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Commercial determinants of health: Future directions

This article is the third in a series of three papers on the Commercial Determinants of Health. For an introduction to the commercial determinants of health see Defining and conceptualising the commercial determinants of health.

To achieve health equity, public policy and businesses need to be held accountable for their role in health outcomes. To do this, current power dynamics need to shift; and ultimately, governance structures must prioritize the health and needs of the public and the planet.

This article summarizes action the current political, economic, health and social systems can take to prevent or mitigate the health harms caused by the commercial sector.

A vision for multilevel governance is presented with the aim of creating transformational systemic change. Elements of the vision include:

• Large organizations use their structural power to advocate for policy and investment in business models that support health, equity, and sustainability.

• Public health practitioners and decision makers collaborate with civil society groups to articulate an alternate future and hold commercial actors and governments accountable.

• Academia and researchers, in collaboration with policy actors, synthesize and disseminate evidence in a way that provides straightforward direction for action by corporate actors.

• Public health practitioners engage broadly with the commercial sectors, perhaps beyond historical boundaries (ex. with influential trade, finance, and business actors).

Public health has a role to mitigate health inequity caused by the commercial sector. Although this journal article focuses on action for the commercial sector, the vision of multilevel collaboration can guide public health’s role to address the commercial determinants of health. That role includes disseminating evidence, lifting community voices, and advocating for policy change.

Use this resource to:

  • deepen understanding of the commercial determinants of health and how they influence health and health equity;
  • facilitate discussion about the commercial determinants of health; and
  • identify public health action that can be taken at different levels to prevent and address the impact of the commercial determinants of health.


Alignment with NCCDH Work:

The concept of the Social Determinants of Health has been used to inform practice, decision making and policies for many years. Recently, the field of public health has described other determinants of health including structural, political, economic, and commercial.
Each of these deepens our understanding of one aspect of what impacts health. 

Limiting corporate power is one strategy explored in Let’s Talk: Redistributing power for health equity, as a way to advance health equity by addressing the commercial determinants of health.

See other resources on the structural determinants of health.


Friel, S., Collin, J., Daube, M., Depoux, A., Freudenberg, N., Gilmore, A. B., Johns, P., Laar, A., Marten, R., McKee, M., & Mialon, M. (2023). Commercial determinants of health: future directions. The Lancet (British Edition)401(10383), 1229–1240.

Tags: Structural determinants, Power, Academic Institution, Document, Journal Article