York study suggests corporate domination of disease associations hinders public policy action

A new study out of York University suggests that corporate domination of two major disease associations – Heart and Stroke Canada and Diabetes Canada – creates a dialogue about the causes and means of preventing these diseases that thwarts public policy action to address their true causes and the best means of managing these chronic diseases.

Dennis Raphael

In the study “The cultural hegemony of chronic disease association discourse in Canada,” led by York University Professor of Health Policy and Management Dennis Raphael, the authors examine why the two disease associations attribute these diseases to bad “lifestyle choices” and ignore broader societal causes of these illnesses.

Raphael said it has been known for decades that the primary causes of cardiovascular disease and adult-onset diabetes are adverse living and working conditions. These diseases, he said, are a direct result of material deprivation, excess stress and coping strategies such as smoking and excess alcohol consumption taken up to deal with these circumstances.

Noticeably absent from disease association messaging are the findings that experiencing deprivation during childhood by living in poverty is a good predictor of developing heart disease and diabetes during adulthood, said Raphael, even if life circumstances improve after childhood.

In this study, the authors argue that the Boards of Directors of these associations are dominated by members from the corporate and financial sector, whose values and beliefs are not receptive to considering broader issues of how inequality and poverty, rather than individual behaviours, cause these diseases.

The authors call for broadening membership of these boards to include those knowledgeable about these broader factors and those who are more likely to develop these diseases: the marginalized, poor, and excluded.

“Heart and Stroke Canada and Diabetes Canada play a large role in educating policymakers and the public about the causes and means of preventing heart disease and diabetes. It is therefore especially concerning they are not communicating what research has shown to be the main factors causing these disease: adverse living and working conditions caused by bad public policy decisions on the parts of governments,” said Raphael.

The study is published in Springer Nature and is available online at https://rdcu.be/QmAL.

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