Although commercial entities can contribute positively to health and society there
is growing evidence that the products and practices of some commercial actors notably
the largest transnational corporations are responsible for escalating rates of avoidable
ill health, planetary damage, and social and health inequity; these problems are increasingly
referred to as the commercial determinants of health. The climate emergency, the non-communicable
disease epidemic, and that just four industry sectors (ie, tobacco, ultra-processed
food, fossil fuel, and alcohol) already account for at least a third of global deaths
illustrate the scale and huge economic cost of the problem.
Most public health research on the commercial determinants of health (CDOH) to date
has focused on a narrow segment of commercial actors. These actors are generally the
transnational corporations producing so-called unhealthy commodities such as tobacco,
alcohol, and ultra-processed foods. Furthermore, as public health researchers, we
often discuss the CDOH using sweeping terms such as private sector, industry, or business
that lump together diverse entities whose only shared characteristic is their engagement
in commerce.
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