How Commercial Determinants of Health Affect Vulnerable and Planetary Health.

Commercial determinants of health (CDOH) is the complex and often negative influences of commercial actors on human and planetary health. The CDOH covers three areas. First, they relate to unhealthy commodities that are contributing to ill health. Secondly, they include business, market, and political practices that are harmful to health and used to sell these commodities and secure a favorable policy environment. Finally, they include the global drivers of ill health, such as market-driven economies and globalization, that have facilitated the use of such harmful practices. Even though CDOH affects everyone, vulnerable groups such as migrant workers are especially at risk and worsen pre-existing economic, social, and racial inequities.

Data from the Thailand Office of Migrant Workers Administration in 2021 shows that there are 3.3 million legally registered migrant workers, about half of whom live in Bangkok and surrounding areas. While illegal migrant workers are likely to be around 3-4 times more numerous, and most of them are unskilled workers. We explore how CDOH affects migrant workers through three illegal migrant workers who live in Bangkok. Sao is an illegal migrant worker from Laos who was abandoned by her Chinese employer who opened a shop in Sampeng Market after she had a work accident. Peng, Burmese migrant workers in Yaowarat, who were left homeless after a fire broke out in Soi Pho, a cheap accommodation area for migrant workers. Sky, a Cambodian male sex worker, contracted HIV from a drug-fueled sex party. They all fled their homes due to the impacts of dam construction, the war in Burma, and global warming caused by capitalist control.

However, the CDOH concept, like other concepts, cannot be used alone to explain complex phenomena but rather requires other concepts to understand and address these planetary health phenomena that affect people.