Making Big Business Everybody’s Business: Aboriginal leaders’ perspectives on the commercial determinants of Indigenous health in Victoria, Australia

Abstract 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.