The Commercial Determinants of Men’s Health Promotion: A Case Study of Gambling,Nonnies,and Athleisurewear

Abstract

Although the social determinants of health have guided equity work with the tailoring of men’s health promotion programs, the role of, and potential for, the commercial determinants of health in those interventions is rarely addressed and poorly understood. While four commercial products, tobacco, alcohol, ultra-processed food, and fossil fuels, account for more than a third of global deaths, there is a need to recognize that consumer goods industries can make both positive and negative contributions to health. This article begins much-needed discussions about what we might learn from, and strategically tap in the commercial sector to seed, scale, and sustain men’s health promotion programs. Three case studies, online sports betting, beer and the rise of the nonny, and athleisurewear, are discussed. Connections between online sports betting and masculinities explain young men’s disproportionate involvement and gambling addictions with recommendations to legislate an end to gambling advertisements and de-incentivize industry profiteering through penalties and higher taxes. Regarding beer and the rise of the nonny, brewers have innovated with non-alcoholic beer based on shifting consumption patterns and masculinities in their core market—men. The nonny reminds health promoters to know their end-user’s values and behaviors to bolster program acceptability. Detailing Under Armour and Lululemon, two highly gendered but diversifying athleisurewear brands, the complexities of, and potential for, leveraging public health and industry collaborations are underscored. Taken together, the article findings suggest men’s health promoters should rigorously explore tapping key commercial entities and tax revenues to advance the health of men and their communities.

Introduction

While the social determinants of health have guided equity work with the tailoring of men’s health promotion programs (Oliffe et al., 2020), the role of, and potential for, the commercial determinants of health in those interventions is rarely addressed and poorly understood (Galdas et al., 2023). This disconnect relates in large part to the many problematics for how particular products, companies, and industries risk rather than promote men’s health, and the related challenges for more positively operationalizing commercial entities. Amid detailing that four commercial products, tobacco, alcohol, ultra-processed food, and fossil fuels, account for more than a third of global deaths, Gilmore et al. (2023) urged the need to recognize that industry can make both positive and negative contributions to health. To convey this dual perspective, they suggested [re]defining the commercial determinants of health as “the systems, practices and pathways through which commercial actors drive health and equity” (Gilmore et al., 2023, p. 1195). Further lobbied by Gilmore et al. (2023) and others (Friel et al., 2023) was primary research to rigorously decide which commercial entities might be purposefully engaged to authentically promote health. The current article offers an introduction to, and thoughtful consideration of the commercial determinants of men’s health promotion drawing on three examples: online sports betting, beer and the rise of the nonny, and athleisurewear. The article purpose is to advance much-needed discussions about what we might reasonably learn from, and strategically tap in the commercial sector to seed, scale, and sustain men’s health promotion programs.

Linking the Commercial Determinants of Health, Masculinities, and Men’s Health Promotion

Much of the commercial determinants of health literature rightly highlights and petitions against the harms of business practices and industries that put profits before people (Gilmore et al., 2023; Maani et al., 2022). Among the four previously listed product culprits, big tobacco has persisted as knowingly injurious, and ever-adaptive in working around government regulations to sell cigarettes, and by extension ill-health. Ranging the strategic surrender to secondhand smoke restrictions that segregated smokers but enabled smoking, arguing consumer’s informed consent as individual’s knowing the harms of their tobacco use, through securing market-entry by masquerading e-cigarettes and vaping as tobacco reduction devices, big tobacco continues to embody the most unscrupulous commercial determinants of health (Binns & Low, 2018). Interestingly, men are overrepresented both as perpetrators and victims of big tobacco (and most other health-risk products) with their dominance in the manufacture and sales, and consumption with higher smoking rates compared with women (Dai et al., 2022; Marino et al., 2021; Patró-Hernández et al., 2020). The connections to masculinities abound here, with global neoliberal markets richly incentivizing (and rewarding) men who competitively pitch their corporate wares to maximize company profits (Berdahl et al., 2018; R. Connell, 2016). Also, idealized masculine identities, including the iconic Marlboro man, are successfully marketed to promote men’s tobacco use (White et al., 2012). Indeed, the successful marketing of health-risk products to men has traditionally employed the persuasive and pervasive selling of masculinity (White et al., 2013). Concluding the big tobacco example, industry disclaimers that men who smoke know their risks seamlessly connects with the rights-based arguments that male smokers make for their own tobacco use, to transact the sale and purchase of risk-taking and self-reliance masculine norms.

