Alessandro Crocetti, Petrina Leersen, Jennifer Browne
The commercial determinants of health (CDoH) are increasingly recognized as major drivers of non-communicable disease and health inequities. However, the extent to which CDoH concepts are translated into policy action remains unclear. This study examined the extent to which Australian public health and health promotion policies recognize and respond to the CDoH. We conducted a critical qualitative content analysis of 94 Australian Commonwealth, state and territory public health and health promotion policy documents published between 2015 and 2025. Using a theory-informed a priori coding framework, we examined explicit recognition of CDoH and the nature of proposed policy responses. Eighteen policies explicitly referred to the CDoH or related concepts, all published from 2021 onwards, indicating recent but uneven policy uptake. Legislative and regulatory measures were concentrated in a small number of Commonwealth-led strategies and focused primarily on tobacco, with more limited attention to unhealthy food and alcohol. State and territory strategies relied more heavily on public awareness campaigns and administrative tools rather than direct regulation of the commercial sector. Governance protections against industry interference were largely confined to tobacco control, with no measures targeting the gambling and fossil fuels industries. Australian public health and health promotion policies demonstrate emerging but uneven recognition of the CDoH, with limited institutionalization through regulatory and governance measures. These findings highlight ongoing challenges in translating health promotion and CDoH frameworks into coherent, whole-of-government policy responses to address the commercial drivers of health and health inequity.