Alessandro Connor Crocetti

Issue Addressed: This study aimed to quantify Aboriginal adults' exposure to digital marketing of unhealthy food and beverages, alcohol, gambling, tobacco and e‐cigarettes; analyse demographic differences in marketing exposure; and describe the nature of digital marketing reaching Aboriginal audiences, including brands, platforms and marketing tactics. Methods: Thirty‐one Aboriginal adults were asked to record their screens, capturing approximately one‐third of their usual daily screen time (maximum 60 min). Recordings were analysed using SCANNER, an automated system trained to detect unhealthy commodity marketing. Demographic data and usual online behaviours were collected via an online survey. Descriptive statistics, a post hoc Mann–Whitney U test and a Fisher–Freeman–Halton extension of Fisher's Exact test were used to analyse differences in marketing detections. Results: Most participants ( n = 29/31, 94%) were exposed to unhealthy digital marketing. Of the 587 marketing instances detected, unhealthy food brands were most common (47%), followed by gambling (28%), alcohol (15%), sweetened beverages (9%) and tobacco (1%). No e‐cigarette marketing was detected. Estimated daily exposure to unhealthy digital marketing was 40.4 (IQR: 11–92) instances per day. Male participants, aged 30 years and under, recorded significantly more marketing detections overall and for unhealthy food, alcohol and gambling brands. Conclusion: Findings highlight the pervasiveness of unhealthy food and beverage, gambling and alcohol marketing in the everyday digital lives of Aboriginal participants. So What?: Comprehensive regulation of unhealthy digital marketing is urgently required to advance Aboriginal health.

While pharmaceutical companies develop life-saving medicines and the pharmacy sector is integral to healthcare delivery, entities within the medicines sector can also operate as powerful commercial actors. The practices of the pharmaceutical industry and the pharmacy sector warrant scrutiny through a commercial determinants of health lens. This is particularly important for Indigenous peoples, who experience inequities within Western healthcare systems while also holding enduring cultural knowledge of traditional medicines. Despite increasing international attention to the practices of the pharmaceutical industry, the influence of the medicines sector, as a whole, on Aboriginal and Torres Strait Islander peoples in Australia has not previously been examined. This study aimed to examine the systems, practices and pathways through which the pharmaceutical industry and the pharmacy sector may influence Aboriginal and Torres Strait Islander health and wellbeing. We applied the Aboriginal research method of Yarning to explore the perspectives and experiences of ten Aboriginal/Torres Strait Islander and nine non-Indigenous participants with expertise relevant to the pharmaceutical industry and/or the pharmacy sector. Five themes revealed tensions between commercial models within the pharmacy sector and community needs; regulatory marginalization of cultural medicines and the need to protect Indigenous cultural and intellectual property; pharmaceutical industry efforts to partner with Aboriginal organizations; the lobbying power of peak pharmacy sector bodies; and opportunities for genuine collaboration. Strengthening culturally safe practice, embedding pharmacists within Aboriginal Community Controlled Health Services, and elevating Aboriginal and Torres Strait Islander governance across the medicines sector are critical to addressing power imbalances and advancing health equity.

Background and aims: Alcohol‐related content on social media, particularly user‐generated content (UGC), is an increasingly normal feature of young people's digital lives and has been linked to increased alcohol use; however, a critical gap remains in understanding how different subgroups of young people are exposed to and engage with such content, and how this may be associated with their alcohol‐related attitudes and behaviours. This systematic review aimed to synthesise evidence on the association between alcohol‐related UGC and young people's alcohol‐related attitudes and behaviours, and to describe patterns of exposure and engagement within subgroups of adolescents and young adults. Methods: A systematic search was conducted in September 2023 and again in February 2026 across MEDLINE, PsycINFO, SocINDEX, EMBASE and CINAHL. Eligible peer‐reviewed quantitative (cross‐sectional and longitudinal), qualitative and mixed‐methods studies described alcohol‐related UGC (including influencer content); explored social media use; examined associations with alcohol‐related attitudes, behaviours or harms; and focused on adolescents or young adults. A narrative synthesis was undertaken. This review was conducted in accordance with PRISMA guidelines, and quality assessment was conducted. Results: Forty‐six studies met the inclusion criteria (24 cross‐sectional, 14 longitudinal, seven qualitative, one mixed methods), with quantitative studies including 44 219 participants. Overall study quality was moderate, with limitations in sampling and non‐response reporting. Among the quantitative studies examining alcohol‐related UGC and behavioural outcomes (including alcohol use and intentions), most ( n = 28/29) reported positive associations. These were observed across passive exposure, active engagement and combined measures, as well as across self, peer and influencer generated content. Subgroup findings ( n = 22) indicated that associations varied across populations and contexts: adolescents, particularly those under 16, appeared more responsive to peer‐generated content via social norms and online identity, while young adults in university settings were influenced by social and institutional contexts, including influencer content. Additional variation was observed among heavy social media users, non‐drinkers and sex subgroups. Conclusions: Exposure to alcohol‐related user‐generated content on social media (including peer and influencer generated content) and engagement with self‐generated content appear to be associated with alcohol use among young people, with largely consistent findings observed across studies. Subgroup findings suggest these associations may vary across contexts and populations, particularly among younger adolescents, young adult university students, heavy social media users, non‐drinkers and sex subgroups.

