severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, has spread globally, leading to more than 2 million confirmed cases (with the true prevalence of infection unknown but certainly much higher) and nearly 200,000 deaths. 1 In the early stages of the pandemic, cases were largely concentrated in the Wuhan province of China, and subsequently northern Italy, with the World Health Organization (WHO) labelling Europe as the epicenter of the pandemic as recently as March 13th. 2 However, as the pandemic progressed, the epicenter moved to the United States, with case numbers surpassing those in China by March 26th, and at the time of writing, standing at nearly four times the total confirmed cases of any other country. 1 It seems clear that the United States was not only ill-prepared and poorly positioned to deal with COVID-19, 3 but also uniquely susceptible to the spread of this illness. The rapid increase in cases, the escalating pressures on hospitals, and the latest modelling estimates suggest that the United States will bear the brunt of COVID-19 related harm as compared to many other high-income nations. It is prudent that we ask why this might be the case, particularly considering the status of the United States as the world's wealthiest country. While the predominant focus of public debate has been on political decision-making as the pandemic unfolded, this narrative fails to acknowledge additional longstanding exacerbating features in the United States that laid the ground for greater spread and slower containment of SARS-CoV-2. As with any such event, assessing the precise causes is a complex issue, but there are two important trends that we consider central to the United States'

Introduction and Aims. Alcohol consumption increases the risk of several types of cancer, including several common cancers. As part of their corporate social responsibility activities, the alcohol industry (AI) disseminates information about alcohol and cancer. We examined the information on this which the AI disseminates to the public through its 'social aspects and public relations organizations' and related bodies. The aim of the study was to determine its comprehensiveness and accuracy. Design and Methods. Qualitative analysis of websites and documents from 27 AI organisations. All text relating to cancer was extracted and analysed thematically. Results. Most of the organisations were found to disseminate misrepresentations of the evidence about the association between alcohol and cancer. Three main industry strategies were identified: (i) denial/omission: denying, omitting or disputing the evidence that alcohol consumption increases cancer risk; (ii) distortion: mentioning cancer, but misrepresenting the risk; and (iii) distraction: focussing discussion away from the independent effects of alcohol on common cancers. Breast cancer and colorectal cancer appeared to be a particular focus for this misrepresentation. Discussion and Conclusions. The AI appears to be engaged in the extensive misrepresentation of evidence about the alcohol-related risk of cancer. These activities have parallels with those of the tobacco industry. This finding is important because the industry is involved in developing alcohol policy in many countries, and in disseminating health information to the public, including schoolchildren. Policymakers, academics, public health and other practitioners should reconsider the appropriateness of their relationships to these AI bodies. [Petticrew M, Maani Hessari N, Knai C, Weiderpass E. How alcohol industry organisations mislead the public about alcohol and cancer. Drug Alcohol Rev 2018;37: [293][294][295][296][297][298][299][300][301][302][303]

Background The term ‘commercial determinants of health’ (CDOH) is increasingly focussing attention upon the role of tobacco, alcohol and food and beverage companies and others—as important drivers of non-communicable diseases (NCDs). However, the CDOH do not seem to be clearly represented in the most common social determinants of health (SDOH) frameworks. We review a wide range of existing frameworks of the determinants of health to determine whether and how commercial determinants are incorporated into current SDOH thinking. Methods We searched for papers and non-academic reports published in English since 2000 describing influences on population health outcomes. We included documents with a formal conceptual framework or diagram, showing the integration of the different determinants. Results Forty-eight framework documents were identified. Only one explicitly included the CDOH in a conceptual diagram. Ten papers discussed the commercial determinants in some form in the text only and fourteen described negative impacts of commercial determinants in the text. Twelve discussed positive roles for the private sector in producing harmful commodities. Overall, descriptions of commercial determinants are frequently understated, not made explicit, or simply missing. The role of commercial actors as vectors of NCDs is largely absent or invisible in many of the most influential conceptual diagrams. Conclusions Our current public health models may risk framing public health problems and solutions in ways that obscure the role that the private sector, in particular large transnational companies, play in shaping the broader environment and individual behaviours, and thus population health outcomes.