While the damage emanating from the commercial determinants of men’s health demands ongoing governance, legislation, and nimble policy adjustments, there has been recent attention to the potential benefits for working with reputable, ethical industry partners. There are some pressers for this [re]thinking, foremost economic drivers. First, public health services, idealized as governments freely, equally, and infinitely providing evidence-based tax-funded care have long been exposed to, and influenced by free-enterprise markets. This can be seen in the fee-for-service model growth with access to specific treatments and specialist providers increasingly tied to private health insurance and/or means-tested to determine subsidies and end-user out-of-pocket expenses. The insurmountable COVID-19 public health debt, deeply contrasted by the pandemic profiteering of some medical supply and pharmaceutical companies (Sell, 2020), has perhaps also hastened exploration for working innovatively with some commercial determinants of health. Second, men’s health promotion, a politically motivated and articulated model of care, has long relied on researchers securing competitive grant funding to develop community-based programs (Oliffe et al., 2020). Amid low funding success rates—typically 15% (Government of Canada, 2017)—for empirically informed men’s health promotion programs, these investments have, for the most part, spawned interventions that prematurely end with the modest project budgets used to build them. Oliffe (2024) calls this the tumbleweed effect—wherein men’s health promotion start-ups are forever adrift and lost without ongoing resources to fully evaluate and adjust, let alone scale and sustain them. Here, strategies associated with commercial determinants of health might ably inform much needed business models for men’s health promotion, and/or directly lever what are essentially dead-end research and development investments. Affirming the potential for such public–private sector collaborations, Friel et al. (2023) note that the time is politically ripe for such ventures given the current drive for businesses to prioritize and actively promote pro-social values as well as meaningfully contribute to sustainable environments.

Of course, there are important caveats for making these industry linkages, and guidelines have been developed for health promoters to rigorously research companies to decide the potential fit of commercial partners. Prominent is Lacy-Nichols et al.’s (2023) five category framework: practices, portfolios, resources, organization, and transparency, which offers an exhaustive checklist to research prospective commercial entity partners. Included are recommendations for researching entity attributes and affiliations (Ralston et al., 2021) including company activities and brands that are seemingly separate (but commercially connected) to the manufacturing and/or marketing of the products being sold (Hoepner & Schopohl, 2018). In addition, structurally, there is support for the WHO to guide national governments to more evenly regulate and collect higher taxes from transnational corporations who produce harmful commodities (Marten et al., 2018), with further recommendations for distributing those tax revenues to finance public health care services (Friel et al., 2023).

In what follows, we share three case studies: online sports betting, beer and the rise of the nonny, and athleisurewear, as a means to introducing and thoughtfully considering the commercial determinants of men’s health promotion.

Online Sports Betting

Online sports betting has emerged as a highly lucrative and addictive contemporary spin on gambling, with commercially driven negative effects on men’s mental health and, by extension, their families and friends (Nyemcsok et al., 2022). The virtual gambling houses that sell online sports betting, by their own admission, always win; yet, the lure of beating the odds and winning big consistently overrides the well-established fact that gamblers always (sooner or later) lose. The gendered marketing of online sports betting to men is troublingly effective, and governments’ significant gambling tax revenue[s], along with industry payments to many of the leagues who host the games being bet on, have further contributed to the exponential growth of this largely unregulated industry.

