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Freudenberg N, Lee K, Buse K, Collin J, Crosbie E, Friel S, Klein DE, Lima JM, Marten R, Mialon M, Zenone M. Defining Priorities for Action and Research on the Commercial Determinants of Health: A Conceptual Review. Am J Public Health 2021; 111:2202-2211. [PMID: 34878875 PMCID: PMC8667845 DOI: 10.2105/ajph.2021.306491] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2021] [Indexed: 11/04/2022]
Abstract
In recent years, the concept of commercial determinants of health (CDoH) has attracted scholarly, public policy, and activist interest. To date, however, this new attention has failed to yield a clear and consistent definition, well-defined metrics for quantifying its impact, or coherent directions for research and intervention. By tracing the origins of this concept over 2 centuries of interactions between market forces and public health action and research, we propose an expanded framework and definition of CDoH. This conceptualization enables public health professionals and researchers to more fully realize the potential of the CDoH concept to yield insights that can be used to improve global and national health and reduce the stark health inequities within and between nations. It also widens the utility of CDoH from its main current use to study noncommunicable diseases to other health conditions such as infectious diseases, mental health conditions, injuries, and exposure to environmental threats. We suggest specific actions that public health professionals can take to transform the burgeoning interest in CDoH into meaningful improvements in health. (Am J Public Health. 2021;111(12):2202-2211. https://doi.org/10.2105/AJPH.2021.306491).
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Affiliation(s)
- Nicholas Freudenberg
- Nicholas Freudenberg is with the Graduate School of Public Health and Health Policy, City University of New York, New York, NY. Kelley Lee is with the Faculty of Health Sciences, Simon Fraser University, Burnaby, Vancouver, BC, Canada. Kent Buse is with The George Institute for Global Health, School of Public Health, Imperial College London, UK. Jeff Collin is with the Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, Scotland. Eric Crosbie is with the School of Community Health Sciences, University of Nevada‒Reno. Sharon Friel is with the Menzies Centre for Health Governance, School of Regulation and Global Governance, Australian National University, Canberra, Australia. Daniel Eisenkraft Klein is with the Dalla Lana School of Public Health, University of Toronto, Canada. Joana Madureira Lima is with the World Health Organization, Regional Office for Europe, Kyrgyzstan Country Office, Bishkek, Kyrgyzstan. Robert Marten is with the Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland. Melissa Mialon is with Trinity Business School, Trinity College, Dublin, Ireland. Marco Zenone is with the London School of Hygiene and Tropical Medicine, London, UK
| | - Kelley Lee
- Nicholas Freudenberg is with the Graduate School of Public Health and Health Policy, City University of New York, New York, NY. Kelley Lee is with the Faculty of Health Sciences, Simon Fraser University, Burnaby, Vancouver, BC, Canada. Kent Buse is with The George Institute for Global Health, School of Public Health, Imperial College London, UK. Jeff Collin is with the Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, Scotland. Eric Crosbie is with the School of Community Health Sciences, University of Nevada‒Reno. Sharon Friel is with the Menzies Centre for Health Governance, School of Regulation and Global Governance, Australian National University, Canberra, Australia. Daniel Eisenkraft Klein is with the Dalla Lana School of Public Health, University of Toronto, Canada. Joana Madureira Lima is with the World Health Organization, Regional Office for Europe, Kyrgyzstan Country Office, Bishkek, Kyrgyzstan. Robert Marten is with the Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland. Melissa Mialon is with Trinity Business School, Trinity College, Dublin, Ireland. Marco Zenone is with the London School of Hygiene and Tropical Medicine, London, UK
| | - Kent Buse
- Nicholas Freudenberg is with the Graduate School of Public Health and Health Policy, City University of New York, New York, NY. Kelley Lee is with the Faculty of Health Sciences, Simon Fraser University, Burnaby, Vancouver, BC, Canada. Kent Buse is with The George Institute for Global Health, School of Public Health, Imperial College London, UK. Jeff Collin is with the Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, Scotland. Eric Crosbie is with the School of Community Health Sciences, University of Nevada‒Reno. Sharon Friel is with the Menzies Centre for Health Governance, School of Regulation and Global Governance, Australian National University, Canberra, Australia. Daniel Eisenkraft Klein is with the Dalla Lana School of Public Health, University of Toronto, Canada. Joana Madureira Lima is with the World Health Organization, Regional Office for Europe, Kyrgyzstan Country Office, Bishkek, Kyrgyzstan. Robert Marten is with the Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland. Melissa Mialon is with Trinity Business School, Trinity College, Dublin, Ireland. Marco Zenone is with the London School of Hygiene and Tropical Medicine, London, UK
