Money Power Health with Nason Maani

Hello everyone and welcome back to Money Power Health.Today's episode is about what it actually looks like, from the inside, when commercial interests try to shape health policy. My guest is Elena Whitham, who served as a Member of the Scottish Parliament and as Minister for Drugs and Alcohol Policy in the Scottish Government. That role put her at the intersection of highly contested territory in public health, where evidence about what works collides with the interests of industries that profit from the products causing harm in the most deprived communities.In this conversation, Elena reflects on her own life experience navigating challenging circumstances, through to working at the local level to national politics. She discusses what commercial influence on health policy-making actually looks like in practice, how it shaped her thinking and approach, the importance of civil society and academics, what advice she would give to other policy-makers based on her experiences, if they are to make a healthier, more equitable Scotland. If you are interested in finding out more about some of the issues we discussed, please find some links with further information:-Responses to a recent consultation on alcohol advertising and promotion: https://consult.gov.scot/alcohol-policy/alcohol-advertising-and-promotion/ -Link to the Public Health Scotland evaluation of Minimum Unit Pricing: https://publichealthscotland.scot/publications/evaluating-the-impact-of-minimum-unit-pricing-for-alcohol-in-scotland-a-synthesis-of-the-evidence/-Latest data release from National Records of Scotland on drug and alcohol deaths in Scotland: https://www.nrscotland.gov.uk/publications/drug-related-deaths-in-scotland-2024/-Link to a resource hub on tools and approaches to addressing commercial drivers of ill-health hosted by our UKRI Population Health Improvement Local Health Global Profits consortium: https://www.bath.ac.uk/campaigns/commercial-determinants-of-health-resource-hub/

Hi everyone and welcome back to Money Power Health. We often tend to think of our health as the product of our own energies, something we alone are accountable for. But in reality, our health is to a large degree shaped by the conditions we find ourselves in, the quality of our air, the wealth of our parents, the food we have access to, our opportunities for work, our time for exercise. Schools and education are a key part of this. Schools shape how we see the world and interact with each other at a critical stage in development. Most people might assume that schools are a place in which commercial influence is largely absent. That however is far from the case. Children are a key market, and brand loyalties formed in childhood can persist into adulthood, and standards of behaviour, of consumption, taste, and definitions of coolness, risk, fun are all being formed during this time. In part due to this, there is now a long history of the manufacturers of unhealthy products funding the development of lesson plans, initiatives and activities in primary and high schools that involve issues like fossil fuels, firearms, alcohol, gambling or smoking. This has significant strategic value, and in order to understand more about why this happens, and what it means for children and young people, I am very pleased to be joined by someone who has led on several studies examining the nature and purpose of such funded materials in schools. May van Schalkwyk is a research fellow in commercial determinant of health in the Global Health Policy Unit and Centre for Pesticide Suicide Prevention at the University of Edinburgh. She also has an honorary public health consultant role with Public Health Scotland and is an honorary research fellow at the London School of Hygiene and Tropical Medicine where she completed her PhD in 2023 and is a member of the commercial determinants research group. May originally trained as a clinical doctor and then specialised in public health medicine. Her research aims to explain how commercial actors influence ideas, knowledge, science and policymaking. She publishes research on the tobacco, alcohol, gambling, fossil fuels, opioid, pesticide and firearm industries, including on the influence of youth education and safety programmes as a form of corporate political activity. Full disclosure: May and I are good friends and go back some time, having met at the London School of Hygiene and Tropical Medicine, and worked together for over seven years researching the commercial determinants of health, including some of the articles we will be discussing. You can find out more about the topics we have discussed, including some of May's recent research articles, in the links below: Alcohol industry funded school programmes: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0259560https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(22)00341-3/fulltextGambling industry funded school programmes: https://academic.oup.com/heapro/article/39/1/daad196/7565070https://www.sciencedirect.com/science/article/pii/S235282732200101XLink to public-facing videos May has made about research on the commercial determinants of health: https://www.youtube.com/channel/UCfnKnt8BHlSgTIdK7jfGwfg

