Building A Culture Of Health - John A. Quelch

The Role of Corporations in Addressing Public Health

Creating A Culture of Health

All American companies are in the health business whether they like it or not. The private sector directly pays for one-fifth of the whopping 17.5% of GDP spent on healthcare in the United States. Rather than viewing health merely as an insurance expense to be controlled, every company needs to embrace building a culture of health as a business opportunity.

Forward thinking companies are doing just that. After CVS removed tobacco products from store shelves and renamed itself CVS Health, new revenues more than made up for lost sales. Johnson and Johnson has achieved a $4 return for every dollar invested in employee health and wellness programs over 30 years. Bath Iron Works in Maine has extended a successful in-house diabetes prevention initiative into the wider community. It expects to cut participants’ future healthcare costs over 5 years by 60% on average.

Recognizing both necessity and opportunity, companies are scrambling to assess and improve the health impact of their business strategies and operations. Last month 150 top executives from diverse industries met for two days at Harvard Business School to hammer out an agenda for building a culture of health in American businesses across four domains: Employee Health, which companies invest in to improve the wellness of current and future employees; Environmental Health, which connects companies’ environmental policies to the health of populations affected by their operations; Community Health, in which businesses boost the health of the local communities in which they operate; Consumer Health, which targets the healthfulness and safety of a company’s products and services for its consumers. “This was not charitable work,” the vice chairman of a large food and beverage company told peers about reducing sugar, salt, and saturated fat in its product portfolio, “It makes business sense.”

The business imperative for companies springs from past neglect and the traditional healthcare system’s ongoing inability to solve America’s health conundrum: poorer health outcomes than in other wealthy countries despite much higher spending on healthcare. How is it possible that American children and adolescents—the future of the U.S. workforce—rank last in health outcomes against wealthy country peers? Not only does this represent a lousy return on investment nationally, it has consequences for American business, including flagging worker productivity and weaker consumer demand for other products and services as consumers spend more on healthcare.

Relying solely on medical care to fix America’s health problem, is futile. Medical treatments influence total health outcomes far less than prevention—defined not just as better diet and exercise, but also in terms of good education, good jobs, good housing, etc. The Affordable Care Act starts to address this complex challenge, but government, non-governmental organizations, and the healthcare industry simply do not have sufficient capabilities or resources to develop and execute innovative solutions on their own. That’s where forward thinking businesses are stepping in to implement health initiatives independently or through partnerships.

Communications company Univision, for instance, which targets Hispanic viewers, has launched health programs aimed at educating Hispanic communities and increasing their healthcare access. IBM in April unveiled IBM Health Corps and its collaboration with Washington DC-based community health center Unity Health Care to help tackle the behavioral health problems of its underserved residents.

Many companies have health-related activities dotted across assorted departments, such as employee benefits, community relations, quality assurance and sustainability. The time is now to connect the dots. What companies do in, say, environmental health bears on the health of communities. What they do for community health can improve the quality, attraction, retention, and motivation of employees. Connections exist across their various efforts. An integrated culture of health strategy would calculate the total population health footprint (PHF) of the company across all four pillars, so the whole would be greater than the sum of its parts. Besides benefiting health, integrating activities across the four pillars will benefit company reputations with both customers and suppliers. Some companies already have a powerful story to tell. Why not tell it?

Specifically, all companies should:

  • Think of health, not as an expense, but as an investment to attract and retain top quality employees. CEOs must champion this initiative, and model their behavior accordingly.
  • Appoint a chief health officer to oversee the company’s health, safety, and environmental impacts across all four pillars.
  • Develop a network of line managers who volunteer to champion the culture of health throughout the organization.
  • Broaden today’s annual sustainability report into a health impact report that covers all four pillars of the company’s PHF.
  • Measure impact across the pillars and collate these metrics into a single net benefit or net deficit number that scores the company’s PHF.
  • Tie executive bonuses in part to improvements in the PHF.

These recommendations are not just for big businesses. The CEO of any small company can create a volunteer culture of health task force to brainstorm ideas for making a difference. And just as small businesses collaborate with their peers through local chambers of commerce to get behind local education-related projects, so they can partner to put community health strategies into place.

Whether big or small, companies looking for a place to start should target one or two areas under the four pillars that they can impact relatively quickly. They can then later extend their efforts into other areas. The point is to get started. America’s health depends on all businesses, not just healthcare companies, to do their part.


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