| | - Jeff Collin
- Nicholas Freudenberg is with the Graduate School of Public Health and Health Policy, City University of New York, New York, NY. Kelley Lee is with the Faculty of Health Sciences, Simon Fraser University, Burnaby, Vancouver, BC, Canada. Kent Buse is with The George Institute for Global Health, School of Public Health, Imperial College London, UK. Jeff Collin is with the Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, Scotland. Eric Crosbie is with the School of Community Health Sciences, University of Nevada‒Reno. Sharon Friel is with the Menzies Centre for Health Governance, School of Regulation and Global Governance, Australian National University, Canberra, Australia. Daniel Eisenkraft Klein is with the Dalla Lana School of Public Health, University of Toronto, Canada. Joana Madureira Lima is with the World Health Organization, Regional Office for Europe, Kyrgyzstan Country Office, Bishkek, Kyrgyzstan. Robert Marten is with the Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland. Melissa Mialon is with Trinity Business School, Trinity College, Dublin, Ireland. Marco Zenone is with the London School of Hygiene and Tropical Medicine, London, UK
| | - Eric Crosbie
- Nicholas Freudenberg is with the Graduate School of Public Health and Health Policy, City University of New York, New York, NY. Kelley Lee is with the Faculty of Health Sciences, Simon Fraser University, Burnaby, Vancouver, BC, Canada. Kent Buse is with The George Institute for Global Health, School of Public Health, Imperial College London, UK. Jeff Collin is with the Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, Scotland. Eric Crosbie is with the School of Community Health Sciences, University of Nevada‒Reno. Sharon Friel is with the Menzies Centre for Health Governance, School of Regulation and Global Governance, Australian National University, Canberra, Australia. Daniel Eisenkraft Klein is with the Dalla Lana School of Public Health, University of Toronto, Canada. Joana Madureira Lima is with the World Health Organization, Regional Office for Europe, Kyrgyzstan Country Office, Bishkek, Kyrgyzstan. Robert Marten is with the Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland. Melissa Mialon is with Trinity Business School, Trinity College, Dublin, Ireland. Marco Zenone is with the London School of Hygiene and Tropical Medicine, London, UK
| | - Sharon Friel
- Nicholas Freudenberg is with the Graduate School of Public Health and Health Policy, City University of New York, New York, NY. Kelley Lee is with the Faculty of Health Sciences, Simon Fraser University, Burnaby, Vancouver, BC, Canada. Kent Buse is with The George Institute for Global Health, School of Public Health, Imperial College London, UK. Jeff Collin is with the Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, Scotland. Eric Crosbie is with the School of Community Health Sciences, University of Nevada‒Reno. Sharon Friel is with the Menzies Centre for Health Governance, School of Regulation and Global Governance, Australian National University, Canberra, Australia. Daniel Eisenkraft Klein is with the Dalla Lana School of Public Health, University of Toronto, Canada. Joana Madureira Lima is with the World Health Organization, Regional Office for Europe, Kyrgyzstan Country Office, Bishkek, Kyrgyzstan. Robert Marten is with the Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland. Melissa Mialon is with Trinity Business School, Trinity College, Dublin, Ireland. Marco Zenone is with the London School of Hygiene and Tropical Medicine, London, UK
| | - Daniel Eisenkraft Klein
- Nicholas Freudenberg is with the Graduate School of Public Health and Health Policy, City University of New York, New York, NY. Kelley Lee is with the Faculty of Health Sciences, Simon Fraser University, Burnaby, Vancouver, BC, Canada. Kent Buse is with The George Institute for Global Health, School of Public Health, Imperial College London, UK. Jeff Collin is with the Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, Scotland. Eric Crosbie is with the School of Community Health Sciences, University of Nevada‒Reno. Sharon Friel is with the Menzies Centre for Health Governance, School of Regulation and Global Governance, Australian National University, Canberra, Australia. Daniel Eisenkraft Klein is with the Dalla Lana School of Public Health, University of Toronto, Canada. Joana Madureira Lima is with the World Health Organization, Regional Office for Europe, Kyrgyzstan Country Office, Bishkek, Kyrgyzstan. Robert Marten is with the Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland. Melissa Mialon is with Trinity Business School, Trinity College, Dublin, Ireland. Marco Zenone is with the London School of Hygiene and Tropical Medicine, London, UK
