Toward Monitoring and Addressing the Commercial Determinants of Health: Where Can We Go From Here?

Tags:
Early View Perspective
Topics:
Commercial Determinants of Health

Policy Points:

  • We describe ways to advance two key priorities related to the commercial determinants of health (CDH): the development of systems to monitor commercial practices and the creation of policy recommendations to address the CDH.
  • Specifically, we discuss corporate nonfinancial reporting as a potential mechanism to obtain data on commercial practices that influence population health, describe the potential risks and benefits, and propose opportunities to advance high-quality corporate reporting on health impacts.
  • We also review previous global agenda-setting exercises to suggest five key considerations to inform the World Health Organization’s forthcoming policy recommendations for addressing the CDH.

In the last two decades, the concept of the commercial determinants of health (CDH) has become an increasingly common lens for understanding the causes of adverse health outcomes and their distribution across populations. In a recent Lancet series on the CDH, Gilmore and colleagues defined the CDH as “the systems, practices, and pathways through which commercial actors drive health and equity.”1 The study of these systems, practices, and pathways has been informed by the work of civil society organizations that have tackled these issues for many decades.2, 3 More recently, the CDH concept has been incorporated into public health practice and policy in some jurisdictions, such as within Australia’s National Preventive Health Strategy.4, 5 Efforts to advance the theoretical and practical use of the CDH concept have faced a myriad of challenges that include insufficient funding, a lack of attention to commercial practices within public health education programs, a lack of metrics for measuring commercial activities and assessing impacts, a diverse and complicated commercial sector, and industry opposition and intimidation.2, 6-8 Despite these challenges, the CDH concept has the potential to be a useful tool to overcome some of the key barriers the field of public health has faced in promoting healthier communities and improving health equity (e.g., advancing policies that challenge entrenched interests).9, 10

In this article, we seek to advance discussion on two key priorities related to the CDH: 1) the development of mechanisms to measure and monitor the practices of commercial entities, and 2) the development of effective policy recommendations for addressing the CDH.

References

1

Gilmore ABFabbri ABaum F, et al. Defining and conceptualising the commercial determinants of healthLancet (London, England)2023401(10383): 11941213https://doi.org/10.1016/S0140-6736(23)00013-2

2

Freudenberg NLee KBuse K, et al. Defining priorities for action and research on the commercial determinants of health: a conceptual reviewAm J Public Health2021111(12): 22022211.th

3

Townsend BJohnson TDRalston R, et al. A framework of NGO inside and outside strategies in the commercial determinants of health: findings from a narrative reviewGlobal Health202319(1): 74https://doi.org/10.1186/s12992-023-00978-x

4

Parker MWhat are the commercial determinants of health, and why do they matter? Intouch Public Health. April 13, 2023. Accessed May 13, 2024. https://intouchpublichealth.net.au/what-are-the-commercial-determinants-of-health-and-why-do-they-matter/e

5

World Health Organization; Small Island Developing States Health; Pan American Health Organization2023 Bridgetown Declaration on NCDs and mental health. December 12, 2023. Accessed June 29, 2024. https://www.who.int/publications/m/item/2023-bridgetown-declaration-on-ncds-and-mental-health

6

Burgess RNyhan KDharia NFreudenberg NRansome YCharacteristics of commercial determinants of health research on corporate activities: a scoping reviewPLoS One202419(4):e0300699. https://doi.org/10.1371/journal.pone.0300699

7

Freudenberg NCrosbie ETeaching the commercial determinants of health. In: N MaaniM PetticrewS Galea, eds. The Commercial Determinants of Health. Oxford University Press; 2023https://doi.org/10.1093/oso/9780197578742.003.0031

8

Lacy-Nichols JNandi SMialon M, et al. Conceptualising commercial entities in public health: beyond unhealthy commodities and transnational corporationsLancet2023401(10383): 12141228https://doi.org/10.1016/S0140-6736(23)00012-0

9

Freudenberg NFraming commercial determinants of health: an assessment of potential for guiding more effective responses to the public health crises of the 21st centuryMilbank Q2023101(S1): 8398https://doi.org/10.1111/1468-0009.12639

10

Friel SCollin JDaube M, et al. Commercial determinants of health: future directionsLancet2023401(10383): 12291240https://doi.org/10.1016/S0140-6736(23)00011-9


Citation:
Burgess R, Srebotnjak T, Lin C, Frierson L, Esty DC, Ransome Y, Freudenberg N. Toward Monitoring and Addressing the Commercial Determinants of Health: Where Can We Go From Here? Milbank Q. 2025;103(2):0525. https://doi.org/10.1111/1468-0009.70012