Historically, men have gambled at twice the rate of women (Wong et al., 2013), and with online sports betting targeting young men, this sex difference will likely grow (McGee, 2020). Indeed, in the U.K. men own more than three quarters (78%) of the online betting accounts (Forrest & McHale, 2022), with males contributing 94% of the gambling sector revenue (GamCare, 2019). These ominous statistics reflect men’s compulsion for elite competitive sports, with allegiances to leagues, teams, and players driving bets on an array of outcomes and games (Watters, 2024). An accepted, even necessary component of watching a game live, betting is marketed as a fun social activity and arena for men’s expertise and risk tolerance—masculine performances that both mirror and heighten their involvement in the competition being watched (Lamont & Hing, 2020). Reinforcing these norms, gambling ads are visible to spectators for up to 20% of every sporting event telecast (McMillan et al., 2024), and the combination of alcohol and betting in sports bars with giant screens and drinks specials results in men consistently wagering more than they otherwise would (Deans et al., 2016). Online betting syndicates also connect men and build peer solidarity, with many gambling apps networked to social media platforms with prompts for users to post details about their wins (Deans, Thomas, Daube, & Derevensky, 2017). The gadgetry and convenience of mobile betting apps is a draw with reports indicating that men who gamble at moderate levels have between two and seven accounts on their phone (Deans, Thomas, Daube, & Derevensky, 2017).

In terms of men’s negative health outcomes, online sports betting is associated with higher levels of problem gambling and more severe gambling issues (Etuk et al., 2022). Herein, men are 7.5 times more likely than women to have their lives disrupted by problem gambling (Hemming, 2018), a dire situation reflected by 70% of callers to the Australian National Gambling Helpline being male (GamCare, 2019). The 30% increase in gambling addictions 2018 through 2021 indicated that young men, 18- to 24-years-old, who had engaged in online sports betting, were the most negatively affected subgroup (Whyte, 2023). Worryingly, betting apps routinely collect the users’ banking information and gambling habits, and even when men delete their apps they are still contacted through email, text, and/or social media lures informing them of free bets, potential winnings and favorable odds for upcoming games (Satariano, 2021). The ironies abound here in that young men are betting on the physical and psychological prowess of elite athletes (masculine health hegemonies), while losing their money and risking addiction and their mental health.

There are also significant structural forces triaging the commercial gambling profits above men’s mental health. Since 2018, the legalization of online sports betting directly maps to men’s increasing rates of gambling addiction (Deans, Thomas, Derevensky, & Daube, 2017). Australia and the United Kingdom have the most liberal sports gambling markets in the world, and the United States has an ever-growing online sportsbook and betting app market that is similarly focused on young men (Etuk et al., 2022). In 2021, amid COVID-19 lockdown restrictions, Canada passed Bill C-218, the Safe and Regulated Sports Betting Act, removing restrictions on single-game wagering to entice more gambling through in-game, multi-game, and cross-league bets (Watters, 2024). Within months of the act being passed, Canadian online sports gambling grew exponentially, with Ontario’s open gambling sector approving >70 gambling websites. Managed by iGaming Ontario, in the third quarter of 2023 alone, sports fans wagered $17.2 billion, and gambling companies quadrupled their earnings, for which the provincial tax revenue tallied >$650 million (iGaming Ontario, 2024; McMillan et al., 2024). Many leagues hosting the games also receive money from the gambling industry. For example, the Australian Football League (AFL) collects $8 million a year, plus 10 cents for every bet placed on the games with their gambling industry partner Sports Bet (Clure, 2023). The owners of the AFL’s television broadcasting rights (the league’s biggest revenue source) also sell gambling advertisements in and around their match telecasts. America’s National Football League (NFL) collects a staggering $2.3 billion in gambling revenue each year from betting on its games (American Gaming Association, 2018). Ironically, a multi-billion-dollar global online sports betting industry has convinced governments, sports leagues and broadcasters alike that “safe gambling” is the responsibility of individuals (i.e., know your limits; chances are you’re about to lose) (iGaming Ontario, 2024), while they all profit, with much of their revenue coming from young men.

