When it comes to our health, companies have a huge influence.
This influence is often overlooked. But around 80 per cent of health or ill-health is determined by environmental factors. That includes where we live, what we buy, the work we do and the air we breathe.
When you consider this figure, it is hard to ignore the role that businesses – and their investors – have to play in the health of our society.
And there are two clear ways companies can drive change: through their employees and their customers.
Broadening the concept of ‘health and safety’ could see companies step up on worker health
We are all familiar with the concept of corporate “Health & Safety”.
Problem is, it often seems more about safety than health. Designed to tackle workplace accidents, it isn’t very holistic. What about the physical and mental health of employees? Or the impact that companies have on the health of their customers?
Fatal injuries to workers in the UK average around 140 per year. In 2018-19 UK companies also reported just over 50,000 injuries which incapacitated the worker for a week or more. These numbers have been falling for the last few years - but they only tell a small fraction of the story.
Important as it is for companies to do all they can to reduce workplace injuries, the ideal would be to look not just at safety, but health and safety more broadly.
This goes beyond accidents with machinery, vehicles, lifting and so on to look at both the physical and mental health of all employees, including to what extent the workplace helps or hinders these things.
We can see health as a bell-curve distribution: the super-healthy at one end, the very ill at the other, but most somewhere in the middle. If we can shift more people positively along that curve, then they will be more present, more productive and will enjoy greater wellbeing.
Given that workers spend on average 35 percent of waking hours working, employers can have a significant influence.
Employers can’t do everything, of course – all employees have a private life where they make health choices, too. But we can make workplaces healthier. We can create better working conditions, such as providing a Living Wage and by offering secure contracts, as well as ensuring healthier on-site food and air quality, and we can use employers’ purchasing power to provide benefits such as employee assistance support, healthcare, or even schemes to incentivise exercise and active travel.
Evidence shows that the design of people’s jobs and whether they feel they have control, autonomy and room for progression is also important to health.
Like direct carbon emissions, an employer’s direct health impacts on employees should be measured to ensure the best actions are taken.
We know that work can make a positive contribution to health and wellbeing – and getting there is a win-win for employer and employee alike.
But this new approach to health shouldn’t stop at employers. Companies also have the power to expand it to think of their customers too.
A ‘polluter pays’ approach to consumer health could see companies factor in externalities
A host of regulations, and “sin taxes”, exist to limit specific activities and products which damage our health. These include food labelling standards, sugar taxes, alcohol minimum unit pricing (in Scotland) and assorted advertising restrictions, for example on junk food and tobacco.
They are designed, however, to tackle issues one at a time. They don’t operate within a coherent framework or attempt to tackle the overarching issue of who should share the blame for activities which damage health, and who should pay the resulting costs.
The backstop is the taxpayer.
Assigning the costs of “externalities” like rising NHS bills is tricky. There are issues of calibration, and even more challenging are issues of causation.
Causation may be obvious in the most egregious cases (as shown in the opioid lawsuits in the US) but there is always the question of consumers' free will. If my customer chooses to eat, drink or smoke my unhealthy product, is that his free choice or have I used my position or my marketing power to influence them unduly?
These are often ethical, philosophical or even political questions, but we can’t discuss them rationally without really good evidence.
If the “polluter pays” principle is going to become more widely applicable – and there are now more sugar taxes than carbon taxes in the world – then we need to be clear about the extent of the pollution and where it is coming from.
Companies should put serious effort into this. Failure to do so could be bad for business, and the opposite is also true.
The first crucial step is to develop simple, practical metrics which companies can use – if only to benchmark themselves and monitor their own progress. The Business for Health initiative is working on developing an index to help companies do this effectively.
Efforts to improve the health impacts of products and services should be business-positive – Greggs is a great example. At the very least they should reduce the risk of being caught by a new regulation or tax on a particular product – AG Barr’s reformulation of Irn Bru ahead of Sugar Tax comes to mind.
When health and health inequalities are such a pressing issue, it is time to re-visit “Health & Safety” – and to adopt better health as something companies and indeed public-sector bodies should strive for, both for their own workers and their consumers.
Read more here in ShareAction's report, Health: An Untapped Asset - How investors can strengthen returns by improving health outcomes