Estimating Wellbeing and Long-Term Costs and Benefits to Limit Commercial Determinants of Health

Abstract The commercial determinants of health (CDoH) are increasingly recognised as significant drivers of non-communicable diseases, health inequalities, and environmental degradation. Local authorities, positioned at the intersection of health, housing, transport, planning, and economic development, are uniquely placed to implement upstream policies that address these determinants. However, their ability to act is often constrained by limited resources, competing policy agendas, and a lack of accessible tools to assess the long-term implications of interventions. This presentation introduces an economic modelling approach that supports local authorities in designing and evaluating upstream policies to mitigate the influence of harmful commercial practices. Moving beyond traditional cost-benefit frameworks focused narrowly on health system savings or short-term outputs, we advocate for an integrated model that estimates both the wellbeing impacts and long-term economic benefits of public health interventions. Our modelling framework builds on systems thinking and incorporates interdependencies between economic, social, and health domains. It can simulate the effects of local level interventions such as implementing alcohol outlet density caps or clean air zones on population health, wellbeing, productivity, and equity over time. By integrating synthetic population datasets, microsimulation methods, and scenario based projections, the model enables policymakers to explore the trade-offs and co-benefits of different strategies. We will share preliminary findings from case studies, illustrating how the model can estimate the distributional effects of interventions across population subgroups. The proposed approach offers a promising path to support local authorities with evidence informed strategies that can realign local systems towards health, sustainability, and equity.