The WHO–UNICEF–Lancet Commission1 identified an important threat to children’s health and futures by stating that children across the globe are exposed to exploitative advertising and marketing by the private sector. Fast food and sugar-sweetened beverages, alcohol, tobacco, e-cigarettes, breastmilk substitutes, and gambling, were positioned as the key products that children are increasingly exposed to and harmed by. However, by focusing on the marketing of particular so-called unhealthy products, the Commission has made a critical oversight. They failed to acknowledge that all marketing to children is potentially harmful to children’s health.

This omission in the report is the result of two interconnected issues: a taken-for-granted assumption that advertising is only unhealthy when the product being marketed to (and consumed by) children is unhealthy, coupled with research on marketing to children that continues to be framed by a narrow definition of health. For instance, there is a plethora of research that centres on the connection between food marketing and childhood obesity,2 yet seemingly little attention to how marketing strategies in general shape children’s emotional, mental, and spiritual selves. By defining health primarily in terms of physical health (the absence of disease, the attainment of certain lifestyles, or the production of the non-fat body), other meanings of health, wellbeing, and children’s lives (such as those of Indigenous cultures) might be ignored and subjugated.3

For decades, scholars and advocates have argued that children’s experience of childhood is eroded as societies become more commercialised and children are increasingly encouraged to become consumers.4 Others have illuminated how the commercialisation of childhood through pervasive and stealthy advertising tactics re-shapes children’s identities at the intersections of gender, sexuality, age, culture, ethnicity, and class.5 For these reasons, researchers and policy makers must shift the focus from merely the so-called unhealthy products that are being marketed to children and towards all products and industries— food, toys, clothing, technology, sports equipment, entertainment, and more.

Collectively, we need to critically interrogate how the commercial exploitation of children works to deliberately and insidiously re-shape children’s health, behaviours, knowledge, and identities. In this way, it does not matter so much whether the product being marketed is healthy or unhealthy in a physical sense, but how marketing encourages forms of consumption that are potentially harmful for the whole child, the planet, and children’s futures.

I receive funding from the Royal Society Te Apārangi Marsden Fund Fast-Start Grant to study how the marketing of health shapes children’s health knowledge, actions, and identities. I declare no competing interests.

Darren Powell

Faculty of Education and Social Work, University of Auckland, Auckland 1135, New Zealand

1 Clark H, Coll-Seck AM, Banerjee A, et al. A future for the world’s children? A WHO–UNICEF–Lancet Commission. Lancet 2020; 395: 605–58.

2 Cairns G, Angus K, Hastings G, Caraher M. Systematic reviews of the evidence on the nature, extent and effects of food marketing to children. A retrospective summary. Appetite 2013; 62: 209–15.

3 Powell D. Schools, corporations, and the war on childhood obesity: how corporate philanthropy shapes public health and education. London: Routledge, 2020.

4 Steinberg, S, ed. Kinderculture: the corporate construction of childhood, 3rd edn. Boulder, CO: Westview Press, 2011.

5 Kenway J, Bullen E, eds. Consuming children: education-entertainment-advertising. Buckingham: Open University Press, 2001.

Authors’ reply

We thank Darren Powell for his insightful feedback. Members of the WHO–UNICEF–Lancet Commission1 agree with Powell that marketing of any products to children might encourage potentially harmful consumption for the child, the planet, and children’s futures, and that more work in both academic and political spheres is needed to highlight the risks.1 Our Commission’s analysis of children’s wellbeing and rights extends to the dangers of the commercialisation of childhood.

Our proposal to add an Optional Protocol to the UN Convention on the Rights of the Child on commercial marketing of harmful products was designed to serve as a first step in protecting children from those who would sell them a lifetime of ill health. Our Commission identified a hierarchy of harm among products

and made the decision to focus on those that directly threaten children’s physical and mental health. Hence our focus on tobacco, alcohol, unhealthy foods, sugar-sweetened beverages, breastmilk substitutes, and gambling applications. Our proposal also targets the predatory data practices of large companies like Facebook and Google, which, without regulation, harvest and use children’s data for profit.2

We are clear-eyed about the opposition an Optional Protocol will face from powerful commercial entities and their political allies. Our goal is to build a coalition for children. Beginning with overt threats to physical and mental health would seem wise. It will be hard enough to tackle opposition from corporations promoting health-harming products. Imagine trying to fight opposition from a large coalition of companies that range from toys and games to technology and household products.

An Optional Protocol, if approved, would give law makers a framework to support national legislation, and the freedom to expand the scope of regulation if the government and voters agree. Additional tools will be needed to combat the ways in which marketing and consumerism negatively impact children’s development and identity.3 As on the issue of climate change, leadership from children and Indigenous activists will be critical to pushing forward this agenda.

We declare no competing interests.

*Anthony Costello, Sarah L Dalglish, Anshu Banerjee, Jeremy Shiffman, Helen Clark on behalf of the WHO–UNICEF–Lancet Commission

Institute for Global Health, University College London, London WC1N 1EH, UK (AC); Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA (SLD, JS); Department of Maternal Newborn Child and Adolescent Health, WHO, Geneva, Switzerland (AB); and The Helen Clark Foundation, Auckland, New Zealand (HC)

1 Clark H, Coll-Seck AM, Banerjee A, et al. A future for the world’s children? A WHO–UNICEF–Lancet Commission. Lancet 2020; 395: 605–58.

2 Children’s Commissioner. Who knows what about me? A Children’s Commissioner Report into the collection and sharing of children’s data. London: Children’s Commissioner of England, 2018.

3 Hill JA. Endangered childhoods: how consumerism is impacting child and youth identity. Med Cult Soc 2011; 33: 347–62.

Source: Vol 396 November 28, 2020

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