How are commercial determinants of health problematised in key health and climate policy guidance?
Abstract
Background: Commercial forces impact health and climate outcomes. Given the need for coherent policy approaches, we critically examine the problematisation of commercial activities in documents guiding the development of multisectoral climate and health policies. This guidance matters: it informs how governments set their climate and health policies, and thus the health of their populations.
Methods: A qualitative content analysis of documents published by the World Health Organization, United Nations Environment Programme and the UK Government between 2014 and 2025 to guide multisectoral action for climate and health, to understand how they problematise commercial actors, products and practices in their a) policy background, b) proposed policy solutions and c) approaches to governance.
Results: Policy guidance documents (n = 25) were more likely to ‘passively’ problematise commercial products (mostly fossil fuels) as harmful to climate and health, than to ‘actively’ attribute these products to specific commercial actors, practices, or policy solutions. Policy solutions prioritised downstream interventions in the health care sector, interventions that emphasised behaviour change and product-shifting, or interventions that advocated a role for a largely undifferentiated ‘private sector’ to deliver and finance policy. Despite some upstream attention to fiscal measures, such as taxes and subsidies towards fossil fuels and carbon-intensive agriculture, several key commercial determinants of health and climate change were not problematised. These included policy solutions for commercial tax avoidance, fossil fuel advertising, and jointly state- and corporate-owned high-emitting enterprises.
Conclusions: Existing health and climate policy guidance is widely neglecting structural, consumptogenic and commercial drivers of harm. Instead, by prioritising interventions in the health care sector, guidance risks performing a narrow, biomedical policy paradigm for climate and health.
Key messages: • Existing guidance for developing health and climate policies widely fails to engage with structural, consumptogenic and commercial drivers of harm, except for partial attention to fiscal measures.
• Guidance prioritises policy solutions within the health care sector. No guidance problematises policy responses to commercial tax avoidance, fossil fuel advertising, or state-owned enterprises.
Related
- The Commercial Determinants of Health: How Clinicians Can Make a Difference
- Operationalising Critical Health Literacy: Gambling Harm Education & Commercial Health Determinants
- The GHEMMS checklist: design, conduct, and reporting guidance for studies modelling climate mitigation actions and their health cobenefits
- Introducing the commercial determinants of health: the arms industry as a case
- From evidence to action: lessons on tackling commercial determinants of health locally
BibTeX
@article{hunt2026commercial,
title = {{How are commercial determinants of health problematised in key health and climate policy guidance?}},
author = {DW Hunt and BK Matthes and G Bates and AB Gilmore},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.072},
url = {https://doi.org/10.1093/eurpub/ckag169.072},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - How are commercial determinants of health problematised in key health and climate policy guidance?
AU - DW Hunt
AU - BK Matthes
AU - G Bates
AU - AB Gilmore
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.072
UR - https://doi.org/10.1093/eurpub/ckag169.072
AB - Background: Commercial forces impact health and climate outcomes. Given the need for coherent policy approaches, we critically examine the problematisation of commercial activities in documents guiding the development of multisectoral climate and health policies. This guidance matters: it informs how governments set their climate and health policies, and thus the health of their populations. Methods: A qualitative content analysis of documents published by the World Health Organization, United Nations Environment Programme and the UK Government between 2014 and 2025 to guide multisectoral action for climate and health, to understand how they problematise commercial actors, products and practices in their a) policy background, b) proposed policy solutions and c) approaches to governance. Results: Policy guidance documents (n = 25) were more likely to ‘passively’ problematise commercial products (mostly fossil fuels) as harmful to climate and health, than to ‘actively’ attribute these products to specific commercial actors, practices, or policy solutions. Policy solutions prioritised downstream interventions in the health care sector, interventions that emphasised behaviour change and product-shifting, or interventions that advocated a role for a largely undifferentiated ‘private sector’ to deliver and finance policy. Despite some upstream attention to fiscal measures, such as taxes and subsidies towards fossil fuels and carbon-intensive agriculture, several key commercial determinants of health and climate change were not problematised. These included policy solutions for commercial tax avoidance, fossil fuel advertising, and jointly state- and corporate-owned high-emitting enterprises. Conclusions: Existing health and climate policy guidance is widely neglecting structural, consumptogenic and commercial drivers of harm. Instead, by prioritising interventions in the health care sector, guidance risks performing a narrow, biomedical policy paradigm for climate and health. Key messages: • Existing guidance for developing health and climate policies widely fails to engage with structural, consumptogenic and commercial drivers of harm, except for partial attention to fiscal measures. • Guidance prioritises policy solutions within the health care sector. No guidance problematises policy responses to commercial tax avoidance, fossil fuel advertising, or state-owned enterprises.
SN - 1101-1262
SN - 1464-360X
ER -