Collective action on harmful commercial influences

Many Directors of Public Health (DsPH) have become increasingly aware of how the commercial determinants of health (CDOH) lie behind so many of the core programmes we deliver to improve our community’s health. Across many of our priorities, whether it be reducing gambling harm, creating a smokefree generation, or helping people access healthier food environments, we recognise that our efforts face a massive headwind: the actions of companies who profit from consumption of an ever increasingly wide range of harmful products.

What unites these industries are the tactics they use, such as aggressive marketing, industry lobbying, donation to political campaigns, research funding, and spreading mis – and dis – information on harm, all lucrative ways to entice our communities and impact their health.

So, when we set out the task to tackle this mammoth problem, led by mammoth industries, we were ambitious to say the least, but standing back at the end of it, I’m proud to say we have made real strides in achieving this.

Our project, funded by The Health Foundation, was a three-year programme of work dedicated to strengthening action on CDOH. It brought together public health leaders from across the UK to strengthen leadership, skills, and practice across the major commercial drivers of ill health, including tobacco, alcohol, gambling products, and unhealthy food.

Through this project, we have not only equipped colleagues with robust evidence and best practice to carry forward into their local work, including developing a suite of tools such as position statements, webinars, ‘CDOH essentials’, and the Good Governance Toolkit, but we have taken a leading role in framing the national discussion on CDOH. In particular, we have held conversations with all four of the UK’s Chief Medical Officers, focusing on three of the biggest killers: alcohol, unhealthy food, and tobacco.

Beyond the close of the project, we have created a sustained movement for change – public health teams have now started to incorporate CDOH into their framing, are putting in place local actions to delegitimatise the unethical practice of health-harming industries, and are continuing the partnerships we fostered through our project.

It has been a real privileged to be involved in this work as a local DPH, chairing the steering group latterly but building on excellent work led by a number of DsPH and Consultants, along with The Health Foundation and academic partners. We’ve achieved a huge amount – not simply the events and resources, but by embedding a renewed determination across the public health community to connect local experiences and levers around the commercial determinants with academic insight and best practice advocacy.