Background
One of the influences on health that remains poorly understood at local level is the commercial sector, despite growing evidence of its major impacts on health and equity. While local businesses create jobs and contribute to the economy and health in positive ways, certain commercial actors have a disproportionate impact on population health.
Approximately 40% of chronic disease deaths globally are directly linked to just four products manufactured by transnational corporations manufacturing: tobacco, ultra-processed foods, alcohol and fossil fuels.
In parallel, representatives of these sectors frequently oppose interventions that local governments could implement.
Our partners and approach
Local Health and Global Profits brings together researchers at the Universities of Bath, Cambridge, Edinburgh, Sheffield and the London School of Hygiene and Tropical Medicine.
They are working with local governments, local populations and public health practitioners, including the Association of Directors of Public Health and civil society groups.
Together, they aim to understand the building blocks, including the commercial factors, that impact on communities’ health.
Taking a systems approach, it will use that knowledge to identify, implement and evaluate the population-level interventions most likely to improve health, wellbeing and equity at scale. It will also work specifically to explore and address the barriers to implementing interventions.
Aims and objectives
The overall aim of the programme is to take an integrated systems approach, in order to
identify potential actions (diverse forms of interventions) to address the upstream determinants of health and the facilitators and barriers to implementing these actions
develop and implement resources and support systems, to better enable local authorities to implement these actions
take a comprehensive approach to assessing the health and economic impacts of these interventions and disseminate the selected interventions and supporting tools.
Objectives
Operating at local level, the primary objectives of this research consortium are to:
use an integrated systems approach to better understand, identify and prioritise potential areas of action to address upstream (commercial and interlinked social, political and economic) determinants of health
critically examine evidence for actions that can address upstream (commercial) determinants of health, categorising them to help identify those that require minimum agency, can promote health and equity at scale and act on system levers
explore facilitators and barriers to the effective implementation of such actions and how these can most effectively be addressed
co-develop appropriate resources (tools and training), support systems and locally relevant evidence that will enable local actors to overcome these barriers
comprehensively assess the anticipated health and economic impacts of actions and whether changing the paradigm of the impact assessment approach (for example changing the underlying economic model) changes their measured effectiveness and how they are perceived and prioritised by policy-makers
compile novel large scale data resources for use at local level to enable this
enable implementation of actions, including policy change, by providing appropriate support systems
undertake complex systems evaluations of the selected actions, resources and support systems
scale up and exchange knowledge to promote equitable population health improvement.
Work packages
Systems approaches to commercial determinants of health and equity: project design
WP1: Identifying System Structures and Levers.
WP2: Actions: identifying, evaluating and categorising options for Local Authorities to address upstream Commercial Determinants of Health.
WP3: Understanding facilitators and barriers to upstream action and developing resources to address barriers.
WP4: Develop and implement tools to assess health, economic and inequality impacts of actions.
WP5: Implementation.
WP6: Evaluation.
WP7: Knowledge exchange and scale-up.
