Chronic diseases and injuries are the leading causes of premature death and preventable illnesses in the United States and around the world. Injuries cause many unnecessary deaths among young adults and children. Traffic crashes hurt 50 million worldwide each year, and firearms and alcohol are also leading threats. Meanwhile, half of all Americans suffer from chronic conditions like heart disease, diabetes, and cancer that account for seven out of every ten deaths and eat up three-quarters of health care dollars. By 2030, chronic diseases will cause more than three quarters of deaths worldwide, costing some $47 trillion over the next two decades.

Conventional wisdom attributes the growth of injuries and chronic illnesses to seemingly inevitable causes such as population aging and changing lifestyles. Such forces are at work, of course, but it is the task of public health scientists like me to probe more deeply.

A closer look reveals that many unnecessary injuries and chronic health problems are spurred by what might be dubbed the “corporate consumption complex” – a network of consumer products companies, financial institutions, trade associations, and public relations firms that deliberately urges people to buy unhealthy foods and unsafe products. In 1961, President Dwight Eisenhower warned that the military industrial complex posed a danger to our democracy and well-being. Today, the consumption complex constitutes a similarly grave threat.

Promoting Consumption No Matter What

Businesses have produced and sold consumer goods for more than 200 years, but since the 1970s, corporations have stepped up efforts to push mass consumption of unregulated or lightly regulated products known to have adverse effects on public health. Antiregulatory lobbying gained force in response to the popular movements of the 1960s and 1970s pushing for environmental reforms, health and safety rules, and other improvements. And a changing global economy has since offered fresh profit opportunities to companies that can market consumer products on a global scale. Through lobbying, campaign contributions and the revolving door between government and business, giant corporations – including processed food and alcoholic beverage producers, gun manufacturers, and vehicle manufacturers – shape legislation, court decisions and government regulations to enable them to exploit such new profit opportunities to the hilt. Close corporate ties to the media and universities enable the companies in the consumption complex to mold public opinion and frame policy choices. This same era has witnessed a weakening of forces that once challenged unsafe corporate practices – faltering labor unions, disappearing independent journalists, waning consumer safety movements, and the decline of politicians willing to speak for ordinary voters rather than corporate interests.

In this imbalanced political world, corporations work virtually unchecked to promote lifestyles reliant on the purchase of highly profitable products that contribute to premature death and preventable illnesses and injuries. A few examples show what I mean:

• In the 1990s, Ford, General Motors and Chrysler developed and heavily promoted sports utility vehicles – which were much more profitable than smaller cars and enjoyed trade protection from European and Japanese carmakers. Unfortunately, these vehicles also polluted more than sedans and were more likely to roll over, causing serious injuries or deaths. By the 1990s, sports utility vehicles contributed to 3,000 excess deaths a year.
• When alcohol consumption among men declined in the late 20th century, Diageo, the world’s largest alcohol company, introduced Smirnoff Ice, a vodka drink targeted to young women, portraying it as a path to glamour and sophistication. Over the next decade, the company’s sales of all vodka products doubled, more than replacing the lost male market. As one alcohol executive told Advertising Age, “the beauty of this category is that it brings in new drinkers, people who really don’t like the taste of beer.” The result? According to the Center for Disease Control, in 2013, a third of female seniors in high school reported that they had engaged in binge drinking at least once in the past month, up from just over one in four in 2011. Each year, 25,000 women and girls die from alcohol-related causes.
• In the United States over the last 40 years, public health measures including taxes, smoking bans and educational campaigns have helped to cut tobacco smoking by half. But in response, global tobacco companies pursue marketing practices in Africa, Asia and Latin America that would be illegal in the United States. Researchers estimate that, after tobacco use caused 100 million premature deaths worldwide during the 20th century, it will cause one billion such unnecessary deaths in the 21st century, as smoking is aggressively pushed for consumers in low and middle income nations.

What Can be Done?

In the past, progress in public health has resulted from joint efforts by social movements and reform-oriented policy makers. Such twin efforts enabled governments to promote clean water and air, and ensure better working conditions and safer supplies of food and medicines. As a result, America and the world saw a sharp reduction in unnecessary deaths across the twentieth century and improvements in consumer and environmental protection after the 1960s. Today, millions of people are again mobilizing worldwide to demand safer and more affordable foods and medications, less polluting forms of transportation, and trade rules that protect the environment and workers. So far, diverse movements take on one industry or product at a time. But they could come together to press shared goals, including rules requiring corporations to disclose the health consequences of their products and business practices – and cover the costs of dealing with adverse consequences. Other important reforms would include global standards for safe product design and honest marketing, and stronger health monitoring based on publicly available scientific knowledge. To make progress, strong democratic movements must prevent corporations from leveraging huge profits to manipulate government officials and distort democratic processes. We do not yet know when or exactly how movements and activists will achieve breakthroughs. But we do know that business as usual can only bring rising health burdens and environmental damage. The time to act is now. The world saw a sharp reduction in unnecessary deaths after the 1960s due to the reform of consumer and environmental protection.

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Read more in Nicholas Freudenberg, Lethal but Legal: Corporations, Consumption and Protecting Public Health (Oxford University Press, 2014).