Commercial determinants of health

Background

Health is driven by social, economic, commercial, environmental and digital determinants. Personal behaviour plays a part, but industry tactics or corporate practices, such as aggressive marketing of unhealthy products or lobbying against stricter health regulations, have a major, well-documented impact on public health. They account for about 70% of health status; individual behaviours for roughly 10%. The “exposome” concept captures all lifetime environmental exposures and their effects on the health of an individual.

Non‑communicable diseases (cardiovascular disease, cancers, chronic respiratory disease, diabetes) cause 90% of deaths and 85% of disability/incapacity in Europe. The economic and health costs linked to cardiovascular disease, obesity, alcohol and tobacco exceed EUR 700 billion per year. Estimates for tobacco point to 700,000 deaths; the related healthcare costs amount to EUR 98–130 billion (up to 1.39% of GDP). Alcohol is estimated to be responsible for 255,000 deaths and for EUR 125 billion in healthcare costs. Obesity is thought to account for more than EUR 10 billion.

Harmful products (tobacco, alcohol, ultra‑processed foods) are implicated in some 2.7 million deaths annually ─ about 25% of total mortality (approximately 7,400/day). As pointed out by the WHO, commercial practices amplify harm: roughly 80% of ultra‑processed food advertising targets young people; industry has mobilised some EUR 30 million to resist sugar taxes; lobbying, externalising disease costs and influencing research remain common.

Work also matters: absences linked to chronic disease and psychosocial risks cost an estimated 2.5–4% of EU GDP ─ about EUR 470–750 billion per year.

Drawing on the WHO’s study, the EESC in the opinion highlights commercial determinants ─ profit-maximising corporate strategies that harm public health. It proposes stronger measures to prevent and reduce non-communicable diseases.

Key points:

In the opinion, the EESC:

• stresses the urgent need to take a comprehensive, preventive approach based on fundamental human rights to the commercial determinants of health, which are defined as strategies of private actors that negatively influence health and democratic checks and balances;
• calls on the EU and its Member States to adopt ambitious policies and strategic funding – including under the next Multiannual Financial Framework for 2028-2034 – to make health a central pillar of European resilience, particularly with a view to prevention;
• encourages the establishment of a balanced regulatory framework that allows businesses to transition towards models that respect public health, by including the precautionary principle, transparency and due diligence clauses in public policies.

Read the opinion.

Additional information

Section: Single Market, Production and Consumption

Opinion number: INT/1080

Opinion type: Own-initiative opinion

Rapporteur: Alain COHEUR

Co-rapporteur: Christophe LEFÈVRE

Reference: Rule 52(2) of the Rules of Procedure

Date of adoption by section: 2/9/2025

Result of the vote: 65 in favour/5 against/6 abstentions

Date of adoption in plenary: 18/9/2025

Result of the vote: in favour/ against/ abstentions

Contacts:

Press officer: Laura Lui

Tel.: +32 2 546 9189

Email: laurairena.lui@eesc.europa.eu

Administrator: Silvia STAFFA

Tel.: +32 2 546 8378

Email: silvia.staffa@eesc.europa.eu