Hello everyone, and welcome back to Money, Power, Health with me, Nason Maani. This week we are speaking to Dr David Blane, a GP in Pollokshaws and Clinical Research Fellow at the University of Glasgow, and the academic coordinator of the Deep End GP network. As you know, in this podcast we have spoken about the ways in which the wider physical and social environments people find themselves in can profoundly shape their health, and how these environments are shaped by inequality and powerful commercial forces. In some ways, we have been talking about mich of what shapes health occurs outside of healthcare, and I have been contacted by clinicians who know only too well how frustrating it can be to attempt to treat patients, only to send them back into the conditions that made them sick, and to try to devote themselves to making their communities healthier, when those wider conditions are worsening, particularly for the most vulnerable. Yet, healthcare can, and should engage with these forces, and one example of an initiative that has sought to do so in inspirational and innovative ways, is the Deep end GP here in Scotland. Today I have the great privilege of speaking to Dr David Blane, senior clinical lecturer in General Practice and Primary care, and academic coordinator of the Deep End GP group in Scotland. Glasgow in particular suffers from extremely high levels of health inequality and deprivation, and it is there that The Deep End GP network, while pools the experience and ideas of GPs in the most deprived areas, was established with the goal of increasing advocacy, mitigating burnout, and providing practical, grassroots interventions to improve patient care in areas with the highest patient need. Together, we explore the origins of the project, how these relate to cost of living challenges, and how one keeps going in spite of sometimes challenging circumstances. I hope you enjoy the conversation. More information on the Deep End GP Network can be found below:The Scottish Deep End Project:https://www.gla.ac.uk/schools/healthwellbeing/research/generalpractice/deepend/Link to latest Deep End reports, manifesto and newsletters:https://www.gla.ac.uk/schools/healthwellbeing/research/generalpractice/deepend/reports/Davids profile:https://www.gla.ac.uk/schools/healthwellbeing/staff/davidblane/Julian Tudor Harts 1971 article on the inverse care law:https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(71)92410-X/fulltext

Hello and welcome back to Money Power Health. “Think global, act local!” “Be the change you want to see in the world!” “Every little bit counts!” We can all get on board with such sentiments, right? Well, todays guest Grant Ennis, would question that. He is the author of the book "Dark PR: How corporate disinformation undermines our health and the environment". In this new book, drawing on his experience working in the environmental, philanthropy, and public health sectors, he lays out the costs of commercial efforts to influence citizen action and discourse, individually and cumulatively. The book offers a wide-ranging appraisal of the narratives that he feels hold us back, the costs of our approaches to issues such as subsidies and tax breaks ,and, argues for the need to think more structurally, to organise, and to unite in broader coalitions if we wish to improve health in foundational, structural ways. I hope you enjoy the conversation. The book is available from Dajara Press in print or ePub: https://darajapress.com/publication/dark-pr-how-corporate-disinformation-harms-our-health-and-the-environment and from Audible as an audiobook: https://www.audible.co.uk/pd/Dark-PR-Audiobook/B0CCT1WMQ2 The publication he mentions led by Mark Petticrew is available here: https://jech.bmj.com/content/71/11/1078 and our related paper on the pollution of discourse and the need for effective counterframing is here: https://www.bmj.com/content/377/bmj.o1128 Dr. Terry Lynn Karl is the researcher he mentioned from Stanford in relation to electorialism: https://cddrl.fsi.stanford.edu/people/Terry_L_Karl The asian disease experiment was published here: Tversky, Amos, and Daniel Kahneman. "The framing of decisions and the psychology of choice." science 211, no. 4481 (1981): 453-458. The full quote from Arundhati Roy that he refers to is here: [the] whole idea of 'you have to be a saint first and then be political' is [a] way of making sure that a whole lot of people are not political.” (Roy, Arundhati. “Interview and Q&A with Arundhati Roy.” In Earth at Risk: Building a Resistance Movement to Save the Planet. Oakland, CA: PM Press, 2013) Music in the podcast was composed and performed by Daniel Maani. You can find out more about his music here: https://www.danielmaani.com

