A new paper in The New England Journal of Medicine is reframing how we think about the rise in chronic diseases and who, or what, is driving it. Instead of solely focusing on the health impact of individual lifestyle choices, such as eating more fiber or less fat, the researchers behind the article argue we should look at the role powerful market forces play in making those choices.

In other words, it's time to spotlight the industries producing everyday products, from those created from fossil fuels to the lure of ultra-processed foods, that play a central and often overlooked role in shaping global health.

The authors argue we should spotlight the role powerful market forces play in our making those choices.

Similar to how we refer to infectious agents, the international team of researchers characterizes these industries as “vectors” of disease.

The paper marks the first time the journal has explicitly identified corporations that manufacture and market health-harming products as primary drivers of non-communicable chronic diseases.

The scope of the problem is vast. Chronic disease, including cancer, diabetes, and neurocognitive disorders now account for the overwhelming majority of deaths worldwide.

The study highlights five major commercial contributors:

Together, these are linked to nearly one-third of all global deaths. The researchers did not conduct a traditional clinical trial. Instead, they synthesized decades of epidemiological data, public health records and internal industry documents, particularly from tobacco companies , to trace patterns between corporate practices and disease outcomes. This approach allowed them to examine not just what is making people sick, but how industries have historically shaped public perception, scientific research and regulatory policy.

“The global increase in certain chronic diseases is startling,” lead author, Dr. Nicholas Chartres of the University of Sydney and lead scientific advisor at the Center to End Corporate Harm, said in a press release. “Increases in health-harming products mirror the rise in certain chronic diseases to a disturbing extent. Chronic diseases now account for 74% of deaths around the world.”

The parallels to smoking cigarettes are worth noting. Internal documents revealed that tobacco companies knew for decades about the dangers of smoking and nicotine addiction but worked actively to obscure those risks. According to the report's authors, similar strategies are now being used across other industries, funding research that downplays harm, lobbies against regulation and sows doubt about harm in the public's mind.

This pattern is not accidental, but systemic, co-author Tracey J. Woodruff and co-founder of the Center to End Corporate Harm at the University of California, San Francisco, explained. Industries deploy a consistent playbook to protect profits, even when public health is at stake.

Industries producing everyday products, from fossil fuels to ultra-processed foods, play an often-overlooked role in shaping global health.

It's not all bad news. The study also points to a hopeful precedent. For instance, once the truth about tobacco's harms became widely known, the policy changes that followed — taxation, advertising restrictions, smoke-free laws and public education campaigns — are credited with saving an estimated 37 million lives.

The authors believe similar strategies could be applied more broadly. What are their proposed solutions? Among them, creating international treaties to limit corporate influence on health policies, establishing financial relationships between researchers and health-harming industries.

Importantly, the paper calls on clinicians, researchers, journalists and policymakers to shift their lens. Rather than placing the burden solely on individuals to make healthier choices, there must be greater scrutiny of the systems and structures that shape those choices in the first place.

For consumers, the message is both sobering and empowering. Understanding how policies are marketed, and how risks may be minimized, can help people make more informed decisions. But the authors are clear: meaningful change will require action at a policy level.

In the end, this study is less about blame and more about clarity. By naming the corporate drivers of disease, it opens the door to new conversations and potentially more effective solutions for some of our most pressing health challenges.