Economic and Commercial Determinants of Health in South‐East Asia

Overview

Increasingly, public health and medical professionals have witnessed commercial system and product influences over population health behaviours and conditions that change people’s ways of life. For example, NCDs were described as ‘lifestyle diseases’ due to their association with behaviours including tobacco use, alcohol use, unhealthy diet, and physical inactivity. Behaviours and consumption patterns are increasingly recognized as socially constructed actions, or commercially driven, heavily influenced by large-scale production, marketing, and distributing of services and products making them readily available and appealing to different groups of the population.

Products targeted towards children and adolescents with long lasting impacts on their health include tobacco, alcohol, and unhealthy diets leading to ill health conditions among children and adolescents. Advertisements of tobacco targeting adolescents cause harm to the young generation. Alcohol consumption among adolescents reported in GSHS over the years reveals, that early initiation of alcohol is at 12-13 years old in many countries. Childhood overweight and obesity is estimated to affect approximately 41 million in 2016 and almost half of all overweight children under 5 lived in Asia. Childhood obesity results in an increased risk of cardiovascular disease, diabetes, and lung diseases.

Recently, WHO attempted to define the commercial determinants of health (CDH) as the conditions, actions and omissions by corporate actors that affect health, arising in the context of the provision of goods, or services, for payment, which include commercial activities, as well as the environment in which commerce takes place, with beneficial or detrimental impacts on health.

The commercial system impacts much of societal living and actions such as social determinants of health (income disparities, education, housing conditions, stigma on population exploited in illicit trades) which are the nonmedical factors that influence health outcomes and inequities. These determinants hold the key to turning the tide of rising global health challenges and health inequities. CDH exerts dramatic impacts on health from the local to global level, across sectors, settings and populations.

The burden of CDH impacts falls inequitably between regions and countries. In South-East Asia, commercial determinants of child and adolescent health, women’s health, and workers’ health, lies in not only the unhealthy products, but also the whole system of supply chains of products within a country, or through transnational establishments, causing labour exploitation of children, women, workers, including human trafficking for labour exploitation. Impacts of commercial products, services, and activities on health require public health intervention to change corporate practices and protect people’s health.