Researchers define and measure the commercial determinants of health

Jul. 14, 2020
Pedestrians walk past a bus stop with a McDonald's advertisement.

In an editorial for the journal Global Health Promotion, CUNY SPH Distinguished Professor Nicholas Freudenberg and Professor Kelley Lee of Simon Fraser University outline how shifting focus to the commercial determinants of health can help in the development of public health interventions to prevent and control non-communicable diseases such as cardiovascular disease, diabetes, and cancer.

The commercial determinants of health are factors that influence health which stem from the profit motive and the practices that corporations use to maximize revenues, market share, and political influence. Examples that harm health include  promotion of unhealthy commodities such as ultra-processed foods and beverages, tobacco, and alcohol, exposing workers to unsafe conditions or toxic exposures, and depriving the public sector of needed resources by evading taxes. 

Nick Freudenberg
Distinguished Professor Nicholas Freudenberg

“Despite clear evidence of the alarming rise in non-communicable diseases globally, the public health community has achieved only limited consensus on effective preventive action,” says Freudenberg. “The commercial determinants concept promises a more holistic, integrated and targeted approach.”

To prevent and control non-communicable diseases worldwide, it is critical to understand the commercial determinants of health as a composite of risk factors, and how these risk factors interact with each other, the authors write. This allows clearer identification of relative vulnerabilities by specific populations over time and place, and across other variables such as age, gender, and socioeconomic status.

“This could provide a powerful dataset to develop targeted interventions and resources to reduce such risks to health and health equity,” the authors write.

Dr. Freudenberg is director of the Urban Food Policy Institute at CUNY SPH and the author of numerous books, including Lethal but Legal: Corporations, Consumption, and Protecting Public Health.

Lee, K., & Freudenberg, N. (2020). Addressing the commercial determinants of health begins with clearer definition and measurement. Global Health Promotion, 27(2), 3–5.

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