Dun-Campbell Kate, Hartwell Greg, Maani Nason, Tompson Alice, van Schalkwyk May Ci, Petticrew Mark
Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom.
PLOS Glob Public Health. 2024 Aug 28;4(8):e0003605. doi: 10.1371/journal.pgph.0003605. eCollection 2024.
Mental ill health has complex and interrelated underlying causes, with wider determinants of health often overlooked as risk factors. The 'commercial determinants of health' are gradually receiving more attention and recognition but there is a relative lack of awareness of the commercial determinants of mental health. This aim of this umbrella review was to synthesise systematic review level evidence for the association between commercial determinants and mental health outcomes. This umbrella review included evidence from high, middle, and low-income countries. We included terms related to broader commercial activities and terms focused on six key unhealthy commodities (tobacco, alcohol, ultra-processed foods, gambling, social media, fossil fuels) and the impacts of fossil fuel consumption (climate change, air pollution, wider pollution). We included 65 reviews and found evidence from high quality reviews for associations between alcohol, tobacco, gambling, social media, ultra-processed foods and air pollution and depression; alcohol, tobacco, gambling, social media, climate change and air pollution with suicide; climate change and air pollution with anxiety; and social media with self-harm. There was a lack of evidence examining wider practices of commercial industries. Our umbrella review demonstrates that by broadening the focus on commercial determinants, the influence of commercial products and activities on mental ill health can be better understood. The lack of research examining broader commercial practices on mental ill health is an area that should be addressed. Our review highlights the existing base of high-quality evidence for many of these unhealthy commodities' impacts on mental ill health and indicates that commercial determinants is a valuable framework for understanding the drivers of mental ill health.
精神健康不佳有复杂且相互关联的潜在原因，健康的更广泛决定因素往往被忽视，未被视作风险因素。“健康的商业决定因素”正逐渐受到更多关注和认可，但对精神健康的商业决定因素的认识相对不足。本综述的目的是综合系统评价层面的证据，以探讨商业决定因素与精神健康结果之间的关联。本综述纳入了来自高收入、中等收入和低收入国家的证据。我们纳入了与更广泛商业活动相关的术语，以及聚焦于六种关键有害商品（烟草、酒精、超加工食品、赌博、社交媒体、化石燃料）以及化石燃料消费影响（气候变化、空气污染、更广泛的污染）的术语。我们纳入了65篇综述，发现高质量综述中有证据表明酒精、烟草、赌博、社交媒体、超加工食品和空气污染与抑郁症之间存在关联；酒精、烟草、赌博、社交媒体、气候变化和空气污染与自杀之间存在关联；气候变化和空气污染与焦虑症之间存在关联；以及社交媒体与自我伤害之间存在关联。缺乏对商业行业更广泛行为的研究证据。我们的综述表明，通过拓宽对商业决定因素的关注，可以更好地理解商业产品和活动对精神健康不佳的影响。缺乏对精神健康不佳方面更广泛商业行为的研究是一个应予以关注的领域。我们的综述突出了关于许多这些有害商品对精神健康不佳影响的现有高质量证据基础，并表明商业决定因素是理解精神健康不佳驱动因素的一个有价值的框架。
