COVID-19 has underscored a crucial aspect of public health: It is hard to be a healthy individual in an unhealthy society. Health and well-being at the individual and population levels depend on more than genetic factors and lifestyle choices. Conditions in which people live, study, work and age, as well as their access to health care — known as the social determinants of health — influence people’s behavior as well as health outcomes.
Inequalities in education, occupation, working conditions, income and wealth — often along gender, racial and ethnic lines — result in disparities in health and health care. These disparities harm disadvantaged groups as well as societies overall. Within countries, poorer population groups have lower life expectancies and spend more of their shorter lives in poor health or with disabilities. Across countries, more unequal societies have worse health outcomes compared to societies with fewer disparities.
This is a policy issue and a business challenge. Societal health impacts businesses greatly, and businesses in turn have an influence on health determinants and outcomes.
Businesses may affect societal health determinants directly such as by providing access to affordable housing or health care and by supporting charities and civil society organizations, or indirectly through lobbying for policies and regulations at local government, national or multinational levels.
In terms of costs incurred, health care costs and productivity loss due to chronic diseases cost the U.S. economy $3.7 trillion in 2016, equivalent to one-fifth of the country’s GDP at the time. The burden of disease is, in part, shaped by business impacts on the social determinants of health and access to health care for a wide range of stakeholders in society.
As employers, businesses set the working conditions of employees and indirectly affect living conditions and life chances — or opportunities to improve one’s quality of life — for employees and their families. Good work — characterized by living wages, adequate support and job control, work-life balance, skills and career development, inclusive cultures, and so on — is good for employees’ health. There are also indirect impacts, such as on food, housing and energy security for employees and their families, their access to education and health care, and their retirement savings.
As corporate citizens and members of communities in which they are located, businesses can also shape the physical environment (such as by polluting or protecting air or water), and social capital and community resilience (by helping or hindering social equity, connections, and capabilities).
As customers, businesses can use their purchasing power to influence the standards and practices of their supply chain partners. Businesses can set goals for their value chains, assess risks, and offer incentives and support (such as financing, guidance and technology) for improving metrics relating to societal health. The knock-on effects on determinants of health for workers across the supply chain, and on their families and communities, could benefit societal health both locally and internationally — including in relatively less well-developed or regulated countries.
As suppliers of products and services, businesses generate benefits, costs and/or trade-offs for their consumers and communities, leading to immediate and long-term effects on societal health. As investors, businesses can influence other companies’ impacts on consumer welfare and enhance communities, through decisions that recognize and address the needs of different stakeholders.
As the ongoing pandemic reveals and amplifies socioeconomic and health inequalities, businesses and societies are rethinking the scope of the private sector’s responsibility for building and maintaining healthier societies that are better prepared to withstand future crises. Many companies are attempting in big and small ways to strengthen and sustain societal health — improve determinants of health, raise overall health outcomes and reduce disparities for disadvantaged groups.
One action area is working conditions. One increasingly popular lever is fair compensation that is adequate to meet basic living needs and cover unexpected events. For example, a multinational consumer goods company has committed to a global fair compensation policy with the aim of ensuring living wages or income by 2030. Diversity, equity and inclusion in employment are increasingly a business imperative. For example, a South African energy company hires and develops staff from under-represented groups, and a multinational recruitment services provider partners with the International Committee of the Red Cross to prepare people with disabilities for work. Supply chain standards are yet another lever: For example, many retail companies require pledges from supplier factories to protect women workers’ health and safety.
A second action area is living conditions — such as support for healthy home environments, and healthy behavior and lifestyles. For example, a multinational life sciences company’s “Resources for Living” program supports employees through everyday challenges and disruptive crises. An insurer provides wellness services and platforms to create and sustain healthy habits through risk assessments, activity goals and tracking, rewards and incentives.
Third, businesses can also bolster community resources. One lever is support for community and charitable organizations, such as by providing paid leave to employees to work for nonprofit organizations, or donating funding and logistics expertise for emergency relief operations. Businesses can support food and energy security for disadvantaged groups — for example, a partnership between a private utility company and the Colombian government seeks to provide energy security for low-income rural customers. Businesses can also invest in community infrastructure such as affordable housing and community parks.
Fourth — and by no means last — businesses can provide access to health services. For example, many health care and life sciences companies have charitable or social business models to provide affordable basic health care and medicines to under-served communities at low or no cost. Businesses increasingly invest in disease prevention, too. For example, a pharmaceutical company offers employees and families access to preventive health care services at low or no cost.
Surveys show relatively high levels of trust in the competence of businesses, and employees and consumers — particularly younger generations — increasingly expect business leaders to speak up and act on societal challenges. COVID-19 has made clear the interdependence of healthy societies and economies. Now is the time to nurture virtuous cycles by committing to and investing in thriving, resilient communities. Businesses — in partnership with other stakeholders — have an opportunity and an economic imperative to build back better by boosting the health of employees, customers, suppliers and investors.