Hello everyone and welcome back to Money Power Health. As we have been discussing in previous episodes, health is to a large degree shaped by our social and physical environments. Public Health, as defined by Acheson, is “the science and art of promoting health, preventing disease, and prolonging life through the organized efforts of society.” Some of that art and science, in fact a lot of it, plays out at the level of local, rather than national government. In the UK, local authorities have statutory public health responsibilities carried out by teams of local public health professionals, led by a Director of Public Health. Directors of public health are responsible for determining the overall vision and objectives for public health in a local area. What’s so fascinating to me about public health in local authority settings is that it is at the coalface. DPHs and their teams have to work alongside a range of other local stakeholders and elected councillors who change over time. For many of them, health might be a secondary concern, or not even something they consider themselves affecting. The skills they apply in doing this, are unique, but incredibly important for many of us who care about money, power and health. This week we are talking about the practice of public health in local authorities, with Greg Fell. Greg Fell is the Director of Public Health in Sheffield, and Vice President of the Association of Directors of Public Health (ADPH). During the COVID-19 pandemic, DPHs like Greg and their teams faced enormous pressures in terms of their capacity, coordination, expertise and media presence. He is a leading voice in UK public health, and has an excellent blog where he pulls together a wide range of knowledge into bite-size, actionable chunks. In this podcast we cover Gregs journey into Public Health, what a Director of Public Health does, the state of health and health inequalities in Sheffield, what it was like working in a public health team during COVID-19, how to think pragmatically while mindful of the wider forces that shape health, what brings satisfaction in work of this type, what personal qualities one needs to be effective in that kind of local government setting, and what commercial determinants of health mean for public health at the local authority level. Huge thanks to Greg for sharing his candid reflections, he is a fountain of information. Link to Gregs blog: https://gregfellpublichealth.wordpress.com Link to ADPH website: https://www.adph.org.uk Link to the article on the pollution of discourse he mentioned: https://www.bmj.com/content/377/bmj.o1128.long Link to the Health Foundation’s excellent report on framing and health: https://www.health.org.uk/publications/a-matter-of-life-or-death Link to the citizens advice bureau he mentioned: https://www.nhs.uk/services/service-directory/sheffield-citizens-advice-bureau/N10977109 Link to Daniel Maani’s music: https://youtalktoomuch.band

Hi everyone, and welcome back to money power health, a podcast on how our health is influenced by wealth and power. As we discussed in our introductory episode with Sandro Galea, one of the main things that determines our health is the distribution of resources and opportunity, yet, when we think of data on health that might better inform decisions, we tend to focus on healthcare related data, on patients, disease prevalence, and risk factor epidemiology. This week I want to speak with someone who is trying to help decision-makers think more broadly, and more upstream, when it comes to data on health. As you will see my guest this week has already been at the heart of some very interesting work on inequalities and health, on who we think of, and whose voices we might include. Her own personal story is a testament to her tenacity, intelligence, and commitment to studying the causes and practical solutions to within and between country inequalities. This week I am speaking to Dr Salma Abdalla about going upstream, when it comes to data and decision-making. She is a Sudanese medical doctor, is an Assistant Professor in Global Health and Epidemiology at Boston University School of Public Health. She studies how data on the social, economic, and commercial determinants can be used to inform decision-making on health and health equity in different contexts. She also studies the effects of trauma on global population mental health. She has published over 50 scientific journal articles, co-authored 8 reports and policy briefs, and co-authored 9 book chapters. She was the Director of the 3-D Commission on Determinants, Data science and Decision making. She also served as a secretariat member for the WHO Independent Panel for Pandemic Preparedness and Response during the COVID-19 pandemic. Dr Abdalla was also engaged in advocacy efforts to incorporate the voices of young people in setting the global public health agenda for several years. She was elected the Secretary General of the International Federation of Medical Students Associations for the term 2013-2014. She was also named an emerging voice in global health in 2018 and a Moremi fellow for young women leadership in Africa in 2012. You can find out more about the 3D commission here: https://3dcommission.health The paper on global health scholarship we discussed is here: https://gh.bmj.com/content/5/10/e002884 The paper on CVD prevalence by wealth is here: https://pubmed.ncbi.nlm.nih.gov/32975572/ The paper that makes reference to "prisoners of the proximate" which I couldn't remember (!) is by AJ McMichael and is here: https://academic.oup.com/aje/article/149/10/887/172868 Thanks for listening as always.