In terms of lessons, online sports betting poignantly (and painfully) reminds men’s health promoters about the importance of engaging users through easy usability and 24/7 convenience, and integrated and tailored interactivity (i.e., custom betting features, syndicates, live odds fluctuations and push-notifications). Beyond selling young men’s involvement with sports through risk, competition and/or connection, online sports betting is masterfully slick in norming and facilitating idealized socially constructed masculine experience[s] and milieus. Regarding the need to better regulate online sports betting to reduce the harms of men’s gambling, we offer three recommendations. First, the many commercial enablers profiting from online sports betting need to be de-incentivized through legislation changes, penalties, and higher taxes. These include the betting app distributors such as Apple, as well as the linked social platforms Instagram and X, along with the leagues and broadcasters. Second, beyond deterrently high gambling industry taxes, advertising needs to be legislated out by governments, akin to the bans (eventually) used to stop big tobacco’s marketing of smoking. Third, all gambling tax revenue needs to be transparently distributed through government tenders to build, evaluate, and adjust a suite of empirically informed men’s health promotion programs. In addition to the downstream programs dedicated to undoing men’s gambling harms and addictions, upstream interventions that research and deliver alternatives to online sports betting must be prioritized.

Beer and the Rise of the Nonny

Men’s alcohol use has long juxtaposed the promise of social connection with the dreadful morbidity and mortality outcomes linked to its overuse (de Visser & Smith, 2007; Zamboanga et al., 2023). Indeed, despite its widespread acceptability, alcohol is the third leading cause of premature death and disability around the world (World Health Organization, 2010), wherein male death rates are more than twice that of females (7.7% vs 2.6% of global deaths) with young men, 20- to 39-years-old, the most negatively impacted age-adjusted subgroup (World Health Organization, 2022). Western cultures norm men’s alcohol use as masculine, facilitating heterosexual connection and conquest with women, and promoting homosocial solidarity and status among men (Fugitt & Ham, 2018; Wilkinson & Wilkinson, 2020). Amid an ever increasing array of alcoholic beverages, beer has remained the product most actively marketed to men with strong alignments to masculinity (Finlay & Wenner, 2020). As with the gambling industry, beer is big business with many beneficiaries from its commercial sale. For example, the Beer Institute, a trade association representing the $409 billion U.S. industry, reported their brewer’s domestic tax payments to state and federal governments for the month of February 2024, was $11.9 million (Beer Institute, 2024). In addition, retailers profit by selling beer at bars and shops, who in turn pay income taxes, with sales taxes also collected from consumers. Canada’s heavily taxed beer (and alcohol more broadly) has been framed as social responsibility, wherein government alcohol tax revenue is used to offset, at least in part, the public health costs for treating its associated harms (Hohnstein, 2020).

In terms of marketing, the utility of beer commercials (especially in televised sports) has prevailed, with that medium continuing to draw the majority of the industry’s advertising budget (Wenner & Jackson, 2009). The gendered dimensions of beer commercials shifted in the 2000s (Finlay & Wenner, 2020), perhaps in an attempt to more widely appeal to a plurality of contemporary masculine consumers. In an analysis of sports-televised beer commercials from 2010 to 2019, Finlay and Wenner (2020) were critical of the “himbos,” “real men,” and “bros” depictions as further destabilizing masculine identities, though polls confirm that for almost two-thirds of men (62%), beer remains their beverage of choice (McCarthy, 2017). Indeed, industry knowledge of male consumers has underpinned their effective marketing and the long-standing popularity of beer, even in the unimaginable decision to sell non-alcoholic beer to men (see Heineken, n.d.). Market research in the United States indicated that the sales of alcoholic beer, which is high calorie and high carb, were falling as younger men turned away from traditional heavy beers (Taylor, 2018). Engagement with grassroots movements including Dry January and Sober October confirmed many young men were looking for healthier alternatives, a trend likely reflecting wider progressive changes in masculinities toward self-health and equitable relationships (Oliffe et al., 2019, 2023).

