Research into the dynamics of the fight against market-driven epidemics

A case definition of market-driven epidemics (MDEs) could help address critical barriers to timely, effective prevention and mitigation, according to a study published in this week PLOS Global Public Health by Jonathan Quick from Duke University School of Medicine, USA, and colleagues.

The misuse and overconsumption of certain consumer products have become major global risk factors for premature deaths at all ages, with a total cost in trillions of dollars. Progress in reducing these types of deaths has been difficult, slow and too often unsuccessful. To address this challenge, Quick and colleagues introduced a case definition of MDEs, which arise when companies aggressively market products with proven harm, deny these harms, and actively resist mitigation efforts.

To demonstrate the application of this concept, the researchers selected three MDE products: cigarettes, sugar and prescription opioids. Based on the history of these three epidemics, the researchers described five MDE phases: market expansion, evidence of damage, business resistance, mitigation, and market adjustment.

From peak consumption to the most recent data available, U.S. cigarette sales fell 82%, sugar consumption fell 15%, and prescription opioid prescriptions fell 62%. In both cases, the tipping point for consumption occurred when compelling evidence of harm, professional alarm, and an authoritative voice in public health or public mobilization overcame the impact of corporate marketing and resistance efforts.

Across the three epidemics, the gap between the suspicion of harm and the consumption tipping point ranged from one to five decades – much of which was due to the time required to generate sufficient evidence of harm. Market adaptation to reduced consumption of target products had both negative consequences (e.g., a geographic shift in companies’ marketing efforts) and positive consequences (e.g., a consumer shift toward sugary drinks).

According to the authors, this is the first comparative analysis of three successful attempts to change the product consumption patterns of millions of people – and over time some of the associated negative health consequences of these products. The MDE epidemiology approach to shortening the latent time between phases provides the global healthcare community with a new method to address existing and emerging potentially harmful products and their health, social and economic impacts.

While the specific product and circumstances are unique to each MDE, understanding the epidemiology of consumption and health consequences, and epidemic milestones, should help public health leaders combat current MDEs and prevent future MDEs to recognize more quickly. Given the similar patterns among different MDEs, public health leaders, researchers, civil society, and others can apply the mitigation strategies presented in the review article to save lives and reduce the impact of persistent and emerging MDEs.

The authors add: “The use of cigarettes and other unhealthy products costs the world millions of lives and trillions of dollars every year. An analysis of U.S. progress against three such market-driven epidemics shows that we can save lives with earlier, more decisive action. by public health leaders, researchers and public mobilization.”

They conclude: ‘The use of cigarettes and other unhealthy products often follows patterns similar to infectious disease epidemics, causing widespread harm before any public health response occurs. We can save lives by identifying these market-driven epidemics earlier and acting more decisively to control them. “