The dominance of ultra-processed foods and meat in diets worldwide underscores the influential role of transnational corporations (including financial actors) in shaping agri-food supply chains, food environments, and dietary patterns. Recognising industrial food systems as determinants of intersecting crises in public health, social equity, and the environment, there is a critical need to address the structural determinants that are perpetuating these dietary patterns. Despite recognition that excessive corporate power is both a driver and barrier to reducing UPFs and meat consumption, existing research has, to date, primarily focused on food manufacturers, overlooking the role of more downstream actors such as fast-food retailers (FFRs). Exploring the political, institutional, and cultural factors enabling or impeding FFR expansion presents an unexplored avenue for policy intervention in global meat reduction initiatives.

Conducting a quantitative analysis, we examined the evolution of firm- and market-level dynamics within the FFR sector at the global-, regional-, and country-levels from 2009 to 2023 across 58 countries with varying income levels. This involved two key steps: 1) utilising Euromonitor and ComputStat databases for FFR market and sales data, and 2) guided by a food systems conceptual framework, elucidating potential drivers of observed trends. Our findings reveal a significant global expansion of FFRs, albeit with considerable regional and national variations. A few dominant firms, notably McDonald’s, Yum! Brands, and Restaurant Brands International, command leading market shares across many of the included countries. Sales appear highest in North America, Europe, and Asia Pacific, the latter likely attributable to contributions from China and Japan. This expansion, accompanied by increased financialisation of food systems – including the increased presence of private equity and hedge fund managers – underscores the growing market and political influence of FFRs, alongside inadequate policy measures to safeguard health, environmental sustainability, and equity in these evolving contexts. These results suggest FFRs may contribute substantially to the nutrition transition, highlighting the urgent need for accountability across multiple sectors to foster policy action for healthy, sustainable, and equitable food systems.

Just as the commercial determinants of health are contributing to our understanding of non-communicable disease, the commercial determinants of suicide can inform ways to prevent self-harm injury and mortality. Harms associated with gambling include financial distress, family violence, relationship breakdown and cardiovascular disease. Gambling is also now recognized as a driver of suicidal distress and the suicide toll. Beneficiaries of gambling revenues include commercial entities who prioritise profits over health, and governments who have developed a reliance on taxation revenues.

This presentation will outline a conceptual model of the commercial determinants of gambling-related harm, self-harm and suicide. This model is informed by a review of the Victorian Suicide Register that found at least 4.2% of suicides in Victoria were gambling-related, as well as interviews with people who have been bereaved by gambling-related suicide or directly experienced gambling-related suicidality.

At the system level taxation arrangements can create dependencies on gambling revenue and influence the way in which help services are provided. At the political level lobbying, donations, and the ‘revolving door’ between parliamentarians and gambling operators creating a barrier to meaningful reform. At the scientific level industry funding of research can bias the evidence base. Corporate social responsibility activities serve as legitimation tools and provide an ‘alibi’ for existing arrangements. Gambling products have been supercharged, enabling rapid and substantial losses.

These systems are underpinned by the discourse of ‘responsible gambling’ that frame gambling as harmless fun and those harmed as the source of the problem. This carefully manages the reputation of the industry and undermines suicide prevention efforts.