Hello everyone, and welcome back to Money Power Health. As I mentioned in the first episode, part of the goal of this podcast is to bear witness to some of the hidden forces that shape health, and the extent to which they relate to money and power. Sometimes it is hard to perceive, but everything from the quality of the air you are breathing, to the bacterial count in your tap water, or your proximity to a firearm, affects your health, and is in large part a consequence of the distribution of money and power. And that isn’t just the case with the physical world. Many of us now also spend a large proportion of our lives and interact with others through social media. That digital world is shaped by commercial forces, just like the physical one is. The companies that produce these are sometimes incredibly large, and active political players, through funding political campaigns, co-designing and conducting research, and engaging in CSR efforts, including with UN organizations. Social media platforms are crucial conduits of information, and networks of influence, though often in highly selective and unequal ways. These are not simply utility providers.  In the case of much of social media, while the platform itself is an environment we inhabit and interact with, it is designed by a company that relies to a large extent on maximising engagement, data collection, and ad revenue, through our presence on it. There has been increasing interest in how social media algorithms may amplify or inadequately moderate harmful content, including hate speech and misinformation, or be used by harmful product manufacturers to promote their products, or shape public discourse. Research is now beginning to consider the ways in which social media companies, and platforms, might be regarded as commercial determinants of health, and since you probably found the podcast via social media, I thought it would be good to devote an episode to understanding some of the health implications that arise as a result of the nature, incentives, platforms and activities of social media companies, since they are responsible for an increasing portion of our social worlds. To do this, I have invited two guests. The first is Professor Nora Kenworthy. She is an associate professor in the school of nursing and health studies at the University of Washington, who has conducted a range of research projects on the health implications of crowd-funding platforms and social media more generally. Joining her is Marco Zenone, a researcher and doctoral candidate at LSHTM who’s studies focus on the intersection of public health, misinformation and marketing on social media. You can find an example of the work Nora referred to on crowdfunding here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8519036/ and an example of Marco's work here: https://onlinelibrary.wiley.com/doi/abs/10.1002/poi3.188 We wrote a short conceptual article on social media as a commercial determinant of health, which you can find here: https://www.ijhpm.com/article_4248_0357b3eafff74f9eec69cd6d310cd803.pdf The music in this podcast was by Daniel Maani. You can check out more of his music here: https://open.spotify.com/artist/4GDF0XnCn78nce0gesJoC7 and here: https://youtalktoomuch.band 

Welcome to Money Power Health, a podcast on how our health is influenced by commercial forces, wealth and power, hosted by Dr. Nason Maani, lecturer in inequalities and global health policy at the University of Edinburghs Global Health Policy Unit.  In this first episode, with the help of guest Professor Sandro Galea, Dean of Boston University School of Public Health, we introduce the podcast, and discuss the main themes in the podcast title. A link to the book mentioned at the start of the podcast is here: https://academic.oup.com/book/44473  And Sandro Galea's book entitled Well, which we also referenced, is here: https://global.oup.com/academic/product/well-9780190916831?cc=gb&lang=en&  You can find out more about Sandro Galea here: https://www.bu.edu/sph/profile/sandro-galea/  If you have any ideas for podcast guests or topics, you can email Nason here: nmaani@ed.ac.uk