Developing a strategic approach to address the commercial determinants of health: insights from a qualitative study with Public Health Wales
1
Institute for Social Marketing and Health, University of Stirling, Stirling, United Kingdom
Popul. Med. 2026;8(Supplement Supplement 1):A3200
ABSTRACT
BACKGROUND:
The commercial determinants of health (CDoH) are major drivers of the global burden of disease (1) and the WHO has called for action (2,3). Whilst there is an emerging literature on how public health actors should respond to CDoH (3,4-6) there is a lack of practical frameworks or audit tools to help, and the process of agreeing actions is understudied. The study aimed to work in partnership with Public Health Wales (PHW), the national public health agency in Wales to develop a strategic approach to address the CDoH.
METHODS:
Semi-structured interviews with 18 senior PHW staff explored awareness of CDoH, current activities, organisational strengths and challenges and views on future strategy. Data were thematically analysed, with a coding scheme developed using deductive and inductive techniques supported by NVivo software. These data, empirical and theoretical literature and expert knowledge informed the development of a novel action framework to address CDoH.
RESULTS:
High levels of understanding of CDoH at senior (non-board) levels were reported by interviewees, although it was less clear whether this knowledge was shared more widely. Interviewees emphasised the need to raise the visibility of existing work, respond more rapidly to emerging commercial activity and establish clear policies governing interactions with commercial groups. A novel action framework developed to help PHW audit existing work and plan future activities comprised three parts: commercial activities, public health responses and competencies required to enact those responses.
CONCLUSIONS:
An agreed definition of CDoH, improved internal knowledge sharing and an evidence-informed framework are required to support PHW action on the CDoH. Translating relevant empirical and theoretical literature into practical tools and recommendations was challenging, and further research is required to identify how abstract concepts such as corporate power can inform action on CDoH globally, and to test the application of the framework developed here.
The commercial determinants of health (CDoH) are major drivers of the global burden of disease (1) and the WHO has called for action (2,3). Whilst there is an emerging literature on how public health actors should respond to CDoH (3,4-6) there is a lack of practical frameworks or audit tools to help, and the process of agreeing actions is understudied. The study aimed to work in partnership with Public Health Wales (PHW), the national public health agency in Wales to develop a strategic approach to address the CDoH.
METHODS:
Semi-structured interviews with 18 senior PHW staff explored awareness of CDoH, current activities, organisational strengths and challenges and views on future strategy. Data were thematically analysed, with a coding scheme developed using deductive and inductive techniques supported by NVivo software. These data, empirical and theoretical literature and expert knowledge informed the development of a novel action framework to address CDoH.
RESULTS:
High levels of understanding of CDoH at senior (non-board) levels were reported by interviewees, although it was less clear whether this knowledge was shared more widely. Interviewees emphasised the need to raise the visibility of existing work, respond more rapidly to emerging commercial activity and establish clear policies governing interactions with commercial groups. A novel action framework developed to help PHW audit existing work and plan future activities comprised three parts: commercial activities, public health responses and competencies required to enact those responses.
CONCLUSIONS:
An agreed definition of CDoH, improved internal knowledge sharing and an evidence-informed framework are required to support PHW action on the CDoH. Translating relevant empirical and theoretical literature into practical tools and recommendations was challenging, and further research is required to identify how abstract concepts such as corporate power can inform action on CDoH globally, and to test the application of the framework developed here.
| eISSN: | 2654-1459 |
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