Economics and Planetary Health

SOPHEA team

November 2023

In this presentation

• Interconnection between economics and Planetary Health
• Commercial determinants of health (CDOH)
• Neoliberalism & Capitalism as underlying concepts
• Concept of growth
• Alternative schools of thought for new concepts in economy
• Action points

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How economics influence Planetary Health

Global economics

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• resource allocation
• consumption patterns
• industrial practices
• …

Influence of climate change on global economics

Examples:

• Climate change poses health risks (heat-related diseases, respiratory problems, etc.) with economic consequences for healthcare systems
• Climate change-related economic costs from extreme weather events can range from 0.05% to 0.82% of global GDP
• Projections suggest a 10% decline in the global economy by 2050 without meeting emissions reduction targets

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The 2019 report of The Lancet Countdown on health and climate change – Watts et al. (2019)

Commercial determinants of health (CDOH)

• Definition: “the systems, practices, and pathways through which commercial actors drive health and equity.”
• commercial entities are diverse and can make both positive and negative contributions to human and planetary health and equity

• However: overwhelming evidence that some, particularly the largest, multinational and transnational corporations are having increasingly negative effects on human and planetary health and social and health inequities

Defining and conceptualizing the commercial determinants - Gilmore et al. (2023)

Lethal impact

• Four commercial products account for over a third of global deaths per year
• Tobacco (9 mio)
• Dietary risk (3 mio)
• Alcohol (2.4 mio)
• Air pollution (4.5 mio)

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• Commercial actors enabled to cause harm and externalize costs
• Healthcare systems struggling to cope

Defining and conceptualizing the commercial determinants - Gilmore et al. (2023)

Neoliberalism & capitalism (I)

• Neoliberalism = economic and political philosophy that emphasizes limited government intervention in markets, free trade, privatization of state-owned enterprises & reduction of regulations
• strong emphasis on individual freedom,
• belief that free markets are the most efficient way to allocate resources

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• Capitalism = economic system in which the means of production and distribution are primarily privately owned, and market forces determine prices and resource allocation
• profit as a primary motivator
• corporations are motivated to maximize profit

Neoliberalism & capitalism (II)

• The combination of neoliberal economic policies and the capitalist system have created an environment where corporations, particularly large multinational entities, have the opportunity to wield significant influence and power due to reduced regulations, economic liberalization, and profit-maximizing incentives

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• Many examples: Coca Cola, Walmart, …

The paradigm of (un)economic growth

• Economic growth = expansion of production of goods and services, typically measured as Gross Domestic Product (GDP)
• GDP indicators widely used but often an inappropriate measure for health and wellbeing outcomes (WHO, 2022)
• Historic dimension: “growth as a process of elite accumulation, the commodification of commons, and the appropriation of human labour and natural resources - a process quite often colonial in character” (Hickel, 2021)
• Uneconomic growth: increases in production come at the �expense of resources and well-being that is worth more �than the items made (Daly, 2014)

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“De-growth”

• Degrowth = active contraction in overall economic activity to a material scale and footprint consistent with remaining inside planetary boundaries
• Degrowth may be voluntary (deliberate contraction) or involuntary (resulting from shocks and crises)

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• “Degrowth calls for the reversal of the processes that lie behind growth: it calls for disaccumulation, decommodification, and decolonisation.” (Hickel, 2021)

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• Degrowth “create[s] new social imaginaries to confront the still hegemonic, growth-based neoliberal capitalism” (Global Health Watch, 2023)

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Post-growth policies

• Post-growth economy abandons GDP growth as an objective and instead reorganises production around societal and planetary well-being rather than around consumption and accumulation
• Post-growth policies focus on restructuring societies to secure people’s livelihoods in a democratic way despite a reduction in aggregate economic activity
• Examples for concrete post-growth policy changes for downshifting of consumption and production
• wealth and income redistribution through domestic and �international taxation
• stringent carbon taxes for the global north
• regulations for maximum and minimum income

Post-growth economics a must for planetary - van Woerden et al. (2023)

Alternative schools of thought in economics

• Ecological economics
• Sees economy as subsystem of society and the biosphere
• Analyses economic processes in terms of their associated resource use and social outcomes (rather than monetary indicators)
• Institutional economics
• important decisions are made by institutions (formal /informal rules) rather than markets
• Feminist economics
• Highlights the role of informal and non-market activities (care work and household tasks predominantly done by women) for the economic and wellbeing outcomes
• Wellbeing economics
• More comprehensive and people-centered approach, advocates for the development and use of alternative indicators and metrics health, education, social connections, environmental sustainability, and subjective well-being or happiness

Actions to take by state actors

• Use regulatory power to change policy systems essential for health, equity, and sustainability

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Commercial determinants of health future directions - Friel et al. (2023)

Actions to take by the commercial sector

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Commercial determinants of health future directions - Friel et al. (2023)

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Action points for researchers

• Explore and understand: how to effect positive systemic change and generate better understanding of obstacles to action
• Defend the use of science: stay critical and as independent as possible in your research and oppose industry efforts to manipulate or distort science to advance industry interests
• Promote and disseminate your findings: on health-harmful effects of different industries on Planetary Health
• Engage with other scientists: and become part of global groups of academic activists

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Commercial determinants of health future directions - Friel et al. (2023)

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Action points for civil society

• Be noisy: publicly support evidence-based health measures; make the case for action to the government and the community; expose and oppose the harmful influences, policies, practices, and products of commercial entities
• Form coalitions: connect and exchange with other civil society members and mobilise. Be persistent.
• Use your professional background: educate others (e.g. doctors and other health professionals can use their legitimacy and authority to emphasise the importance of prevention)

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Commercial determinants of health future directions - Friel et al. (2023)

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Questions or comments ?

Thank you for your attention.