The commercial determinants of health (CDoH) are an emerging area of inquiry; however, a comprehensive understanding of commercial activities impacting Aboriginal and Torres Strait Islander peoples remains elusive. In 2021, an Australian parliamentary inquiry was initiated to examine how the corporate sector can better engage with Aboriginal and Torres Strait Islander consumers. This study examined the commercial determinants of Aboriginal and Torres Strait Islander health and social wellbeing by analysing submissions to the Inquiry. Twenty-five submissions and 5 supplementary submissions made to the Inquiry by 32 organisations (9 for-profit and 23 non-profit), and the Inquiry’s interim report were analysed. Aboriginal and Torres Strait Islander voices were not identifiable in most (60%) of the submissions. Our findings revealed that commercial entities from various sectors (telecommunications, energy, retail, alcohol, superannuation, insurance, and finance sectors) are harming Aboriginal and Torres Strait Islander peoples through supply of harmful products, misleading branding, unethical retail practices, burdensome contracts and predatory lending. Submissions suggested that unscrupulous commercial practices have increased financial stress, harmed mental wellbeing and reduced access to essential services for Aboriginal and Torres Strait Islander consumers, despite many affirming corporate social responsibility strategies, such as Reconciliation Action Plans. The exploitation of Aboriginal and Torres Strait Islander peoples by the commercial sector is unethical and has significant implications for social wellbeing. Several recommendations for policy, practice, and research are drawn from this analysis including greater regulation of harmful commercial practices and products, stronger oversight of corporate social responsibility strategies related to Aboriginal and Torres Strait Islander peoples, and more inclusive design of government and parliamentary inquiries to facilitate greater participation of Aboriginal and Torres Strait Islander peoples in matters affecting them.

In Australia, colonialism, institutionalised and interpersonal racism, and inequitable access to determinants of health have resulted in significant disparities in the wellbeing of Aboriginal and Torres Strait Islander peoples. While social, cultural, and behavioural determinants of Indigenous health are well-documented, research on the commercial sector's impact on Indigenous health is limited. This project aimed to explore the commercial determinants of health (CDoH) and wellbeing for Aboriginal and Torres Strait Islander peoples.

The project consisted of four studies: (i) a systematic scoping review synthesising international evidence on the commercial sector’s influence on Indigenous health; (ii) an analysis of Australian media coverage of commercial activities impacting Aboriginal and Torres Strait Islander health; (iii) a case study examining the health impacts of a specific commercial actor on Aboriginal health; and (iv) a thematic analysis of interviews with Victorian Aboriginal peoples regarding CDoH.

Findings reveal that industries such as mining, tobacco, alcohol, gambling, and ultra-processed foods often harm Indigenous health. However, Indigenous-owned businesses can enhance cultural wellbeing through connections to Country and self-determination. Media can influence public discourse, often suppressing Aboriginal perspectives on commercial activities. The case study of Woolworths Group’s proposed alcohol megastore near 'dry' Aboriginal communities in Darwin highlights the power of Aboriginal-led advocacy, leading to the proposal's withdrawal.

Commercial entities impact Aboriginal and Torres Strait Islander peoples through practices like privatisation of public services, lobbying, aggressive marketing, insufficient oversight of corporate social responsibility, and the exploitation of Aboriginal culture. These practices affect health and wellbeing through social, cultural, and behavioural pathways. The research underscores the harm caused by various commercial entities and practices while highlighting the power of Aboriginal resistance and the benefits of Aboriginal-owned businesses. It calls for urgent policy action from federal and state governments to prioritise the health of Aboriginal and Torres Strait Islander peoples over commercial profits.

Background
Food, alcohol, and gambling industries are often siloed as distinct industries and/or behavioural risk factors. Australian food, alcohol, and gambling industries are especially integrated through legal requirements, regulatory relationships, integrated businesses, and supply chains. Recent commercial determinants of health (CDoH) literature have sought to better describe commercial entities’ role in public health, and particularly harms. This work uses a CDoH framework to analyse these in this policy context.
Methods
This study analyses the intersection of these industries and their commercial determinants of health through case studies derived from interviews (n=26) and triangulated using document analysis of grey literature documents and academic literature. The case studies were framed according to the commercial entities and public health framework and the guiding questions underpinning this developed by Lacy-Nichols et al.
Results
Case studies of specific actors within the Australian food alcohol and gambling industries emerged through the interviews. Those most frequently described included Woolworths Group, Crown Resorts, and Clubs NSW. These represent integrated commercial entities with similar portfolios of products and varying levels of complexity, resources, organisational attributes, and transparency practices. However, there are many key similarities in their commercial practices, and how their practices affect population health. These are discussed with key comparisons between the case studies.
Conclusions
Food, alcohol and gambling industries represent powerful Australian industries, and there are a number of particularly powerful actors within these industries. This work seeks to deepen understandings of how the practices and attributes key actors across these industries contribute significantly to Australians’ health and wellbeing. Opportunities for intervention include monitoring these and further regulating key leverage points such as common harmful practices, product portfolios, increasing transparency, and addressing issues of market concentration and geography, among others.