Colloquially known as the nonny (or near-beer), the sales of non-alcoholic beer are steadily increasing (Richter, 2024). The nonny is positioned as a consumer option and choice rather than marketed as a replacement for alcoholic beer. Confirming the taste acceptability of nonny beer, a longitudinal study in Finland (n = 47,066) indicated higher income, well-educated men who already purchased large volumes of alcoholic beer were the primary purchasers of non-alcoholic beer (Katainen et al., 2023). A study of draught non-alcoholic beer at 14 U.K. pubs and bars indicated a 4% to 5% decrease in the sale of draught alcoholic beer, but no overall revenue loss (De-loyde et al., 2023). Indeed, Heineken 0.0, a leading nonny in the United States, grossed more than $77 million in 2023 (Statista, 2023). Although Staub et al. (2022) cautioned that men and women perceive nonny drinkers as more feminine compared with alcohol beer drinkers, the marketing of non-alcoholic beers aligns to contemporary social trends for moderation, healthy lifestyles and the ability to participate in activities otherwise prohibited when drinking alcoholic beer. The Heineken 0.0 catch phrase, the moment you couldn’t have a beer . . . now you can, accompanied by a trio of humorous ads featuring young male motorcyclists, boating enthusiasts, and an office worker having a nonny with lunch—depicted men’s new-found freedom to consume non-alcoholic beer anytime, anywhere while doing anything (Fleming, 2020). Contrasting the negative health effects for overusing alcoholic beer, non-alcoholic beer—as low carbohydrate, low calorie, and a source of polyphenols, folic acid, and other nutrients—may have health benefits, and has even been touted as a recovery beverage for athletes (Graber-Stiehl, 2018).

In terms of what might be learnt from the successful selling of non-alcoholic beer to men, we offer two suggestions. First, it is clear that brewers decided to innovate based on shifting consumption patterns and masculinities in their core market—men. Health promoters have long idealized their tailored interventions as prompting gender transformative changes, with traditional masculinity the perennial baseline and centerpiece for explaining men’s health practices, and/or claiming program effects. The success of the nonny is a poignant reminder to inductively know consumers’ current values and behaviors rather than assuming outdated masculine norms and practices to build men’s health promotion programs. Herein, the nonny play to men’s autonomy and well-being clearly speaks to contemporary masculinities for deciding how they prefer to feel, show up, be seen, and socially connect. Second, that beer makers and merchants could profit from selling harm reduction (and perhaps health promotion) underscores the need for formal business plans to guide the feasibility of men’s health promotion interventions. Can men’s health promoters collaborate with brewers around the nonny? Yes, but with some caveats. There is potential for working with some craft brewers who specialize in nonny-only beer production (see Nonny, n.d.; Partake Brewing, n.d.). For the brewers selling both alcoholic and non-alcoholic beer, there might be some value for directing the nonny sales tax revenue to strength-based public health promotion programs that affirm men switching to and/or subbing out alcoholic with non-alcoholic beer.

Athleisurewear

Starting with form-fitting yoga pants (Holmes, 2015), and driven by consumers’ increased health and fitness consciousness (D. Green, 2017), athleisurewear, which refers to athletic apparel that is also suitable for non-athletic settings, changed the game in sports retail. Predicted to be worth US$549.41 billion by 2028 (Grand View Research, 2024), the athleisurewear industry is highly competitive in its selling of clothing that accessorizes health and wellness while seamlessly transitioning between exercise, work, school, and social gatherings (Rollender, 2019). Indeed, wearing athleisurewear esthetically signals and motivates self-health (Perera et al., 2023) with claims that users’ experience increased self-esteem and positive emotional and mental states (Lipson et al., 2020). In essence, the athleisurewear industry strategically markets and commercially sells health promotion for profit. Among the market leaders, Under Armour and Lululemon are deeply gendered brands, both in terms of their initial respective emphases on men and women, and the diversification that followed with their gender-inclusive marketing. Briefly sharing some progress and challenges encountered by these two athleisurewear companies in what follows, opportunities and complexities for the commercial determinants of men’s health promotion are discussed.

