6.B. Scientific session: Strengthening local responses to the commercial determinants of healt
Year: 2025
Type: article
Abstract: Commercial actors play a vital role in society, yet there is growing evidence that they are responsible for escalating levels of avoidable ill health, planetary damage and social and health inequity. These problems are now referred to as the ‘commercial determinants of health’ (CDoH), recently defined in a Lancet Series as “the systems, practices and pathways through which commercial actors drive health and equity”(1). One element of CDoH is the role of health harming industries in driving non-communicable diseases (NCDs), the burden of which is increasing. It is estimated that tobacco, fossil fuels, ultra-processed foods and alcohol cause an estimated 40-80% of global NCD deaths.1 Yet despite the urgent need to address these corporate harms, progress in national NCD policy implementation has stagnated, particularly in relation to these products(2). The situation in England mirrors the global, with national policy (other than tobacco), inadequate(3). Instead of the population level actions most likely to be effective and equitable, policy has focused on promoting individual behaviour change, generally requiring high levels of individual agency and likely to increase inequity(3). In this national policy vacuum, local governments, including those in England, are beginning to act. While local powers are often limited compared to national government, there is often potential to, inter alia, ban advertising of high-carbon or unhealthy products; use planning and licensing regulations to reduce outlet density and create healthy (eg alcohol- and junk food-free) public spaces; harness polluter-pays levies to charge businesses for the clean-up of waste; or adopt a well-being approach to the local economy and use social value procurement to spend public money for local benefit. Barriers to local action include resource and capacity constraints, corporate pressure against regulation including a persistent framing emphasis on individual responsibility and, despite growing interest in the CDoH, a lack of systems-based, solutions-focused and locally salient evidence. To address these gaps, Population Health Improvement UK (https://www.phiuk.org/about) through its research theme on Local Health Global Profits (LHGP)(https://www.phiuk.org/local-health-global-profits) aims to take a systems approach to understanding and addressing the commercial and other structural determinants of health and equity at local level in England. To enable shared learning across countries in Europe this workshop will present the background to and work of LHGP. Through 4 presentations and a 20 minute discussion, it will draw on audience experiences to help advance efforts to understand and address the CDoH. (1) Gilmore et al (2023). Defining and conceptualising the commercial determinants of health. The Lancet. (2) https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(23)00042-6/fulltext (3) https://www.health.org.uk/reports-and-analysis/reports/addressing-the-leading-risk-factors-for-ill-health Key messages • Local authorities can play a key role in addressing the commercial determinants of health by implementing upstream policies that promote health, equity, and sustainability at the community level. • Despite growing interest in systems approaches, their uptake remains low. Supporting local authorities with evidence and strategies is crucial to design and implement effective upstream policies.
Authors: Organised by: Population Health Improvement UK: Local Health, Global Profits (UK), Chair persons: Anna Gilmore (UK), Benjamin Hawkins (UK)
Language: English
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $3,181
OpenAlex ID: W7101411668
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