The LHGP research consortium brings together leading researchers from the Universities of Bath, Cambridge, Edinburgh, Sheffield, and the London School of Hygiene and Tropical Medicine and is part of the Population Health Improvement (PHI UK) network and is funded by UK Research and Innovation (UKRI).
The consortium works with local governments, local populations, public health practitioners, and civil society organisations across the UK including the Association of Directors of Public Health, Action on Smoking and Health, Obesity Health Alliance, Alcohol Health Alliance, and Centre for Thriving Places.
LHGP’s work aims to identify, implement and evaluate population-level actions most likely to improve health, wellbeing and equity at local authority level by addressing the commercial determinants of health (CDoH), defined as ‘the systems, practices, and pathways through which commercial actors drive health and equity’.
The LHGP consortium takes a systems approach to address the upstream (commercial) determinants of health at local government level. The aim is to drive improvements in health at scale; drive reductions in health inequity; help create thriving local communities; create a network of academics, civil society groups, and local governments working with local populations to achieve this; and address harmful CDoH.
LHGP is part of the Population Health Improvement UK (PHI UK) initiative, funded by UK Research and Innovation (UKRI) with a £35 million investment over four years. The funding supports research, capacity building, and knowledge dissemination activities. LHGP does not accept funding from companies or other commercial organisations whose interests are not aligned with improved public health.
LHGP aims to identify and understand positive aspects of the CDoH as well as address harmful components through:
Developing resources to support local authorities
Implementing population-level action
Evaluating the health and economic impacts of these actions
Scaling up successful strategies
LHGP is organised into seven interconnected Work Packages (WPs), each focusing on different aspects of addressing commercial determinants of health:
WP1: Systems mapping
WP2: Identifying actions
WP3: Understanding barriers and facilitators
WP4: Economic impact assessment
WP5: Implementation of actions
WP6: Evaluation of actions as well as a systems approach
WP7: Knowledge exchange and scale-up
The commercial determinants of health (CDoH) refer to how economic systems, business practices, and societal norms influence people’s health. This includes the actions of the commercial sector, like marketing unhealthy products, lobbying against public health policies, or funding research that benefits their interests. It also includes deregulation of health-harming industries or how governments may prioritise economic growth at the expense of health
But CDoH isn’t just about negative impacts. Positive economic activities can also promote health. For example, businesses that follow circular economy models (reducing waste, reusing materials, and supporting sustainability) can benefit both people and the planet. Similarly, policies that prioritise wellbeing over short-term profits can create healthier and more resilient communities.
Understanding CDoH means looking at the bigger picture, and how the choices made by businesses, governments, and communities affect our health and wellbeing. By supporting systems and values that prioritise health, we can build thriving, equitable communities for everyone.
A public health intervention is any specific activity or policy designed to promote health and well-being at a population level, such as a health promotion campaign, or implementing a HFSS (High in Fat, Salt and Sugar) food advertising ban. The term “actions” rather than “interventions” is deliberately used to help convey a breadth of focus that goes beyond specific individual activities with linear effects on health, to include activities with indirect or system-wide effects on health. This could include, for example, implementing aspects of progressive economic models, or changing approaches to policy making processes.
Local Authorities play a crucial role in LHGP by co-producing research, implementing actions, and providing real-world feedback. They help ensure that the project addresses local needs and priorities and are the primary intended beneficiaries of our work.
LHGP employs a systems approach to understand the complex interplay between various factors influencing public health. This involves mapping out the complex systems of commercial, social, political, and economic determinants that influence an outcome and identifying leverage points where actions might drive change in the system.
Actions are selected through a combination of evidence reviews, expert interviews, stakeholder consultations, and participatory systems mapping workshops. The focus is on identifying actions that can be implemented at a local level to achieve large-scale health improvements.
Part of understanding actions to address the CDoH at local level includes examining how corporations may influence local policies and governance processes to protect their interests, often at the expense of public health. LHGP aims to support the development of governance mechanisms that prevent and address CPA to ensure that public health policy processes remain effective and independent. This includes, for example, promoting a robust understanding of what might constitute a ‘conflict of interest’ in the context of local government decision-making.
The project uses a combination of qualitative and quantitative methods to assess the health and economic impacts of implemented actions. This includes collecting large-scale data, conducting cost-benefit analyses, and evaluating changes in public health outcomes as well as interviewing policy practitioners and co-producing systems maps with our local authority partners.
The anticipated outcomes include:
Improved health equity
Reduction in chronic disease prevalence
Increased capacity of local authorities to address commercial determinants
Development of scalable, evidence-based actions.
Local governments face barriers such as resource constraints, lack of locally relevant evidence, and opposition from commercial entities when trying to take action to reduce health inequalities and prevent chronic diseases. LHGP aims to address these challenges by providing tailored resources, training, and support systems.
Knowledge exchange is a key component of LHGP, ensuring that findings and best practices are shared across local authorities, public health organisations, academic institutions and the public. This helps to scale successful actions and promote widespread adoption.
The long-term vision is to support sustainable, healthy communities by conducting independent, high-quality research into addressing upstream CDoH. The project aims to produce research findings that may inform policy and practice at local, national, and international levels to reduce health inequalities and improve public health outcomes.
Local governments are responsible for many of the wider determinants of health, such as housing, transportation, advertising and planning. Addressing the commercial aspects of these systems at this level can significantly improve public health outcomes and reduce health inequalities by creating healthier living environments.
Non-communicable diseases (NCDs) place a significant economic burden on healthcare systems. Increasing numbers of NCDs are driven in part by harmful commercial practices, including the sale and promotion of products like alcohol, tobacco, fossil fuels, and less healthy food; and systems that contribute to health and social harms. Beyond direct healthcare costs, the impact of these practices extends to broader societal challenges, including environmental degradation, mental health harm, and poverty, further straining social and economic systems. Addressing harmful aspects of the CDOH can reduce these costs by preventing diseases through upstream action.
LHGP focuses on developing examples of scalable actions by creating resources and support systems that can be adapted and implemented across various local authorities. The project also engages in knowledge exchange to promote wider adoption of successful strategies.