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Correspondence to Dr Charles Henry Livingstone; charles. livingstone@ monash. edu © Author(s) (or their employer(s)) 2022. Reuse permitted under CC BYNC. No commercial reuse. See rights and permissions. Published by BMJ. INTRODUCTION To counteract global growth in noncommunicable diseases (NCDs), the health consequences of climate and environmental emergencies, and inequity in health, it is necessary to better understand fundamental influences on health, and recognise how these differ within and between populations. Social determinants of health (SDoH) studies provide understanding of how inequality shapes health. However, we understand less about how capitalism, globalised corporate and commercial systems and broader political–economic and global governance conditions facilitating these, directly and indirectly shape inequality and health. As these systems have profound influence over population health and social circumstances, understandings of commercial determinants of health (CDoH), and integrating these conceptually within SDoH, are crucial. CDoH represent a significant global health concern for a number of reasons. Due to the globalised nature of modern commerce, and the transnational presence of commercial actors, the effects of CDoH are felt the world over. 4 These are facilitated by the weakening of global governance structures such as the World Trade Organization, the proliferation of multinational free trade policies that favour business and the increasing concentration of commercial actors into global oligopolies, among others. These systems have roots in colonialism, and see commercial interests originating from highincome countries extracting resources and wealth from lowincome and middleincome countries (LMICs). While the effects of commercial and corporate influences on population health are continually being identified and recognised, these are an emerging field of public health and are yet to be comprehensively integrated within CDoH framing. As a recent review found, CDoH literature lacks precision, with CDoH definitions and/ or conceptual frameworks only occasionally provided, portrayed as ‘assumed knowledge’, inconsistently applied and unrepresentative of broader literature. Additionally, CDoH are not wellarticulated nor communicated, with analyses often narrowly formulated around specific industries, and yet to be included systematically within public health policy frameworks and interventions. Together, these represent ‘an elephant in the room’: the increasingly obvious but often ignored problem of the profound influence of commercial and corporate influences on human and planetary health.