The commercial determinants of health (CDoH) are the systems, practices and pathways through which commercial actors drive health and equity. This review aimed to identify CDoH governance approaches, distinguishing between promoted and criticized approaches.
We conducted a systematic scoping review in PubMed and Google Scholar databases. Relevant grey literature was also identified through citation searching and reference list review. Our search strategy combined terms related to economic and commercial determinants of health, governance models and health outcomes. English-language publications between January 2000 to December 2025 were included. Relevant data from included sources were extracted and then synthesized using an inductive approach.
Our review of 155 publications identified numerous CDoH governance tools and collaborative approaches, but it also revealed inadequate empirical evidence on governance strategies. Market regulation, taxation and civil society advocacy emerged as consistently supported governance mechanisms, while industry self-regulation was consistently identified as ineffective. Global frameworks and accountability mechanisms were highlighted as necessary elements for CDoH governance, but there was no convergence on specific accountability instruments. Collaborative governance approaches, such as health in all policies and whole-of-government, were generally viewed positively; however, private sector involvement remains contentious.
To our knowledge, this is the first review to systematically identify governance approaches discussed across the CDoH literature and examine patterns of support or criticism for different approaches. We found inadequate empirical evidence on the effectiveness of specific approaches and a lack of consistent terminology, which has important implications for future research.
