ESG presentation

Guiding Principles to Establish a Culture of Health for Business

In support of its project with the

Advancing a Culture of Health for Business in the United States

April 2019

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Executive Summary

The private sector, particularly large corporations, has a tremendous influence on culture. It is also integral in achieving high social and health standards for all stakeholders including employees, families and communities. Increasingly, shareholders, investors, boards and executives are prioritizing business values and citizenship, as well as financial measures, knowing that these affect public perception, brand and long- term sustainability.

This project sets out to understand the scientific and technical basis for attributing positive health and business outcomes to an array of business practices and activities that may or may not be primarily directed toward improvements in population health. The project identifies suitable health measures within those business practices for businesses and investors to use to promote understanding and decision-making and presents a set of guiding principles that will help establish a Culture of Health for Business. Surveys of corporate health disclosures and of health measures in existing environmental, social and governance reporting frameworks and research methodologies provide reference points.

Population health and well-being in the United States underperforms its peers in quality at a higher cost. Outcomes and risk factors are correlated to socioeconomic status. Targeting improvements in the healthcare system alone is insufficient to address deficiencies that lie elsewhere.

The private sector is responsible for a range of undesirable outcomes in the workplace, the community and environment. Equally, many U.S. companies have implemented health- related programs and policies that have resulted in important shifts in health and wellness attitudes and behaviors. Fortunately, more companies than ever have begun to recognize their role and impact on population health and are using their reach and influence to improve health. Today, U.S. companies are uniquely suited to accelerate the pace of change in promoting a culture of health.

A broad literature review was conducted to better understand the basis for the means by which the private sector influences health and to identify which business practices, widespread or not, had discrete health and business impacts, both positive and negative. The research was focused on the workforce, their families and communities but has broad applicability to supply chains and customers. Ultimately, 16 Culture of Health Business Practices were found to be particularly effective at both influencing the determinants of health and having positive health and business outcomes. The results of this research are graphically shown the following figure:

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Culture of Health for Business Research Results Summary

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The Robert Wood Johnson Foundation funded a project with GRI to understand the scientific and technical basis for attributing positive health and business outcomes to an array of business practices that may or may not be primarily intended to improve individual, family and community health. Scientists generally recognize five factors that contribute to a person’s health and, by extension to that, of the population. These factors can be broken down into macro health determinants and correlated to the degree to which the private sector can influence them. Further, they can be correlated to 16 Culture of Health Business Practices, the subject of this project.

Smart Business Practices that Influence Health and Business Performance

RESOURCES https://www.cdc.gov/nchhstp/ socialdeterminants/definitions.html https://www.goinvo.com/vision/ determinants-of-health/ Advancing a Corporate Culture of Health in the United States, a GRI-RWJF project, January 2019.

Health Culture

Responsible Corporate Political Activity

Responsible Marketing Practices

Health Promotion & Wellness

Paid Family & Medical Leave

Health Insurance

Equality, Diversity & Impartiality

Financial Literacy

Work Time

Job Security

Pay Practices

Occupational Health & Safety

Physical Environment

Community Environmental Impacts

Social Capital & Cohesion

Community Involvement

STRATEGIC

POLICIES & BENEFITS

WORKFORCE & OPERATIONS

COMMUNITY

CULTURE OF HEALTH BUSINESS PRACTICES (COHBPs)

Research shows that these COH Business Practices lead to demonstrable improvements in these important indicators of business performance and health outcomes

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Health Culture

Responsible Corporate Political Activity

Responsible Marketing Practices

Health Promotion & Wellness

Paid Family & Medical Leave

Health Insurance

Equality, Diversity & Impartiality

Financial Literacy

Work Time

Job Security

Pay Practices

Occupational Health & Safety

Physical Environment

Community Environmental Impacts

Social Capital & Cohesion

Community Involvement

STRATEGIC

POLICIES & BENEFITS

WORKFORCE & OPERATIONS

COMMUNITY

1 Data bars correspond broadly to the relative strength of correlations, strength of evidence, and effect sizes of health outcomes for each determinant as described in the Literature Review of this project (Summary of Quantitative Outcomes). Data bars in the higher range represent a combination of strong correlations, strong evidence, and/or larger effect sizes; data bars in the low range represent a combination of statistically insignificant to weak correlations, weak evidence, and/or small effect sizes.N

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2 Known health and business outcomes represented here are derived, conservatively, from the literature review associated with this project. Only statistically significant results have been presented. The literature itself contains evidence of many more positive relationships between COHBP and health and business impacts based on weaker correlations or strong supposition.

3 Research literature was confined to busines outcomes from political activity in general and not as it pertains to health specificallyrelationships between COHBP and health and business impacts based on weaker correlations or strong supposition.

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Measures, metrics and indicators play an important role in supporting corporate efforts to build a culture of health. Research into the current state of health measures in the environmental, social and governance reporting frameworks and research methodologies shows that while many traditional indicators of health (eg., health and safety, environment impacts) are strong, the full gamut of measures needed to support the widespread adoption of a culture of health is missing. This deficit is mirrored in the body of health measures actually reported on by U.S. corporations in financial and non-financial reports.

To encourage the widespread adoption and continued leadership in these 16 COHBPs and to generally promote a culture of health, four principles were developed that contextualize health as a core strategic priority and articulate society’s changing expectations of business and investors to provide further leadership and contributions in this area:

PRINCIPLE 1 | The private sector is essential to shaping and promoting societal values, narratives and language around health and well-being, and to improving population health in ways that prioritize health equity, collective action, and harm reduction.

PRINCIPLE 2 | Business success depends on healthy workforces, suppliers, communities, and other stakeholders within the ecology of the supply chain; a healthy society is a shared value.

PRINCIPLE 3 | Successful business leadership recognizes health as a strategic priority to be integrated consistently across governance, strategy, investments, operations, products, services, and value chains.

PRINCIPLE 4 | Responsible businesses measure and disclose their health impacts and contributions to a Culture of Health. Businesses and investors use this to enhance operational and investment decision-making, ultimately reinforcing and rewarding behaviors that promote health.

In addition to the private sector and investors, many other marketplace entities will be required to institute a resilient culture of health for business including grass roots support from the workforce, their families and communities, investors, ESG researchers, standards bodies, the assurance community, ESG-minded non-profits and consultancies, issue-specific interest groups and industry associations amongst others.

The full report can be found here: https://www.globalreporting.org/cultureofhealthforbusiness.