Countering the commercial determinants of health: strategic challenges for public health

Abstract

Private enterprise is widely seen as making a positive contribution to societal wellbeing.In 2018, more than 80% of Australians were employed in the private sector. 1 Commerce and industry -from small business to large corporations -generate wealth, drive technological innovation, and provide products and services that the community values.However, when the regulation of commercial practices is weak -particularly in the case of large corporations -chasing profits can trump public welfare.The findings of the Royal Commission into Misconduct in the Banking, Superannuation and Financial Services Industry aptly illustrate this conflict, concluding that "much if not all of the conduct identified in the first round of hearings can be traced to entities preferring pursuit of profit to pursuit of any other purpose." 2 The focus of this special issue on the 'commercial determinants of health' is on the corporations which produce and market unhealthy commodities such as tobacco, alcohol, soft drinks and processed food.The limited regulatory control of these industries has contributed to their role in driving the growing global epidemic of noncommunicable disease.The papers commissioned for this issue help to further illuminate how the behaviour of these companies serves to undermine advances in chronic disease prevention.In this, we have been guided by Kickbusch et al's widely cited definition of the commercial determinants of health as "strategies and approaches used by the private sector to promote products and choices that are detrimental to health". 3 This terminology reflects the increasing global understanding of how unhealthy commodity industries affect health, and is the term favoured by the World Health Organization (WHO) and other United Nations agencies.In using the commercial determinants of health framework, we also acknowledge the discussion in the literature of the 'corporate determinants of health' and the recent body of research on transnational corporations.[4][5][6][7][8][9] This work recognises the wider impact of major corporations on health and wellbeing, beyond the manufacture and marketing of commodities.This framing considers both the direct and indirect effects of corporate operations, including through the production process, environmental footprint, employment and remuneration practices, financial practices (such as meeting tax obligations) and political behaviour.10 Kickbusch et al proposed that there would be value in using the commercial determinants of health banner as a multidisciplinary field to Countering the commercial determinants of health: strategic challenges for public health

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