# Commercial determinants of health—a scoping review of research ‘made in Germany’

## TL;DR

This paper maps Germany's research on how commercial products and industries affect health, finding limited focus on commercial determinants of non-communicable diseases.

## Contribution

The study provides the first scoping review of CDOH research from Germany, highlighting gaps in the field.

## Key findings

- Only 11% of included German research explicitly mentioned 'commercial determinants of health'.
- German CDOH research focused on industries like tobacco, alcohol, food, and pharmaceuticals.
- Authorship networks in German CDOH research were found to be fragmented.

## Abstract

Commercial products such as tobacco, alcohol, ultra-processed food and fossil fuels drive the global burden of non-communicable diseases (NCDs) and the escalating climate crisis. The concept ‘commercial determinants of health’ (CDOH) offers a framework for understanding the ways in which commercial actors, processes, and products influence health. With most CDOH research originating from Anglo-Saxon countries, we sought to map Germany’s CDOH research landscape and related scientific discourse. We conducted a scoping review according to a pre-registered protocol. Records were identified through systematic searches in Medline, Embase, Web of Science, and Google Scholar, last updated 6 December 2024, and by searching seminal CDOH literature. We included peer-reviewed articles (co-)authored by researchers affiliated with German institutions, which examined the public health effects of corporate sector practices; results were presented in an evidence map. We included 136 articles, comprising 64 original research articles (47.1%), 36 overview type articles (26.5%), and 17 opinion pieces (12.5%). Fifteen mentioned the ‘commercial determinants of health’ (11.0%). Research activities focused on the tobacco, alcohol, food, and pharmaceutical industries; articles were primarily concerned with political, scientific, marketing, and reputational management practices. A supplementary social network analysis showed fragmented authorship networks. CDOH are key upstream determinants to consider in the prevention of NCDs. Germany faces a substantial and growing burden of disease from NCDs but the country’s research on the CDOH is limited. We suggest that researchers embrace the scholarship on CDOH, and that practitioners harness relevant insights in addressing the commercially driven NCD burden.