Commercial determinants of health

Commercial determinants of health are defined as the systems, practices and pathways through which commercial actors drive health and equity (Gilmore et al., 2023). Commercial practices influencing health can be political, scientific, financial or related to marketing, labour, supply chain or managing the reputation of the commercial actor (Gilmore et al., 2023).

Commercial practices influence the health of people living in remote Aboriginal and Torres Strait Islander communities, and the food retail environment is a key pathway through which these practices influence health and wellbeing. Our team is leading a study applying a commercial determinants of health framework to the sugar-sweetened beverage (SSB) industry to explore the ways that their commercial practices influence health and wellbeing of remote Aboriginal and Torres Strait Islander Peoples.

Study aims

Understand the practices of SSB manufacturers influencing the health of remote Aboriginal and Torres Strait Islander communities and the role of remote community stores in moderating these commercial practices.

The objectives of the project are to:

1. Identify the mechanisms via which leading SSB manufacturers influence the health of remote Aboriginal and Torres Strait Islander communities both directly and indirectly
2. Understand mechanisms through which Aboriginal and Torres Strait Islander store directors and other food retail players interact with SSB manufacturers in remote communities, including the influence of store policies and values moderating beverage industry practices
3. Explore how food retail players perceive their relationships with SSB manufacturers in enabling or hindering healthy food retail policy and practice in remote communities

Methods

This project adopts the Lancet commercial entities in public health framework (Lacy-Nichols et al., 2023) and involves a desktop analysis of industry websites and documents, interviews with representatives from community stores. An in-person co-design workshop at the end of the project will bring together retail organisations and partners to share the findings and determine any research, practice or advocacy priorities arising from the broader Commercial Determinants of Health- Remote Stores Project.

Relevance of this research

Working with Aboriginal and Torres Strait Islander researchers, organisations and communities, the findings will help to:

• Provide insight into how Aboriginal and Torres Strait Islander leaders use their power to moderate the practices of beverage manufacturers
• Identify actions to drive health-promoting retail practices to further shape the influence of beverage manufacturers
• For example, the findings could Form the basis of a monitoring tool to assess beverage manufacturers’ commercial practices in remote communities, providing stores with a mechanism for accountability

Governance

This research contributes to the Commercial Determinants of Health project led by Professor Mark Wenitong and Associate Professor Megan Ferguson titled ‘A co-designed framework to drive action to promote health and equity in remote Aboriginal and Torres Strait Islander community stores’. Further information about this project is available here.

Molly Fairweather and Julie Brimblecombe are leading this project at Monash, and are guided by a Task Group with expertise in remote food environments and commercial determinants of health to inform the work. Members of the task group include:

• Professor Julie Brimblecombe, (Monash University)
• Molly Fairweather (Monash University)
• Associate Professor Megan Ferguson (University of Queensland)
• Dr Beau Cubillo (Menzies School of Health Research)
• Associate Professor Katherine Cullerton (University of Queensland)
• Dr Jenn Lacy-Nichols (University of Melbourne)
• Dr Sarah Dickie (Monash University)
• Dr Kate Wingrove (The University of Queensland)
• Ellie Chan (The University of Queensland)

Ethics

The study was approved by the Northern Territory Health and Menzies School of Health Research Human Research Ethics Committee [NTHREC 2024-4800] as well as the University of Queensland Human Research Ethics Committee [2025/HE000976].

References

Gilmore, A. B., Fabbri, A., Baum, F., Bertscher, A., Bondy, K., Chang, H. J., ... & Thow, A. M. (2023). Defining and conceptualising the commercial determinants of health. The Lancet, 401(10383), 1194-1213.

Lacy-Nichols, J., Nandi, S., Mialon, M., McCambridge, J., Lee, K., Jones, A., ... & Moodie, R. (2023). Conceptualising commercial entities in public health: beyond unhealthy commodities and transnational corporations. The Lancet, 401(10383), 1214-1228.

Get in touch

For any questions about the project, contact Molly Fairweather, molly.fairweather@monash.edu