Under Armour began in 1996 with the shorty—a soft, skin tight, stretchy t-shirt that wicked sweat away to keep athletes cool, dry and light (Under Armour, n.d.-a). A U.S. commercial success story, the Under Armour founder and CEO Kevin Plank worked out of his grandmother’s basement to design and sell (predominately to men) breathable gridiron under pad garments that reduced the moisture typically trapped by sweating. However, as the product range grew, the marketing of masculine performance and power was extended to strong femininities, with Under Armour actively selling to women from 2006 (J. Green, 2016; Under Armour, 2014). With technological fabric innovation and a growing demand for sporty aesthetics, Lululemon began by selling high-end yoga pants and athletic wear to women (Lipson et al., 2020). To increase revenue, in 2013 they started marketing to men with the ABC (anti-ball crushing) pants (Ferguson, 2023; Wong, 2016) ahead of launching their first men’s campaign in 2017, Strength to be. Featuring a series of five short films that challenged traditional masculine stereotypes, men’s inner strength for self-deciding their identity was promoted (Mourin, 2018), prompting then men’s brand director Karl Aaker to claim: “With our heritage in yoga and its core philosophy, we are uniquely positioned to play a role in this important and progressive topic (masculinity)” (Howland, 2017; Kolm, 2017). Both companies’ marketing strategies moved to be decidedly gender-inclusive while staying on point with the original advertising messaging. Beyond selling athleisurewear, Under Armour and Lululemon both invested in their own brand’s e-health communities. In 2015, with the goal of more fully connecting with its consumers, Under Armour acquired fitness app companies MapMyRun, Endomondo, and MyFitnessPal to build their digital fitness and wellness community (Becker et al., 2021; Pafitis, 2020). In 2015, a $500 million acquisition was made by Lululemon to purchase Mirror, a fitness startup that featured wall-mounted interactive mirrors with cameras and speakers for streaming at-home workouts (Salpini, 2022). Both companies decidedly messaged e-health promotion as part of their business and core consumer and community commitment.

While athleisurewear grew in men’s (and women’s) health promotion as a pricey individual choice with an emphasis on self-discipline for self-fulfillment, there was little connection to men challenged by social determinants of health and inequities (Lavrence & Lozanski, 2014). To address this, in 2022 Under Armour launched its Access to Sport campaign with a “long-term commitment of resources, focus and energy: To break down barriers for those who strive for more by creating opportunities for millions of youth to engage in sport by 2030” (Under Armour, n.d.-a). Lululemon’s 2023 focus on mental health was characterized by a diverse international 11-member advisory board (Lululemon, 2023b) to focus on employee mental health and industry programming in conjunction with their Centre for Social Impact (Lululemon, n.d.-a) who annually report primary research findings (Lululemon, n.d.-b) in a quest to disrupt inequity in global well-being. Of course, Under Armour and Lululemon’s much-publicized gendered marketing and social community-building efforts drew public scrutiny regarding the authenticity of company alignments with consumer values. For example, in 2017 Under Armour acknowledged the company as top heavy with male executives and board members, and while suggesting that reflected the male dominated industry, they provided assurances that they were committed to gender balance in higher-end company vice president, executive officer and director positions to reflect the consumers they served, and meet the gender equality call in the sports industry and broader social environments (Barker, 2017). Similarly, calling out potential discrepancies between value-based marketing and commercial actions (Howaniec, 2023), Stand.earth, an environmental advocacy organization, lodged a greenwashing complaint against Lululemon requesting an anti-competition investigation, claiming its 2020 “Be Planet” campaign was misleading consumers regarding its environmental practices (Benchetrit, 2024). Such scrutiny and accountability challenges underscore society’s power to lobby for health protections and gender equity as an authentic commercial entity commitment.

What might men’s health promotion learn from these two athleisurewear company examples? First, the value of, and resonance with, inclusive masculinities (Anderson & McCormack, 2018) is evident in both Under Armour’s and Lululemon’s deliberate marketing to progressive rather than traditional masculinities and femininities. There is also a tilt toward gender-mainstreaming with strong contemporary femininities, and flexible masculine identities, along with some advancement toward non-binary (albeit named as unisex Lululemon, n.d.-c; Under Armour, n.d.-b) at a point in history characterized by gender categories and widespread divisiveness (Hines, 2020). Second, the diverse branding, as emblazoned or implicit on the apparel, signals allegiance and belonging but masterfully caters to the consumer’s preference for their marker aesthetics. Men’s health promoters might usefully incorporate these two strategies in the design, delivery and branding of gender-inclusive and/or masculinities programs. In terms of collaboration potential, there are great opportunities for reciprocity between the athleisurewear industry and men’s health promoters. For example, that Under Armour’s e-health acquisitions were sold for loss in 2020 (Etherington, 2020), and Lululemon’s $500 million Mirror investment has effectively been written off as a loss (Sozzi, 2023) suggests risk management benefits for consulting academic researchers who have empirical design and evaluation expertise in health promotion programs. In addition, to advance Lululemon’s in-house health equity research (see Lululemon, 2023a) toward brand interventions, there are some strong potential academic-industry collaborations. There are likely also opportunities for adapting existing but stalled men’s health promotion programs with athleisurewear’s investment, marketing expertise, and branding strategies.

