This deep dive is our monthly love letter to the community. We keep it free for everyone because knowledge on commercial influence should be accessible to all.
Why aren’t we making more progress?
Why aren’t we making more progress? It’s a question professionals working in public health, climate, food, or equity know too well.
You might be working on individual-level interventions but not seeing widespread behavior change. Maybe you’re tackling social determinants (e.g., access to housing, quality care, amenities, education, or food) but wondering what’s causing those gaps in the first place. You may be striving for policies to protect people and planet but are seeing them fail to pass or be reversed.
You might sense that in many cases there’s a larger engine driving harm, blocking change, co-opting solutions, and deepening inequities.
You’re not wrong.
That engine has a name: commercial determinants.
The elephant in the room
This newsletter is dedicated to commercial determinants, those often overlooked but widespread ways that businesses act to shape the systems we all depend on in their pursuit of profit. Commercial determinants are often the elephant in the room when struggling to fix root causes of ill health, environmental degradation, and societal problems. The extent of commercial reach tends to be the blind spot in many efforts seeking to drive change, even among those that take one or two aspects of commercial activity into account.
Different kinds of commercial products, services, and activities do bring benefits to people, but many cause harm. We recently saw harmful commercial determinants at work when:
A meat and dairy industry coalition launched a PR campaign to discredit scientists who called for less meat consumption to fight chronic diseases and climate change.
3M, a chemical company, concealed evidence for decades that its products were toxic, likely causing serious harm.
Inequality soared as monopolistic corporations concentrated wealth and power at the very top.
These examples aren’t accidents and they’re not innocuous. They’re calculated, coordinated, and deeply consequential, happening both in the shadows and in the open.
Baked into the system and standard practice
Some of the harm-producing business activities are plain illegal, but businesses do them anyway. Many activities are legal but unethical. Some are incentivized by policies or entirely normalized (celebrated even) as how business is done, where individual corporate employees may not intend to cause harm, but harm is often the effect. Think:
Agricultural subsidies and visa programs encouraging industrial, chemical-based monocultures reliant on low-paid immigrant labor.
Insurance companies denying care through prior authorization delays as routine cost control even when it leads to dangerous treatment gaps.
Advertising campaigns for harmful products that are celebrated with major industry awards even when they drive increased consumption and public health harms.
Yet, when businesses exploit workers, flood the market with harmful products, pollute the environment, attack researchers, evade taxes, or bribe policymakers, it hurts all of us.
The same strategies, again and again
The destructive strategies industries use aren’t new. They are remarkably consistent across sectors, geographies, and generations. Whether we describe these tactics as corporate, capitalist, private sector, economic, or market-driven, the patterns repeat. Whether we prefer to call these determinants forces, influences, or drivers, the patterns persist.
The evidence this newsletter will share is not from conspiracy theories. It comes from rigorous research to bring commercial determinants out of the shadows. The 10 frequent tactics in the harmful commercial determinants playbook go something like this:
Make and sell harmful products: from junk food and fossil fuels to toxic chemicals and addictive tech.
Use aggressive, misleading, and manipulative advertising to push harmful products, divide people along identity lines, and target communities of color and lower opportunity neighborhoods the most.
Exploit workers by cutting corners on safety, stealing wages, and blocking unions.
Dodge taxes and gouge prices to avoid fiscal responsibility while denying people access to affordable healthcare, food, and services.
Pressure politicians through lobbying, donations, and the threat of moving company operations, to block regulations and avoid accountability.
Blame individuals for disease, pollution, or poverty while arguing that corporations don’t need oversight and that big government or “The Nanny State” is the problem.
Fund biased research to downplay harms and hide internal evidence of dangers, while attacking credible science and muddying the facts so it’s harder to act.
Discredit and intimidate critics by punishing whistleblowers, scientists, and advocates who speak up and scaring others into silence.
Weaponize laws and courts by filing frivolous lawsuits and exploiting legal loopholes to quiet opposition and dodge responsibility for harms, while working to bias courts and laws in favor of commercial interests.
Put on a good face using PR campaigns, greenwashing, and healthwashing, and self-interested philanthropic and charity efforts to position themselves as “part of the solution,” while promoting ineffective voluntary standards to manage reputations without changing course.
Capturing minds, hearts, and regulations
They shape how we think: what we believe is normal and desirable, who’s to blame for harm, and whether we even bother to fight back.
They push for weak rules (or no rules at all), while grabbing billions in government handouts.
They expect taxpayers and families to pay for the real harms they cause to our health, environment, and communities.
And they don’t work alone. Industries copy each other’s tactics and team up to protect shared interests, privatize profit, and socialize harm.
We don’t hear about commercial determinants enough
Part of the issue is that while the peer-reviewed science literature on commercial determinants is rapidly growing, it remains out of reach of many. It’s locked behind paywalls and impenetrable academic jargon. And each field has its own unique language to describe the same thing, often leaving us talking past each other.
At the same time, the media vastly under-reports bad business behavior: like America’s millionaires and billionaires evading $150 billion of taxes each year or how air pollution from oil and gas kills more people than all homicides combined.
With last year’s federal rollback of $9 billion in funding for public media, these stories will become rarer still at a time when commercial influence is rapidly expanding and needs to be reduced. There has never been more need for accessible yet rigorous analysis of problematic business activities. This newsletter will fill the gap in identifying, analyzing, and addressing harmful commercial determinants.
It doesn’t have to be this way
It’s not too late for change. Researchers, advocates, and communities around the world are fighting back…and winning. We can learn from them and from each other.
Next week, we’ll start to delve into how things could be.
We do not run ads, and we do not take corporate sponsors. Paid subscribers, founding members, and tippers help us stay independent and keep these deep dives open for all.
What’s one issue you’re working on that has a commercial dimension?
Hit reply or drop a comment. We’d love to feature reader experiences in future issues along with how a commercial determinants lens can contribute to solutions.
Click on any of the links we cite above or check out these selected annotated reads:
By Anna Gilmore and 20 colleagues in The Lancet, 2023
This 2023 paper and its three sister manuscripts in a special issue of The Lancet journal on the commercial determinants of health brought together so many of the most prominent voices in the field. The paper outlines a model and framework for how to think about all of the strategies and tactics used by harmful industries around the world. The authors’ diagram and accompanying narrative are vital primers to understanding our commercially determined world.
By Nicholas Freudenberg in Oxford University Press, 2016
Nicholas Freidenberg is a giant in the academic field of the commercial determinants of health. In this 2016 book, he looks at the examples of food, tobacco, alcohol, firearms, automobiles, and pharmaceuticals to show how so many of the harmful things businesses do are currently perfectly legal. He calls on public health to move away from trying to change individual behaviors (e.g., trying to educate people about the harms of smoking and poor diets) and towards addressing what he calls the corporate consumption complex.
This excellent expose by The New Yorker magazine shows so many pieces of the commercial determinants playbook at work in a single example: 3M company and PFAS. PFAS stands for "per- and polyfluoroalkyl substances," a group of synthetic chemicals that have been used in various consumer products and industrial processes since the 1950s. After learning of PFAS toxicity in the 1990s, 3M hid and denied its own evidence from the public and regulators and continued to produce and sell its products. The substances are now found all around us, including in stain-resistant fabrics, nonstick coatings, and firefighting foams, and have contaminated air, soil, water, and our bodies.