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Cited by 758Global Public Health Policies and EpidemiologyPublic Health Policies and EducationOccupational Health and Global Justice

Defining and conceptualising the commercial determinants of health

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Gilmore, Anna B, Fabbri, Alice, Baum, Fran, Bertscher, Adam, Bondy, Krista, Chang, Ha-Joon, Demaio, Sandro, Erzse, Agnes +13 more·2023·The Lancet
DOI 10.1016/s0140-6736(23)00013-2
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Abstract

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. This paper, the first in a Series on the commercial determinants of health, explains how the shift towards market fundamentalism and increasingly powerful transnational corporations has created a pathological system in which commercial actors are increasingly enabled to cause harm and externalise the costs of doing so. Consequently, as harms to human and planetary health increase, commercial sector wealth and power increase, whereas the countervailing forces having to meet these costs (notably individuals, governments, and civil society organisations) become correspondingly impoverished and disempowered or captured by commercial interests. This power imbalance leads to policy inertia; although many policy solutions are available, they are not being implemented. Health harms are escalating, leaving health-care systems increasingly unable to cope. Governments can and must act to improve, rather than continue to threaten, the wellbeing of future generations, development, and economic growth.

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  • Commercial determinants influence which oral health interventions are adopted, resisted, or sustained.

    “These forces influence which interventions are adopted, resisted, or sustained and must be addressed through policy, governance, and accountability mechanisms (Gilmore et al 2023).”

    From New Frontiers for Implementation Science in Oral Health: Digital and Equity-Driven Pathways (2026) · cites this paper as Gilmore et al 2023

    The Level 3 – Sectoral public policies section says commercial actors can block, weaken, delay, undermine, and overturn health-related policies. Moving Towards Solutions calls for governments to hold commercial entities to account. The paper does not establish which oral-health interventions are adopted, resisted, or sustained; its discussion is at the broader public-health policy level. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Commercial determinants shape oral health through marketing, lobbying, product availability, and consumption environments, especially around sugar-sweetened beverages and ultra-processed foods.

    “Commercial determinants shape oral health through marketing, lobbying, product availability, and consumption environments, especially around sugar-sweetened beverages and ultraprocessed foods.”

    From New Frontiers for Implementation Science in Oral Health: Digital and Equity-Driven Pathways (2026) · cites this paper as Gilmore et al 2023

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Cited by

Sorted by citations

Authors
Gilmore, A. B., Fabbri, A., Baum, F., Bertscher, A., Bondy, K., Chang, H.-J., Demaio, S., Erzse, A., Freudenberg, N., Friel, S., Hofman, K. J., Johns, P., Abdool Karim, S., Lacy-Nichols, J., de Carvalho, C. M. P., Marten, R., McKee, M., Petticrew, M., Robertson, L., Tangcharoensathien, V., & Thow, A. M.
Affiliations
  • University of Bath (GB)
  • The University of Adelaide (AU)
  • University of Stirling (GB)
  • SOAS University of London (GB)
  • Victorian Health Promotion Foundation (AU)
  • South African Medical Research Council (ZA)
  • City University of New York (US)
  • Australian National University (AU)
  • World Health Organization (CH)
  • London School of Hygiene & Tropical Medicine (GB)
  • University of Otago (NZ)
  • Ministry of Public Health (TH)
  • The University of Sydney (AU)
Corresponding author
Gilmore, Anna B
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2023-04
Volume
401
Issue
10383
Pages
1194-1213
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(23)00013-2
OpenAlex
W4360603423
Cited by
758
References
8
Citations by year
2026: 230 · 2025: 231 · 2024: 196 · 2023: 100 · 2014: 1
FWCI
48.09
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
  • Stirling Online Research Repository (University of Stirling) (submittedVersion, cc-by)
  • Pure (University of Bath) (submittedVersion, cc-by)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (submittedVersion)
  • SOAS Research Online (SOAS University of London) (submittedVersion, cc-by)
  • ANU Open Research (Australian National University) (submittedVersion)
  • Center for International and Regional Studies (Georgetown University) (submittedVersion)
  • Minerva Access (University of Melbourne) (submittedVersion)
  • Greater South Information System
Funders
  • World Health Organization
  • Wellcome Trust (MR/S037519/1)
  • Scottish Government
  • Cancer Research UK (MR/S037519/1, 23108)
  • National Institute for Health and Care Research (MR/S037519/1)
  • British Heart Foundation
  • University of Bath (MR/S037519/1)
  • South African Medical Research Council (23108)
  • National Heart Foundation of New Zealand
  • Public Health Agency
  • Chief Scientist Office, Scottish Government Health and Social Care Directorate
  • Medical Research Council (MR/S037519/1)
  • Engineering and Physical Sciences Research Council
  • Economic and Social Research Council (MR/S037519/1)
  • Natural Environment Research Council
  • Health and Social Care Research and Development Division
Topics
  • Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Global Public Health Policies and Epidemiology
  • Health Sciences › Health Professions › General Health Professions › Public Health Policies and Education
  • Social Sciences › Health › Occupational Health and Global Justice
Keywords
commercial determinants of health, multinational corporations, market fundamentalism, health disparities, non-communicable diseases, tobacco industry, fossil fuel industry, alcohol industry, climate crisis, policy inertia, planetary health, health policy
MeSH terms
Commerce, Government, Health Policy, Humans, Industry, Nicotiana, Policy

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

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