Using a systems approach to identify areas of action for addressing the CDoH

Abstract Commercial determinants of health (CDoH) present a challenge for authorities working to improve public health within local communities. Commercial actors influence local systems in many ways, involving multiple actors and stakeholders. This complexity makes it challenging to identify actions with potential to drive sustainable change, reshaping dynamic systems to improve health and equity. Work package 1 (WP1) of the Local Health Global Profits (LHGP) study aims to assess the ways in which taking a systems approach may contribute to identifying leverage points where action can address the CDoH at local level. The work package involves two stages. In Stage 1, expert stakeholders constructed a conceptual map of commercial influences on health amenable to intervention at local level, setting the boundaries of the system and identifying domains which were used to generate a CDoH action domains framework. In Stage 2, we will work with eight localities across England, bringing together representatives from local government, third sector and the public with diverse expertise (e.g. public health, planning, transport, education, finance), to develop topic- and locality-specific conceptual system maps. These maps will be refined using qualitative methods with key stakeholders and the CDoH action domains framework. Following this, a smaller working group within each site, will identify actions to implement. In this presentation, we will share results and reflections on the use of systems methods with LAs. Systems approaches have been widely promoted in public health but are yet to be tested and robustly evaluated as a method for identifying areas of action in local governments working to address CDoH. This work will forge important developments and innovations in this area of public health research.