The Catch-22 Of Partnership


November 11, 2012 by Sarah S.

“At the time, it never crossed my mind that marketing 40-ounce bottles (yes, 40 ounces, more than half a six-pack) of a more potent alcoholic beverage […] to inner-city customers, primarily African-Americans with higher than typical unemployment levels might be—there is no other way to put it—more than a little irresponsible.”

As I began to explore the question of whether the food industry could be a friend to public health, this quote from Hank Cardello in Stuffed continually crept into my mind. Granted, this story took place some time ago and we’ve come along way in general knowledge about the detrimental effects of marketing certain products to vulnerable populations. But, the cynic in me still cries out that any industry led by people who honestly never considered that this marketing strategy could be harmful has a long way to go before it can be considered a friend to public health.

Even if we take a more optimistic view, there are several issues that must be resolved before the food industry and public health can truly work together to improve the health of our citizens.  Probably the most important (and most obvious) hurdle is that the food industry is going to act in the interest of making a profit — to expect them to behave any differently would be unrealistic. And this, I believe, is the Catch-22 of public/private partnership:

If the food industry is going to make sweeping changes to improve the foods and beverages it markets, these changes must be profitable. To be profitable, the public health sector must first succeed in convincing people to demand and choose the healthier options over the less healthy ones. But, for widespread success, the public health sector must have funding (often from industry, introducing a potential for duplicity) and must fight against the advertising and promotion of the profitable, less-healthy options.

For example, I took this picture at the store yesterday. We have an up-hill battle if we’re fighting against double-decker Oreos…

It seems to me that, in light of the profit-driven reality of industry, one of the first steps in moving toward public-private partnerships is for the public health world to think critically about how industry can benefit from working alongside public health and then to communicate that message to industry leaders effectively. The process of working together might begin as participation and interaction between these two groups that could progress to true partnership in the future. (For a description of the difference between participation and partnership, see this viewpoint from the European Commission on public-private partnerships).

While I’m not sure that this point in time will be reached anytime soon, it seems that the major chronic health problems plaguing our society won’t be controlled until the general population internalizes the message that they need to eat less of the readily-available, nutrient-poor foods that stock the shelves OR until the food industry stops stocking the shelves with this type of food. The difficulty lies in the fact that neither of things will happen without the other also occurring. I’m at a loss for solutions – does anyone else have ideas?


Cardello, H. (2009). Stuffed: An insider’s look at who’s really making America fat. New York: Harper Collins Publishers.

Hawkes, C., Buse, K. (2011). Public health sector and food industry interaction: it’s time to clarify the term ‘partnership’ and be honest about underlying interests. European Journal of Public Health, 21(4), 400-403.


3 thoughts on “The Catch-22 Of Partnership

  1. blistenfelt says:

    I agree with everything that you said here, but I have an additional question. Can public health successfully promote a message of eating more fruits and vegetables (and other less refined foods) while at the same time trying to pad food industry wallets by encouraging “healthier” packaged and industrialized foods? Is this the future we foresee for public health nutrition? While packaged foods are certainly here to stay in American diets, I can’t help but think that there has to be a better way to promote public health and good nutrition without moving towards what could be a very slippery slope. By engaging in a public-private partnership with the food industry, what does public health as an agency really have to gain? Whether food companies increase their profits or not, public health agencies are unlikely to see any financial benefit from the partnership. Additionally, I am skeptical that relatively minor changes by food companies will significantly impact obesity or other chronic conditions and disease, the ultimate goal of public health. While a public-private partnership sounds like a great idea, I’m not sure if the effort involved is worth the outcome.

  2. hpworley says:

    When did they come out with Double Decker Mint Oreo’s? Seriously? I think you defined the delicate nature of this relationship very well by stating that while we should hope for some form of partnership, we have to be realistic that profit will always be the number one priority for the food industry. I appreciate your presentation of it being a circular relationship, with action from one relying on demand from the other. What I continue to struggle with is what are we really asking from the food industry? Make healthier processed food? Push low-fat Oreo’s over Double Stuffed Oreo’s? Stop advertising Oreo’s? I would venture to say that most American’s know that Oreo’s are not on the diet plan for perfect health or weight loss and even without them being advertised, know they’re out there. And they buy and eat them anyways (including me, I really might have to try those Oreo’s, how’s that for effective advertising and unintended consequences!). A review of Nabisco’s website indicates there are 46 different kinds of Oreo’s/Oreo packaging (1)! Can we expect Nabisco will quit developing new variations of Oreos? Probably not. It’s a muddled and dubious relationship. While monetary support from an industry with so much income would be beneficial to allow better reach of our messages, it allows outside voices to alter that message. I’m with you, there is no easy solution and I don’t know what it is either…

    1) (2012). Oreo. Retrieved from

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