Target 3.4: Reduce non-communicable disease; promote mental health
By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being
Owners remove an obstacle nothing else removes. Others must also act.
Why shareholder democracy is necessary
NCDs killed at least 43 million people in 2021, 18 million of them before age 70. Just four commercial products (tobacco, alcohol, ultra-processed food and fossil fuels) account for an estimated 19 million deaths a year. That is 41 percent of NCD deaths. The products and marketing of listed companies therefore drive a large share of the preventable burden. The mental-health arm now traces to corporate conduct in court. A Los Angeles jury found in March 2026 that Instagram and YouTube were "deliberately built to be addictive" and liable for a young plaintiff's depression. In August 2026, Meta reportedly settled for approximately 17 billion dollars and agreed to teen-specific safety defaults. The settlement came eight days into a federal trial brought by 29 state attorneys general over features engineered to maximize minor engagement. In the United States, employers and their insurers also control access to mental health care itself. The Department of Labor's first-ever parity enforcement suit found UnitedHealthcare systematically cut reimbursement to mental health providers by 25 to 35 percent. The suit also found that UnitedHealthcare ran an algorithm to deny outpatient psychotherapy while sparing comparable medical care. Owners of insurers and self-insured employers can end these practices. Corporate lobbying blocks the prevention side too. WHO's treaty secretariat calls tobacco industry interference the single greatest obstacle to tobacco control. The Interfaith Center on Corporate Responsibility has taken tobacco, a leading driver of these deaths, to the proxy ballot; its members filed a 2016 resolution asking Walgreens' board to review the risks of continuing tobacco sales in its pharmacies. India's food regulator dropped front-of-pack warning labels in 2026 after Coca-Cola and other industry executives argued against them. The arithmetic of a one-third mortality reduction still runs through actors owners cannot direct. Modeled pathways depend on hypertension treatment and cancer screening delivered by health systems. Some 82 percent of premature NCD deaths occur in low- and middle-income countries, and state-owned China National Tobacco holds 43.6 percent of the world cigarette market. Owners supply a necessary input and remove documented obstacles while governments and health systems must deliver the rest.
How this was scoredNecessary
Necessary. Owners remove an obstacle nothing else removes. Others must also act.
We have not yet written down the two answers behind this rating. Recording them on every item, so a reader can check the reasoning and not only the conclusion, is work in progress.
Every rating is the higher of two answers, one for what companies do and one for what they spend to stop the outcome, because the same vote reaches both. See the full method.
Sources
- Noncommunicable diseases, World Health Organization, 2025-09-25
- Defining and conceptualising the commercial determinants of health, The Lancet, 2023-04-08
- Vision, mission and strategic context (tobacco industry interference), WHO Framework Convention on Tobacco Control Knowledge Hub, n.d.
- India wanted warning labels on chip packets, soda but big food fought back, Business Standard, 2026-08-25
- Jury finds Meta and Google negligent in social media harms trial, NPR, 2026-03-25
- Reducing Premature Mortality from Cardiovascular and Other Non-Communicable Diseases by One Third: Achieving Sustainable Development Goal Indicator 3.4.1, Global Heart, 2020-07-30
- What is China Tobacco?, OCCRP, 2021-06-22
- 29 States Take Meta to Trial: First Federal Social-Media MDL Case Reaches a Jury, MDL Update, 2026-08
- U.S. Department of Labor Settles Unprecedented Lawsuit Against United Healthcare for Violations of the Mental Health Parity and Addiction Equity Act, Epstein Becker Green, 2021-08
- Shareholder Resolution Challenges Walgreens on Continued Sales of Tobacco, Interfaith Center on Corporate Responsibility, 2016-08-25
What civil society organizations are helping owners on this
Publicized its members' 2024 shareholder proposal at Meta on child safety, filed by Fiduciary Trust International with shareholder Lisette Cooper.
Coordinated investor resolutions at Tesco in 2021 and Unilever in 2022 asking the companies to set targets for growing the share of sales from healthier products, both withdrawn after the companies made commitments.
Unilever shareholder campaign wins industry-leading health transparency, ShareAction, 2022-03
Files child safety proposals at Meta on behalf of Lisette Cooper, most recently a 2026 proposal to tie executive pay to child safety improvements, citing court findings on addictive design and mental health harm.
4 campaigns on record
Assess the feasibility of tying senior executive compensation to improvements in child safety on its platforms.
With 13 faith-based and institutional investors holding about 800 million dollars of Meta stock
Result: not stated in source; prior child safety proposals at Meta received up to 59 percent support from independent shareholders
Disclose sales against government-endorsed nutrient profile models and adopt ambitious targets to increase sales of healthier products.
With Candriam, ACTIAM, Trinity Health, Guy's & St Thomas' Foundation, CCLA Investment Management, Greater Manchester Pension Fund
Result: Withdrawn after agreement
Unilever committed to measure and publish sales against government-endorsed nutrient profile models globally and for 16 key markets, and to set new targets by October 2022.
Unilever shareholder campaign wins industry-leading health transparency, ShareAction, 2022-03
Disclose the share of sales from healthier products and set a target and strategy for significantly increasing it by 2030 with annual progress reports.
Result: Withdrawn after agreement
Tesco committed to raise healthier product sales from 58 to 65 percent of UK sales by 2025 and extended the pledge across its UK, Ireland, Central European and Booker businesses.
Shareholders hail landmark victory after Tesco expands junk food pledge, Retail Gazette, 2021-05
Report within six months on the financial risk, including long term legal and reputational risk, of continuing to sell tobacco products in the company's stores.
With Sisters of St. Joseph of Peace, Sisters of the Humility of Mary, Sisters of Charity of St. Elizabeth, Trinity Health
Result: It never reached a vote. Walgreens asked the Securities and Exchange Commission for permission to leave the proposal out of its proxy, and the staff said it would not object to the company omitting it as a matter of ordinary business under Rule 14a-8(i)(7). The company's report of the January 26, 2017 annual meeting lists no tobacco proposal among the six items voted on.
We found no documented change. Walgreens continued to sell tobacco.
Related subjects on other maps
How this rating was made
Every item on every one of our maps is read against one question: how far does this depend on the people who own companies voting their values? We answer it twice, once for what companies do and once for what they spend to stop the outcome, and take whichever answer is higher, since the same vote reaches both. The score carries its reasoning and its sources so that a reader can check it rather than take it.
- Pivotal. Owners voting their values can deliver most of the outcome.
- Necessary. Owners remove an obstacle nothing else removes, and others must also act.
- Helpful. Owners voting their values help, and others carry most of it.
- Independent. This moves without owners. Other levers carry it.
The advocacy record on this page holds only what a source we opened says happened. Where we searched and found nothing, the page says so rather than leaving a silence. Where a campaign names a filer the source does not name, it says that too. Ratings are ours; the list of subjects is UN Sustainable Development Goals's, and we link to their original.
How we score dependency, in full.