment for multiple confounders.Conclusions Positive affect and affect balance did not seem to be predictive of future coronary heart disease in men and women who were free of diagnosed coronary heart disease at recruitment to the study. A weak positive association between negative affect and coronary heart disease was found and needs to be confirmed in further studies.
Summary The reduction of health inequities is an ethical imperative, according to the WHO Commission on Social Determinants of Health (CSDH). Drawing on detailed multidisciplinary evidence assembled ...by the Globalization Knowledge Network that supported the CSDH, we define globalisation in mainly economic terms. We consider and reject the presumption that globalisation will yield health benefits as a result of its contribution to rapid economic growth and associated reductions in poverty. Expanding on this point, we describe four disequalising dynamics by which contemporary globalisation causes divergence: the global reorganisation of production and emergence of a global labour-market; the increasing importance of binding trade agreements and processes to resolve disputes; the rapidly increasing mobility of financial capital; and the persistence of debt crises in developing countries. Generic policies designed to reduce health inequities are described with reference to the three Rs of redistribution, regulation, and rights. We conclude with an examination of the interconnected intellectual and institutional challenges to reduction of health inequities that are created by contemporary globalisation.
ABSTRACT
Aims To examine whether high social capital at work is associated with an increased likelihood of smoking cessation in baseline smokers.
Design Prospective cohort study.
Setting Finland.
...Participants A total of 4853 employees who reported to be smokers in the baseline survey in 2000–2002 (response rate 68%) and responded to a follow‐up survey on smoking status in 2004–2005 (response rate 77%).
Measurements Work‐place social capital was assessed using a validated and psychometrically tested eight‐item measure. Control variables included sex, age, socio‐economic position, marital status, place of work, heavy drinking, physical activity, body mass index and physician‐diagnosed depression.
Findings In multi‐level logistic regression models adjusted for all the covariates, the odds for being a non‐smoker at follow‐up were 1.26 95% confidence interval (CI) = 1.03–1.55 times higher for baseline smokers who reported high individual‐level social capital than for their counterparts with low social capital. In an analysis stratified by socio‐economic position, a significant association between individual‐level social capital and smoking cessation was observed in the high socio‐economic group odds ratio (OR) (95% CI) = 1.63 (1.01–2.63), but not in intermediate (OR = 1.10 (0.83–1.47) or low socio‐economic groups (OR = 1.28 (0.86–1.91). Work unit‐level social capital was not associated with smoking cessation.
Conclusions If the observed associations are causal, these findings suggest that high perceived social capital at work may facilitate smoking cessation among smokers in higher‐status jobs.
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