Power and the commercial determinants of health: ideas for a research agenda

### Summary box Researchers increasingly recognise a lack of definitional clarity around the commercial determinants of health (CDoH).1–4 Common to many conceptualisations of CDoH is a focus on ‘unhealthy commodities’,5–9 political practices,9–12 business practices5 7 11 13 14 and macro-level conditions.4 8 11 15 16 A recent review1 of CDoH definitions found many characterised as ‘expressions of economic and political power wielded by large corporate entities, described as ‘powerful economic operators’’. While some recognise power in CDoH,2 power has often been overlooked. It is foundational to the future CDoH research agenda. Research on CDoH often refers to power implicitly, for example, through references to ‘powerful economic operators’ or ‘big’ industries, for example, big tobacco or big food.9 17 18 Power is also invoked as a tool that actors employ to keep issues off agendas,19 frame agendas20 21 and influence decision making.22 This implies that certain industries and businesses are powerful, but why they are powerful or how they exercise power is often left unexplained. While it may be accurate to say that …