Following the COVID-19 pandemic, ‘planetary health’ has been accorded increased attention in scholarly and policy discourse. By highlighting the impact of human activities on ecosystems and their implications for public health, this paradigm represents a welcome effort to systematise global health in the Anthropocene. Nevertheless, this paper argues that this formulation remains of limited use to informing a genuinely transformative public health politics. Utilising conceptual insights from critical political economy and Zizekian ideology critique, it demonstrates that planetary health has largely adopted a post-political orientation. This constitutes a governmental modality narrowing the political domain by ideologically foreclosing consideration and contestation of prevailing political economic processes as contributing to pernicious socio-ecological outcomes. That is, while the latter are subjected to vigorous political debate, their structural determinants are discursively pacified and pushed beyond dispute. Such evisceration engenders a politics of consensual governance, techno-managerial planning, and expert administration within the status quo, rather than seeking more radical change.

The paper argues planetary health buttresses this post-political orientation in two key respects. First, the paradigm is marked by a depoliticised formulation of the ‘Anthropocene’, which evacuates from political debate the antagonisms of neoliberalism and capitalism responsible for contemporary socio-ecological and health calamities. Second, this promotes techno-managerial and market-based solutions designed to better govern within this status quo – holding that the mechanisms responsible for the present predicament can solve it. Through naturalising extant political economic configurations as the horizon for public health initiatives, this formulation thereby forecloses both its contestation and formulation of a broader planetary health politics. Conversely, the paper concludes by outlining an alternative, more transformative public health politics. At its base, this centres on a more capacious, re-politicised conception of planetary health that contests the prevailing political economic system and its instrumental, technoscientific commodification of socio-nature.

Background: This paper presents the findings of a major four-year study of the global tobacco supply chain. Transnational Tobacco and Leaf Companies (TTLCs) and other tobacco supply chain companies argue that provision of livelihoods, exports and corporate social responsibility (CSR) exonerates tobacco. Our objective was to consider these claims.
Methods: This study presents the results of three studies: a literature review and two analyses of data from the innovative Tobacco Supply Chain Database (TSCD).
Study 1: A scoping review of academic literature (124 papers) reviewing how the tobacco supply chain embeds the tobacco industry as a development actor.
Study 2: The statistical association between countries hosting TTLC subsidiaries (TSCD) and TTLC interference in health policy (Global Tobacco Industry Interference Index) was analysed (n=76 countries).
Study 3: Document and website analysis of TSCD independent (non-TTLC) tobacco supply chain companies comparing descriptions of tobacco supply chain involvement and CSR (n=80 independent companies).
Results:
Study 1: Although there are instances of advantages of involvement in the tobacco supply chain, TTLCs undermine governments leading to declines in tobacco workers’ income, equality, quality of life (cultural and health and wellbeing) and nations’ environment and economy.
Study 2: Countries that hosted more TTLCs had more policy interference (farming subsidiaries p=.046, tobacco product manufacturing subsidiaries p=.008).
Study 3: Independent companies were more likely to mention CSR than their connection to tobacco for example 68% linked to CSR activity on their home page whereas only 16% linked to involvement in the tobacco supply chain.
Conclusion: Tobacco supply chain involvement is detrimental to public health and the environment despite companies' CSR activities. Lack of transparency on supply chain involvement by companies is thus a concern. More transparency should be required for companies listing on stock exchanges. Any involvement in the tobacco supply chain should prevent companies being described as an 'ethical investment'. At a national level, tobacco supply chain involvement weakens governments' public health governance. Public health bodies should support countries and companies to extricate themselves from the tobacco supply chain.