Discussion and Conclusion

There are historical reasons and contemporary needs to thoroughly research and thoughtfully consider the commercial determinants of men’s health promotion. As Lacy-Nichols et al. (2023) suggests, studying commercial determinants, in and of itself, warrants and demands primary research. Indeed, investigating the three examples for the current article revealed volumes of data, from diverse sources (including gray literature, company reports, media stories, business news) requiring fact-checks to reconcile, or perhaps more realistically contextualize commentaries that reflect complex commercial entities and determinants of health. Nonetheless, in what follows we briefly discuss three avenues for working within the commercial determinants of men’s health promotion.

First, rather than coming off as academes’ foray into investigative journalism, research to the commercial determinants of men’s health promotion needs to be applied with the explicit (albeit somewhat simple) goal of advancing the health of men and their communities. Herein, there is a need to cautiously progress the long-standing commercial determinants of health deficit commentaries and the problematics narratives about men’s health promotion, to purposefully (and pragmatically) focus on some practicalities. For example, it is clear that online sports betting is repeating the historically unregulated marketing by big tobacco, and there is a critical need to nimbly end the selling and cultural norming of self-regulated gambling with waiver-based inspired legislation. Waiting for population, public health data to comprehend the epidemiological magnitude of young men’s gambling addictions would be a travesty. The imperative here, as a starting point, is to prevent online sports betting advertising to reduce the commercial harms to men’s health.

Second, for the longest time men’s health promotion research has anchored itself to traditional masculinity in ways that actually mirror academes’ critique about the grip of restrictive hegemonic masculinity. The rise of the nonny is both unprecedented and progressive, reflecting contemporary masculine values and an openness and strength to operate on their own terms (outside of outdated traditional masculine stereotypes). In his book—Fall in Love with the Problem, not the Solution, Uri Levine (2023) speaks to engaging end-users with the idea before the innovation, and being willing to fail fast and go again. Men’s health promotion is risk-averse and somewhat besotted with the utopia of finding the remedy, albeit on shoestring research and pilot program budgets. With the right industry partners men’s health promoters might learn to recognize scaling and sustainability as a business decision and acumen deeply tied to product but entirely contingent on budget, effective marketing and consumer demand.

Third, reputable companies that are truly invested in men’s health promotion need academe as much as academe needs industry. The reliance of men’s health promotion research on cumbersome bureaucratic government processes for redistributing some of the taxes collected is untenable, and ineffective for nimbly advancing interventions to arrest the problems so richly (and repetitively) described. Industry, including athleisurewear, is potential partners for health researchers diversifying their pitches and collaborations to more rapidly promote the health of men and their communities. With heightened consumer social consciousness (Prendergast & Tsang, 2019), companies are acutely motivated to employ business models that balance profits with purpose. While certified B corporations (B-Corp) are evaluated in terms of social accountability and community impact (Diez-Busto et al., 2021), there remains the imperative for men’s health promoters to independently and longitudinally investigate commercial entities to decide the potential for value-aligned partnerships with business.

In terms of limitations, the three specific industry examples and the information shared were drawn from wide-ranging sources, some of which decidedly reside outside academic literature. Acknowledged as a limitation, this caveat also underscores the complexities and intensive work involved in strictly following all that Lacy-Nichols et al. (2023) mapped in their checklist for researching the commercial determinants of health.

In conclusion, pragmatically, the predominance of tumbleweed programs in men’s health promotion needs attention, system innovation, and diversification. In researching and writing this article, we are (cautiously) convinced of the potential for tapping some commercial determinants of health to sustainably advance the health of men and their communities.