The commercial determinants of health (CDoH) are increasingly recognized as major drivers of non-communicable disease and health inequities. However, the extent to which CDoH concepts are translated into policy action remains unclear. This study examined the extent to which Australian public health and health promotion policies recognize and respond to the CDoH. We conducted a critical qualitative content analysis of 94 Australian Commonwealth, state and territory public health and health promotion policy documents published between 2015 and 2025. Using a theory-informed a priori coding framework, we examined explicit recognition of CDoH and the nature of proposed policy responses. Eighteen policies explicitly referred to the CDoH or related concepts, all published from 2021 onwards, indicating recent but uneven policy uptake. Legislative and regulatory measures were concentrated in a small number of Commonwealth-led strategies and focused primarily on tobacco, with more limited attention to unhealthy food and alcohol. State and territory strategies relied more heavily on public awareness campaigns and administrative tools rather than direct regulation of the commercial sector. Governance protections against industry interference were largely confined to tobacco control, with no measures targeting the gambling and fossil fuels industries. Australian public health and health promotion policies demonstrate emerging but uneven recognition of the CDoH, with limited institutionalization through regulatory and governance measures. These findings highlight ongoing challenges in translating health promotion and CDoH frameworks into coherent, whole-of-government policy responses to address the commercial drivers of health and health inequity.

Aboriginal and Torres Strait Islander peoples experience a disproportionate burden of gambling-related harms, yet there is limited evidence on the determinants, impacts and solutions. While gambling has both cultural and social dimensions within many communities, commercial gambling products pose significant risks, particularly within the broader context of colonisation, socioeconomic inequities, and targeted industry practices. This scoping review systematically mapped and synthesised, informed by Aboriginal perspectives, the literature on the determinants and impacts of gambling harm among Aboriginal and Torres Strait Islander peoples in Australia, alongside proposed actions to reduce harm and evidence gaps. A systematic search of peer-reviewed and grey literature published after 2001 was conducted across Medline, CINAHL, PsycINFO, Informit Indigenous collection and Scopus, alongside grey literature from Australian Aboriginal and Torres Strait Islander health organisations, government agencies, and web-based sources. Articles were included if they focussed on Aboriginal and/or Torres Strait Islander peoples in Australia and examined gambling determinants, impacts or solutions. Forty-two articles (29 peer-reviewed, 13 grey literature) were identified. Socio-cultural determinants were most frequently examined (79%), followed by individual determinants (60%), with less attention to environmental (33%), social (31%), commercial (19%) and political (7%) determinants. Commercial gambling, particularly electronic gaming machines and online sports betting, was linked to financial distress, family violence and erosion of kinship networks. Responses were predominantly individual or community-based (63%), with fewer addressing structural drivers (25%). Future research should adopt a commercial determinants of health lens, particularly to examine online gambling and marketing practices on Aboriginal and Torres Strait Islander peoples.

Social media platforms are increasingly saturated with alcohol-related user-generated content (UGC), which can shape young people’s attitudes and behaviours towards drinking. While all young people are potentially influenced by this content, certain groups, such as Aboriginal young people; lesbian, gay, bisexual, transgender, queer, or other sexual and gender minorities (LGBTQ+) young people; and those living in regional areas, experience disproportionate alcohol-related harms and may have unique experiences with alcohol-related UGC. However, research examining these diverse perspectives remains limited. This qualitative study explored perspectives of Aboriginal, LGBTQ+, and regional young people (aged 16–20) regarding alcohol-related social media practices through semi-structured interviews (n = 24). Reflexive thematic analysis was applied, with four overarching themes constructed from the data: (i) participants described alcohol posting as performative practice tied to sociability, identity, and peer influence; (ii) social media posts and digital amplification were seen to embed binge drinking culture within youth identity; (iii) Aboriginal, LGBTQ+, and regional participants reported distinct responses to alcohol UGC, with experiences shaped by stereotyping, safety concerns, and permissive environments; (iv) influencer-generated content was viewed as highly pervasive and many participants expressed scepticism at its authenticity. Policy action is needed to protect young people from the harms associated with online alcohol promotion and must recognize the intersectional experiences of young people from Aboriginal, LGBTQ+ and regional communities.