| | - Joana Madureira Lima
- Nicholas Freudenberg is with the Graduate School of Public Health and Health Policy, City University of New York, New York, NY. Kelley Lee is with the Faculty of Health Sciences, Simon Fraser University, Burnaby, Vancouver, BC, Canada. Kent Buse is with The George Institute for Global Health, School of Public Health, Imperial College London, UK. Jeff Collin is with the Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, Scotland. Eric Crosbie is with the School of Community Health Sciences, University of Nevada‒Reno. Sharon Friel is with the Menzies Centre for Health Governance, School of Regulation and Global Governance, Australian National University, Canberra, Australia. Daniel Eisenkraft Klein is with the Dalla Lana School of Public Health, University of Toronto, Canada. Joana Madureira Lima is with the World Health Organization, Regional Office for Europe, Kyrgyzstan Country Office, Bishkek, Kyrgyzstan. Robert Marten is with the Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland. Melissa Mialon is with Trinity Business School, Trinity College, Dublin, Ireland. Marco Zenone is with the London School of Hygiene and Tropical Medicine, London, UK
| | - Robert Marten
- Nicholas Freudenberg is with the Graduate School of Public Health and Health Policy, City University of New York, New York, NY. Kelley Lee is with the Faculty of Health Sciences, Simon Fraser University, Burnaby, Vancouver, BC, Canada. Kent Buse is with The George Institute for Global Health, School of Public Health, Imperial College London, UK. Jeff Collin is with the Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, Scotland. Eric Crosbie is with the School of Community Health Sciences, University of Nevada‒Reno. Sharon Friel is with the Menzies Centre for Health Governance, School of Regulation and Global Governance, Australian National University, Canberra, Australia. Daniel Eisenkraft Klein is with the Dalla Lana School of Public Health, University of Toronto, Canada. Joana Madureira Lima is with the World Health Organization, Regional Office for Europe, Kyrgyzstan Country Office, Bishkek, Kyrgyzstan. Robert Marten is with the Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland. Melissa Mialon is with Trinity Business School, Trinity College, Dublin, Ireland. Marco Zenone is with the London School of Hygiene and Tropical Medicine, London, UK
| | - Melissa Mialon
- Nicholas Freudenberg is with the Graduate School of Public Health and Health Policy, City University of New York, New York, NY. Kelley Lee is with the Faculty of Health Sciences, Simon Fraser University, Burnaby, Vancouver, BC, Canada. Kent Buse is with The George Institute for Global Health, School of Public Health, Imperial College London, UK. Jeff Collin is with the Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, Scotland. Eric Crosbie is with the School of Community Health Sciences, University of Nevada‒Reno. Sharon Friel is with the Menzies Centre for Health Governance, School of Regulation and Global Governance, Australian National University, Canberra, Australia. Daniel Eisenkraft Klein is with the Dalla Lana School of Public Health, University of Toronto, Canada. Joana Madureira Lima is with the World Health Organization, Regional Office for Europe, Kyrgyzstan Country Office, Bishkek, Kyrgyzstan. Robert Marten is with the Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland. Melissa Mialon is with Trinity Business School, Trinity College, Dublin, Ireland. Marco Zenone is with the London School of Hygiene and Tropical Medicine, London, UK
| | - Marco Zenone
- Nicholas Freudenberg is with the Graduate School of Public Health and Health Policy, City University of New York, New York, NY. Kelley Lee is with the Faculty of Health Sciences, Simon Fraser University, Burnaby, Vancouver, BC, Canada. Kent Buse is with The George Institute for Global Health, School of Public Health, Imperial College London, UK. Jeff Collin is with the Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, Scotland. Eric Crosbie is with the School of Community Health Sciences, University of Nevada‒Reno. Sharon Friel is with the Menzies Centre for Health Governance, School of Regulation and Global Governance, Australian National University, Canberra, Australia. Daniel Eisenkraft Klein is with the Dalla Lana School of Public Health, University of Toronto, Canada. Joana Madureira Lima is with the World Health Organization, Regional Office for Europe, Kyrgyzstan Country Office, Bishkek, Kyrgyzstan. Robert Marten is with the Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland. Melissa Mialon is with Trinity Business School, Trinity College, Dublin, Ireland. Marco Zenone is with the London School of Hygiene and Tropical Medicine, London, UK
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