1763Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada.
School of Public Health, 2009City University New York, New York, USA.
Int J Health Serv. 2022 Jan;52(1):115-128. doi: 10.1177/00207314211044992. Epub 2021 Nov 1.
The commercial determinants of health (CDoH) describe the adverse health effects associated with for-profit actors and their actions. Despite efforts to advance the definition, conceptualization, and empirical analyses of CDoH, the term's practical application to mitigate these effects requires the capacity to measure the influences of specific components of CDoH and the cumulative impacts of CDoH on the health and well-being of specific populations. Building on the Global Burden of Disease Study, we begin by conceptualizing CDoH as risk factor exposures that span agency and structural influences. We identify 6 components of these influences and propose an initial set of indicators and datasets to rank exposures as high, medium, or low. These are combined into a commercial determinants of health index (CDoHi) and illustrated by 3 countries. Although now a proof of concept, comparative analysis of CDoH exposures by population, over time and space, and their associated health outcomes will become possible with further development of indicators and datasets. Expansion of the CDoHi and application to varied populations groups will enable finer targeting of interventions to reduce health harms. The measurement of improvements to health and wellness from such interventions will, in turn, inform overall efforts to address the CDoH.
商业健康决定因素（CDoH）描述了与营利性行为体及其行为相关的不良健康影响。尽管人们努力推进 CDoH 的定义、概念化和实证分析，但要将其实际应用于减轻这些影响，需要有能力衡量 CDoH 特定组成部分的影响以及 CDoH 对特定人群健康和福祉的累积影响。本研究以全球疾病负担研究为基础，将 CDoH 概念化为跨越机构和结构影响的风险因素暴露。我们确定了这些影响的 6 个组成部分，并提出了一组初始指标和数据集，将暴露分为高、中、低。这些被组合成一个商业健康决定因素指数（CDoHi），并通过 3 个国家进行了说明。尽管这只是一个概念验证，但随着指标和数据集的进一步发展，对人口、时间和空间的 CDoH 暴露进行比较分析，以及对其相关健康结果进行比较分析，将成为可能。CDoHi 的扩展和对不同人群组的应用将能够更精确地确定干预措施以减少健康危害。对这些干预措施对健康和福利的改善的衡量反过来将为解决 CDoH 的总体努力提供信息。
