The influence of corporate market power on health: exploring the structure-conduct-performance model from a public health perspective

Abstract

Background The detrimental impact of dominant corporations active in health-harming commodity industries is well recognised. However, to date, existing analyses of the ways in which corporations influence health have paid limited attention to corporate market power. Accordingly, the public health implications of concentrated market structures, the use of anti-competitive market strategies, and the ways in which market power mediates the allocation and distribution of resources via market systems, remain relatively unexplored. To address this gap, this paper aimed to identify and explore key literature that could inform a comprehensive framework to examine corporate market power from a public health perspective. The ultra-processed food (UPF) industry was used to provide illustrative examples. Methods A scoping review of a diverse range of literature, including Industrial Organization, welfare economics, global political economy and antitrust policy, was conducted to identify important concepts and metrics that could be drawn upon within the field of public health to understand and explore market power. The Structure-Conduct-Performance (SCP) model, a guiding principle of antitrust policy and the regulation of market power, was used as an organising framework. Results We described each of the components of the traditional SCP model and how they have historically been used to assess market power through examining the interrelations between the structure of industries and markets, the conduct of dominant firms, and the overall ability of markets and firms to efficiently allocate and distribute the scarce resources. Conclusion We argue that the SCP model is well-placed to broaden public health research into the ways in which corporations influence health. In addition, the development of a comprehensive framework based on the key findings of this paper could help the public health community to better engage with a set of policy and regulatory tools that have the potential to curb the concentration of corporate power for the betterment of population health.

Maximising the wealth of few at the expense of the health of many: a public health analysis of market power and corporate wealth and income distribution in the global soft drink market

“…Nevertheless, the kind of analysis presented in this paper is likely to serve as a useful point of departure for the development of a broad-based interdisciplinary research program aimed at comprehensively assessing the ways in businesses and markets influence public health and health equity. Future work could, for instance, incorporate assessments of how markets contribute to social equity, respect human rights, provide social needs, promote the development of innovations that provide real social benefits, encourage human creativity and freedoms, and influence and co-evolve with the socio-political institutions within which they are embedded [ 68 , 136 – 139 ]. Such work could also incorporate planetary health outcomes, such as impacts on ecological systems and processes, and impact on animal welfare [ 136 , 140 ].…”

“…A range of dimensions and indicators were descriptively analysed to explore market power and corporate wealth and income distribution (see Table 1 for a summary of the indicators, levels of analysis and methods used) [ 68 ]. These dimensions are discussed in further detail in the following sections.…”

“…We analysed market capitalization values from 1962 to 2019 (based on available data). Market capitalization is a commonly used measure of the value of a company that is traded on a stock market, calculated by multiplying the total number of shares by the present share price [ 68 ]. It is typically understood to represent the expected future profits of a company, taking into account risks, and discounted to the present [ 80 ].…”

“Protein” Industry Convergence and Its Implications for Resilient and Equitable Food Systems

“…As one example, the marketing efforts that have accompanied these trends frequently promote one-sizefits all or "neoliberal diets, " which may homogenize previously diverse food cultures, as well as increase consumption of less nutritious, ultra-processed products (Winson, 2013;Otero, 2018). In conjunction with multilateral trade agreements that favor dominant firms (Wood et al, 2021), such changes contribute to loss of domestic producers and increases in the prices that consumers pay for less processed domestic foods (Werner et al, 2019). A better understanding of the constraints on individuals and households to make dietary choices that reflect their values, and the role of dominant firms in structuring food access and availability to enact such constraints, is needed (Hendrickson and James, 2016).…”

Market concentration and the healthiness of packaged food and non-alcoholic beverage sales across the European single market

“…Market structure describes the degree at which competition takes place between different companies for specific goods and services within (product) markets (11,12) . A key metric to assess the market structure and power of companies is market concentration (13) .…”