Rationale

The commercial determinants of health (CDoH) is the cross-cutting element and the central theme of the proposal for the preconference. It is most actively addressed by all working groups of the JAPreventNCD at different levels and the Urban Public Health EUPHA section is dealing with these topics to contribute to develop a healthier environment.

We already know the impact that exposure to health-harming products (such as tobacco, alcohol, unhealthy foods, fossil fuels) can cause and contribute to non-communicable diseases. The Lancet series suggests that impact from unhealthy diets, air pollution from fossil fuels, alcohol and tobacco, in total reaches 58% of all deaths and 78% of deaths from non-communicable disease which are shortening people’s lives and causing years of poor-health. CDoH refer to the strategies and approaches used by private sector actors to promote products and choices that are detrimental to health. They cover three areas: they relate to unhealthy commodities that are contributing to NCD; they include business, market, the influence of other commercial and quasi-commercial actors and the broad range of practices through which they might influence human health and health inequity; the influence to political practices that are harmful to health and used to sell these commodities and secure a favourable policy environment; they include the global drivers of ill-health, such as market-driven economies and globalization, that have facilitated the use of such harmful practices.

Through policy briefs, scientific papers, and pilot projects, JAPreventNCD, the European Public Health Association Urban Public Health Section, and other scientific groups support policies addressing the commercial determinants of health. At the same time, local and urban policies act as testing grounds for innovation, generating evidence on feasibility, effectiveness, acceptability, and equity impacts that can strengthen national and EU regulation. To ensure this exchange is effective, local policies should align with national and EU recommendations, enabling municipalities to address local health challenges while contributing to broader policy learning and harmonisation across governance levels.

We aim to join efforts to increase visibility and strengthen the positioning of the commercial determinants of health on the European political agenda. The general objectives of the pre-conference are:

• To delve deeper into identifying how the policies, practices, recommendations and knowledge generated in the local environment can contribute to refining, improving or aligning the recommendations, policies about CDoH for the national and EU level that are developed in the other WPs and vice versa.
• What additional developments are needed to “help” politicians for in an easier and more effective way can support and implement policies to reduce the impact of CDoH.on health.

This issue will be developed in an introductory session about the politics and the CDoH following by:

A first one-hour session relating with the car-dependent infrastructure that shape the urbanism in cities. CDoH capture how private sector interests, such as real estate, and transport, shape urban development, with consequences for population health. Profit‑driven and short‑term decision‑making often favours car‑dependent infrastructure, dense developments with limited green space, and the externalisation of environmental and health costs. In the case of transport: commercial interests linked to the automotive and fossil fuel sectors have shaped planning through lobbying and narrative framing, prioritising private motorised transport overactive and public transport, with impacts on physical activity, air pollution, injury risk, and climate. These processes reinforce unequal power relations, with health‑harming urban environments disproportionately affecting lower‑income and marginalised populations.

The second one-hour session will be addressed to show and discuss how diet-related NCD are shaped not only by individual choices, but by food environments that influence what is available, affordable, accessible and socially normal. These environments are strongly affected by CDoH, including marketing strategies, pricing practices, product placement, corporate influence and market structures. Addressing unhealthy food environments requires coordinated action across governance levels. Municipalities shape everyday settings, national governments regulate markets and public systems, while EU institutions influence broader legal, economic and policy frameworks.

The third one-hour session will be addressed to review how municipalities can reduce related health harms of commercial determinants of tobacco and alcohol through measures such as smoke-free public spaces, restrictions on advertising and sales, licensing regulations, zoning policies, and community prevention programs. These local actions influence health behaviours, reduce inequalities, and support healthier urban environments. In addition to EU directives and national legislation that aims to reduce consumption and related harms by limiting industry influence, protecting public health, and creating supportive regulatory environments. These policies also provide a framework for coordinated prevention strategies and health equity across countries.

Issues to discuss

1. To what extent can urban and local policy initiatives function as shaping and instigators of the development of national and EU strategies to address the CDoH and viceversa, how the national and EU policy recommendations should be formulated to inform, enable, and strengthen the implementation and adaptation to the municipal policies and communities’ needs.
2. Which participatory tools and methodological approaches are available to analyze and address the commercial determinants of health at the local level.
3. To explore how policies addressing CDoH can reduce health inequalities and avoid widening socio-economic disparities.
4. how communities can become more aware of the power of the environment in which we live to shape our behaviors,
5. the capacity and barriers of policymakers to change this situation,
6. and the influence of businesses, their marketing, and their strategies in hindering such changes.