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Health: An Untapped Asset - How investors can strengthen returns by improving health outcomes


Health is important to individuals, to communities, and to the economy. Good health is an asset, and, like climate change, poor health is a systemic risk that many investors simply cannot diversify away from. In this report we examine the role of investors in driving positive health outcomes.

We find that:

  • There is a gap in investor stewardship on health;
  • Barriers exist to integrating health into stewardship practices;
  • There’s momentum and an opportunity to transform the investment sector for better health outcomes;
  • Focussed action could kick-start an investment sector movement for better health.

Health is integral to social and economic prosperity

Good health is an asset. It allows us to thrive, to live independent and fulfilling lives and to contribute productively to society and our economy. As a society, we value health above all else. It is in our interest for our money to be invested in a way that supports good health - and like climate change, poor health is a systemic risk that investors cannot just diversify away from.

As the Covid-19 pandemic has shown, we all share the cost burden of poor health. It is a burden that is becoming increasingly unsustainable. Even prior to the pandemic, health gains seen in recent decades had slowed and in some parts of the world, gone into decline.

It is for these reasons that the investment sector must incorporate health into their stewardship. Yet currently it remains a blind spot – which is leaving them (and society at large) vulnerable.

With funding from the Health Foundation and support from Guy’s & St Thomas’ Foundation, we conducted a six-month review to understand just how asset owners and managers can contribute to a healthier society and improve the resilience of their investments.

A new framework for health: How investors can capitalise on this untapped opportunity

Good health is not a result of good healthcare alone. As much as 80 per cent of health outcomes are driven by environmental factors; by the social, commercial and physical environments in which we live and work.

Company activities influence the jobs we do, the products and services we are sold and the places we live – as such they have a huge influence over wider health determining factors.

Given the wide and complex range of factors that influence our health, we’ve developed a framework to help investors understand how these relate to their investments. This centres around three pillars:

Worker health

Companies can influence the health of their workers through the pay they provide, the security of contracts they offer, and through the provision of benefits such as sick pay, parental leave, health insurance and other health-related schemes.

Every sector has an influence over the health of their workers, but certain sectors where workplace health practices tend to be particularly poor include care, hospitality and retail.

Consumer health

Consumer health is influenced by the types of products and services that are produced and sold, as well as how these are priced and marketed.

As much as one-third of deaths worldwide are attributable to overconsumption of certain products – including alcohol, tobacco and food.

This pillar is also relevant to gambling companies and essential service providers, as well as social media companies.

Community health

Companies can influence health by shaping the environments in which we live. This encompasses the air we breathe as well as the quality of homes we live in and the infrastructure around us.

Currently, around 91 per cent of the world’s population lives in places where air quality levels exceed recommended limits set by WHO.

This pillar is particularly relevant to companies with large vehicle fleets, construction companies and real estate developers.

Examining the state of play: Health remains a blind spot but momentum is growing

Through a series of interviews and surveys with asset owners and asset managers, we assessed investors current approaches to health and where the opportunities for action might lie. We found that investors do not currently prioritise health, which has allowed companies to overlook their impact. Vast amounts of capital are still flowing into health-damaging sectors – and even in ‘ethical’ and ‘sustainable’ funds, health is still undervalued.

But the tides are turning. Most asset owners we spoke to said improving health was a ‘clear priority’ and expressed an interest in their beneficiaries (such as pension savers) having a “healthy society to retire into”. Asset managers, meanwhile, acknowledged this demand as well as seeing the value in a holistic approach to health which would enable them to bring coherence across a range of engagement topics.

We believe we are in a moment for action. With huge amounts of capital to leverage, investors have a critical role to shift companies away from negative impacts, towards more sustainable business models. As well as better integrating health into their stewardship. We’re calling for investors to join health-relevant collaborative engagements. This may include lending support to those already taking place such as those on nutrition and good work, or helping to develop new initiatives where there are gaps, such as for air quality and alcohol.

With the global spotlight on population health and inequalities, now is the moment for investors to act. In doing so they could simultaneously improve the resilience of their portfolios, reduce financial risk, and drive toward better health outcomes for all.

Read the full report

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Find out more about our work improving people's health and our Long-term Investors for Public Health programme.