Commodified upbringings: A narrative review on commercial determinants of child and adolescent mental health
Review article
Background
In 2020, the WHO-UNICEF-Lancet Commission asked: A future for the world’s children?
The World Health Organization (WHO), together with UNICEF and The Lancet issued a new Commission on the future for the world’s children. It laid the foundations for a new global movement for child health that addresses the two existential crises adversely affecting children’s health, well-being and development.
The Commission presented high-level recommendations that position children at the centre of the Sustainable Development Goals (SDGs).
The first sentences of the Commission’s Executive Summary outlined the two crises:
Despite dramatic improvements in survival, nutrition, and education over recent decades, today’s children face an uncertain future. Climate change, ecological degradation, migrating populations, conflict, pervasive inequalities, and predatory commercial practices threaten the health and future of children in every country.”
WHO-UNICEF-Lancet Commission on the future for the world’s children
The health and wellbeing of children now and in the future depends on overcoming new challenges that are escalating at such speed as to threaten the progress and successes of the past two decades in child health.
The climate emergency is rapidly undermining the future survival of all species, and the likelihood of a world in which all children enjoy their right to health appears increasingly out of reach. A second existential threat that is more insidious has emerged: predatory commercial exploitation that is encouraging harmful and addictive activities that are extremely deleterious to young people’s health.
Abstract
Introduction
The mental health of children and adolescents has become a major global health concern, with increasing diagnoses and use of psychotropic drugs. The commercial determinants of health (CDoH) paradigm links economic and social forces to health outcomes.
Highlighting the influence of industries such as food, pharmaceuticals, technology, social media, gambling, alcohol, tobacco and pornography on the mental health of this population is crucial.
Materials and Methods
This narrative review synthesises existing literature on the impact of commercial determinants on child and adolescent mental health.
Researchers conducted a comprehensive search using PubMed, PsycINFO and Google Scholar, covering publications from 2000 to 2024. The review focused on peer-reviewed articles, reports and relevant grey literature examining the influence of commercial practices on mental health.
Results and Discussion
The review found 45 studies from different countries and industries, highlighting how commercial practices and exposure to their content negatively impact children’s and adolescents’ mental health.
Beyond traditional industries such as tobacco, food and alcohol, the review explores others.
- Social media use is linked with increased anxiety and depression due to social comparison and cyberbullying.
- Easy access to pornographic content distorts perceptions of relationships and sexuality, contributing to anxiety, depression and behavioural disorders.
- The gambling industry’s normalisation of betting through advertising influences addictive behaviour from an early age.
- Aggressive marketing by the pharmaceutical industry can lead to excessive or inappropriate use of diagnostic labels and psychotropic medications, exacerbating mental health problems and posing significant ethical and public health challenges.
Conclusion
Commercial determinants significantly impact child and adolescent mental health, necessitating a multifaceted approach to address these challenges. Parents and children’s education, implementation of public policies and regulation of harmful commercial practices are essential to protect and promote mental health in future generations.
Understanding and mitigating the effects of CDoH are crucial for ensuring a healthy developmental environment for children.
Commercial Determinants of Health (CDoH)
Movendi International provides more than 60 resource articles about CDoH and alcohol, or the commercial drivers of alcohol harm.
The term ‘commercial determinants of health’ (CDOH) is increasingly focusing attention on the role of tobacco, alcohol and food and beverage companies and others – as important drivers of non-communicable diseases (NCDs). However, the CDOH do not seem to be clearly represented in the most common social determinants of health (SDOH) frameworks.
In 2020, a study reviewed a wide range of existing frameworks of the determinants of health to determine whether and how commercial determinants are incorporated into current SDOH thinking.
This is important to ensure public health models properly frame and address public health problems and solutions in ways that illustrate and tackle the role that the private sector, in particular large transnational companies and their health harming products and practices, play in shaping the broader environment and individual behaviours, and thus population health outcomes.
Regarding the alcohol industry as commercial driver of ill-health and avoidable deaths, Movendi International has compiled evidence to illustrate the fundamental and direct conflict of interest.
Three examples of CDoH regarding the predatory practices of Big Alcohol are: