The US government’s assertive use of import tariffs means the health implications of trade policy can no longer be sidelined, warn experts publishing in The BMJ.

Dr Courtney McNamara at Newcastle University and Dr Benjamin Hawkins at the University of Cambridge say given how deeply trade policy shapes the conditions for health, “health considerations must be treated as integral to trade policy rather than a peripheral concern.”

Robust research shows how trade policy can influence factors such as access to medicines, exposure to harmful commodities like tobacco products, availability and affordability of food, and wider determinants of health such as employment, they explain. 

And although the US could see benefits if domestic jobs are protected or demand for imports that are harmful to health is reduced, evidence suggests short term harms, both in and outside the US, through higher medicine costs, volatile food prices, and increased economic uncertainty.

Yet effects on health are often neglected in trade policymaking, say the authors.

Dr McNamara said: “Trade policy can sound distant and technical, but it shapes everyday life — the price and availability of medicines, what food costs in the supermarket, and whether people feel secure in their jobs.

“This research helps make those hidden links visible, so decisions about tariffs and trade are judged not just by economic outcomes, but by what they mean for people’s daily lives and, ultimately, their health.”

Health effects neglected in trade policy making

Trade agreements they note, are often negotiated behind closed doors, are highly technical, and couched in esoteric legal terminology, making it hard for public health professionals and the wider public to engage with or scrutinise their implications.

What’s more, the effects of these agreements are often spread over a large area and large number of people (diffuse), indirect, and only become evident over time, making their health effects hard to isolate or to attract meaningful attention from health advocates.

They argue that the US tariffs should serve as a wake-up call for the health community and that health representatives need to be involved at all stages of trade policymaking, not only to advance and protect public health but also to counter the influence of powerful commercial interests.

They acknowledge that it’s not easy to embed health considerations within formal trade policymaking, but say academics and researchers have a key role in generating systematic evidence of - and attention to - the health effects of trade policy.

At the same time, they point out that trade policymakers must recognise that protecting health is not only compatible with trade objectives, but also essential to their legitimacy and long term success.

“Ensuring that trade decisions support health is not only the right thing to do, but a strategic imperative for building resilient economies,” they conclude.

Reference: Analysis: Why US import tariffs matter for health doi: 10.1136/bmj-2025-086271
Journal: The BMJ  https://www.bmj.com/content/392/bmj-2025-086271

(Courtesy of and adapted from The BMJ )