Background: The commercial determinants of health is a rapidly expanding field of research; however Indigenous perspectives remain notably underrepresented. For Indigenous peoples the intersection of globalisation, colonialism and capitalism may amplify commercially-driven health inequities. This study aimed to explore the perspectives of Aboriginal leaders regarding the influence of commercial activities on Aboriginal health and wellbeing in Victoria, Australia.Methods: Semi-structured interviews with 23 Aboriginal leaders from across five sectors (n = 15 urban,n = 8 rural/regional) were analysed through reflexive thematic analysis.Results: Three overarching themes were identified encompassing (i) harmful commercial practices and processes, (ii) improving corporate engagement and (iii) opportunities for self-determination through business. Participants expressed concern over aggressive marketing by the gambling industry, commercial exploitation of Aboriginal culture, the privatisation of public services, and lack of oversignt of corporate social responsibility strategies. Simultaneously, Aboriginal-led businesses were viewed as opportunities for cultural connection, and financial empowerment and self-determination.Conclusion: Numerous commercial entities and activities are perceived to influence Aboriginal health and wellbeing. This study highlights the need for stronger policy and regulation to mitigate harmful industry practices while incentivising the potential positive impacts of the commercial activities on Aboriginal health and wellbeing.

Background The commercial determinants of health is a rapidly expanding field of research; however Indigenous perspectives remain notably underrepresented. For Indigenous peoples the intersection of globalisation, colonialism and capitalism may amplify commercially-driven health inequities. This study aimed to understand the perspectives of Aboriginal leaders in Victoria, Australia, regarding the impact of commercial entities and their practices on Aboriginal health and wellbeing. Methods Semi-structured interviews with 23 Aboriginal leaders from across five sectors (n = 15 urban, n = 8 rural/regional) were analysed through reflexive thematic analysis. Results Five overarching themes were identified, encompassing i) the adverse impacts of industries on Aboriginal peoples, ii) the intersection between colonialism and western economic paradigms, iii) tokenistic corporate engagement with Aboriginal communities, iv) supporting Aboriginal-owned businesses, and v) opportunities for self-determination through business. Participants expressed concern over aggressive marketing by the gambling industry, the exploitation of Aboriginal culture by commercial industries, the privatisation of public services, and the lack of oversignt of corporate social responsibility strategies. Simultaneously, Aboriginal-led businesses were viewed as opportunities for cultural and financial empowerment and self-determination. Conclusion Numerous commercial actors and practices are perceived to influence Aboriginal health and wellbeing. This study highlights the need for strong policy and regulation to mitigate harmful industry practices while incentivising the potential positive impacts of the commercial activities on Aboriginal health and wellbeing.

This study aimed to examine the extent and nature of Australian news media coverage of commercial industry activities that explicitly speak to Aboriginal and Torres Strait Islander contexts. We undertook content and framing analysis of Australian newspaper and online media articles published between January 2018 and March 2022 that included terms related to ‘Indigenous’, ‘commercial’ and ‘health’. Analysis focused on the nature of coverage, framing of responsibility, patterns over time and stakeholder representation. Forty-six media articles were included in the analysis. Half of these articles related to the actions of three companies (Woolworths, WAM Clothing and Rio Tinto). Most articles described negative health and well-being impacts of commercial activity, while four described positive impacts. The most common voice represented in media articles was from industry (n = 25). Aboriginal or Torres Strait Islander voices were represented in 21 articles. This analysis highlights how commercial activities in Australia are reported to negatively influence Aboriginal and Torres Strait Islander health and well-being, and that industry voices are more commonly represented in the media related to these issues.

Background: The health and wellbeing impacts of commercial activity on Indigenous populations is an emerging field of research. The alcohol industry is a key driver of health and social harms within Australia. In 2016 Woolworths, the largest food and beverage retailer in Australia, proposed to build a Dan Murphy’s alcohol megastore in Darwin, near three ‘dry’ Aboriginal communities. This study examines the tactics used by Woolworths to advance the Dan Murphy’s proposal and understand how civil society action can overcome powerful commercial interests to protect Aboriginal and Torres Strait Islander health and wellbeing.Methods: Data from 11 interviews with Aboriginal and non-Aboriginal informants were combined with data extracted from media articles and government, non-government and industry documents. Thematic analysis was informed by an adapted corporate health impact assessment framework.Results: Woolworths employed several strategies including lobbying, political pressure, litigation, and divisive public rhetoric, while ignoring the evidence suggesting the store would increase alcohol-related harm. The advocacy campaign against the proposal highlighted the importance of Aboriginal and non-Aboriginal groups working together to counter commercial interests and the need to champion Aboriginal leadership. Advocacy strategies included elevating the voices of community Elders in the media and corporate activism via Woolworths’ investors.Conclusions: The strategies used by the coalition of Aboriginal and non-Aboriginal groups may be useful in future advocacy campaigns to safeguard Aboriginal and Torres Strait Islander health and wellbeing from commercial interests.