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.
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By John A. Quelch

Every company, large and small, has an impact on health. It does so in four ways. First, through the healthfulness and safety of the products and services it sells. Second, through its attention to employee health and well-being in its work practices and benefits. Third, through contributions to the broader communities in which it operates. Fourth, through the environmental impact of its operations.

In every company, decisions are made every day in these four areas, wittingly or unwittingly, that impact public health. Almost no companies integrate their health efforts, include health as a corporate value or calculate their total public health footprint.

Typically, product design and quality assurance managers attend to the health and safety of products. Benefits managers in a human resources department offer employee wellness programs. A Vice President for community relations or the head of the company's foundation may allocate some funds to community health projects. A director of sustainability seeks to reduce the company's carbon footprint and water use. These worthy efforts are rarely integrated across corporate silos.

Mention health in most companies and the cost of health insurance is what comes to mind, not how the company can invest to prevent further escalation in societal health care costs. Even companies in the health care industry, who should know better, don't measure their public health footprints. They may include the word health in mission statements but the CEO does not stress health as a core value that should be considered every time an employee makes a decision.

Let's look at each of the four components of a company's public health footprint:

Consumer Health. Indra Nooyi boldly challenged the nutritional value of PepsiCo's product portfolio when she became CEO in 2008. Since then, her performance with purpose philosophy prompted large research and development investments which have led to new and redesigned products and have taken billions of calories out of the food system at the same time that profits have increased.

Employee Health. Johnson & Johnson has been investing in employee health and wellness programs -- mental as well as physical -- for over thirty years. The famous J&J credo encourages this employee focus and the current CEO, Alex Gorsky, models these behaviors in his own lifestyle. But employee health also applies to the employees of upstream subcontractors. Following the Rana Plaza building collapse in Bangladesh, apparel company Primark broke ranks with industry peers to assess and provide compensation way beyond what was legally required to those injured and to the families of those killed in its subcontractor's factory.

Community Health. Univision reaches out regularly to all Hispanic communities in the US. Through its Contigo program, it helped many thousands enroll for health insurance via the Obamacare exchanges. IBM has long been committed to the communities in which it operates, following the precepts as of its founder, Thomas Watson Sr. Through its On Demand Community, IBM's Foundation encourages tens of thousands of employees to help nonprofits in their communities, providing them with free software.

Environmental Health. Royal Caribbean Cruise Lines has led its industry by applying its ABC (above and beyond compliance) philosophy to on board waste water recycling and reduced CO2 emissions. Many RCCL executives populate industry standards committees, not to hold back regulation but to push the industry towards better environmental performance in new ship design. Levi Strauss has likewise moved the needle on environmental safety in apparel manufacture, establishing a restricted chemical list (to protect workers from needless exposure to toxins) that is strictly applied to its subcontractors as well as in its own factories.

Some companies have focused and done a good job on one of the pillars but ignored others. Other companies have initiatives on two or three of the four dimensions but they are not integrated. For example, the meaning of sustainability is being broadened from a focus on environmental impacts to embrace healthful products and the well-being of direct and indirect employees.

Why is a joined-up approach important? First, businesses are already doing much, individually and collectively, to improving public health but receiving little or no credit for doing so. Second, an audit across the four dimensions of a company's health footprint will reveal gaps in the company's efforts that can be addressed. Third, there are some interactions across the four elements that are going unrecognized and under exploited. Fourth, integration of a company's health contributions goes hand-in-hand with elevating the culture of health as a core objective.

One company that has pushed further forward on integrating a culture of health into its organizational philosophy is Target. As a retailer, Target is embedded in many communities. Target has also implemented many innovations to advance employee wellness, mindful of the fact that many employees take their first jobs with Target. Target's sustainability office tries hard to reduce its environmental footprint through store design and intelligent product selection. Healthful products are highlighted in Target store flyers, but Target admits that its main challenge remains the consumer health pillar; with over 50,000 stock keeping units, it's hard to maximize healthfulness while insuring sufficient consumer choice.

Fifteen years ago, Dow Chemical was a poster child for environmental irresponsibility. Today, Dow has not only cleaned up its own act, it has environmental impact criteria built into its product design process and is even selling its expertise in environmental impact area to other companies as a value-added service. Dow has also invested in employee wellness and safety programs and in reducing diabetes in the communities where its factories are located.

We recently surveyed corporate executives regarding the progress their companies had so far made on the four dimensions and their perceptions on investments in these areas to benefit the companies. The results (see sidebar) show that companies are further along in understanding the value of embracing employee and environmental health than they are consumer and community health.

So what should companies do to establish a culture of health? We offer the following seven step plan of action.

1. View health as an investment, not an expense. Understand the benefits that corporations can enjoy -- increased revenues, lower costs, better reputations among consumers and employees, if they embrace the culture of health.

2. The initiative must be championed by the CEO if health is going to become part of the corporate value system. The CEO must model healthy behaviors and demonstrate that health impacts are integrated into his/her everyday decision-making.

3. Appoint a chief health officer to oversee the company's health, safety, and environmental impacts across all four pillars, not just employee and environmental health.

4. Develop a network of line managers who volunteer to champion the culture of health throughout the organization.

5. Measure impact across the pillars and collate these metrics into a single net benefit or net deficit number that scores the company's population health footprint.

6. Broaden today's annual sustainability report into a health impact report that covers all four pillars of the company's population health footprint.

7. Tie executive bonuses in part to improvements in the population health footprint. Lego ties only 25 percent of senior executive bonuses to financial performance with the remaining 75 percent allocated to contributions to planet, people and (children's) play.

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.