Category Archives: Business
The Bipartisan Policy Center (BPC) in Washington, D.C., and nine CEOs from leading U.S. companies issued a report yesterday that lays out their ideas for improving individual and community health while reducing health care costs. The report, Building Better Health: Innovative Strategies from America's Business Leaders, shares strategies from all the companies and makes several recommendations:
- Implement and track the outcomes of corporate health and wellness programs
- Collaborate on the implementation of community-based programs
- Improve the health care system by supporting the movement toward transparency and payment and delivery models that are based on outcomes rather than on volume
The CEOs are members of the BPC’s CEO Council and collectively employ more than one million people and provide coverage for over 150 million people. Council participants include McKinsey & Company, Aetna, Johnson & Johnson, The Coca-Cola Company, Verizon Communications, Bank of America, Blue Cross Blue Shield Association and Walgreens Co.
In addition to the report, the council released an interactive website with examples of initiatives the companies have taken to improve individual and community health. Some examples also improve the corporations’ bottom lines, such as Verizon’s partnerships with university research centers to test wireless health monitors that individuals or companies can download and buy through the technology company. However, David Erickson, director of the Center for Community Development Investments at the Federal Reserve Bank of San Francisco, points out that no for-profit company can afford the investments required for improving public health without also being able to see an impact on their own bottom line. Examples include increased sales and greater efficiencies in delivering health care.
For example, Walgreens has increased its share of flu shots given from fewer than one million in 2009 to more than seven million in 2013. While that represents improved income for the company, Walgreens—which has stores within three miles of 63 percent of Americans, 75 percent of African-Americans and 78 percent of Latinos—has also worked with state and federal health officials to publicize and increase immunization initiatives. It has also worked with many third-party payers so that patients are often fully or largely covered for the vaccines, with little or no copayment required. Retail clinics such as those at many Walgreen stores also often improve on current health care delivery, such as being open 365 days a year, unlike most doctors’ offices.
For the last several years, the U.S. Centers for Disease Control and Prevention (CDC) has been promoting a concept called “Total Worker Health,” which combines safety programs to prevent accidents on the job with health promotion programs such as smoking cessation. The idea is that emerging evidence recognizes that both work-related factors and health factors that are often beyond the workplace together contribute to many health and safety problems for employees and their families.
A new report in the CDC’s latest Morbidity and Mortality Weekly Report (MMWR) shows why the combination can be critical, finding that the risk for coronary heart disease (CHD) and stroke is higher for blue-collar and service workers than it is for white-collar workers. Studies have suggested that before, but the new MMWR recommends strategies that companies can implement to reduce that risk.
In the new report, CDC researcher Sarah Luckhaupt, MD, analyzed National Health Interview Survey data for 2008-2012. She found that the prevalence of a history of CHD or stroke among people ages 18 to 55 was 1.9 percent for employed adults, but among the employed the risk was 40 percent higher in blue-collar workers (e.g. construction workers and truck drivers) and 53 percent higher in service workers (e.g. hairdressers and restaurant servers). Luckhaupt says that job stress, shift work, exposure to particulate matter, noise and secondhand smoke are all likely contributing factors to the higher rates of CHD and stroke.
In a conversation with NewPublicHealth, Luckhaupt said that employers can help improve the health profiles of employees by using the Total Worker Health program, launched by CDC and the National Institute for Occupational Safety and Health three years ago as a guideline for workplace wellness programs. CDC now publishes quarterly reports on effective Total Worker Health programs established by employers across the United States. Recent examples include:
- Live Well/Work Well at the Dartmouth-Hitchcock Medical Center in N.H., which aims to improve worker safety and health at the medical center.
- Hearing loss prevention at the Domtar Paper Company in Kingsport, Tenn., and the 3M manufacturing plant in Hutchinson, Minn., which address both noise reduction exposure on the job and in the community.
- A “Culture of Health” at Lincoln Industries, a manufacturing factory in Lincoln, Neb., which includes companywide stretching for 15 minutes every day to help prepare the muscles that will be used on the job; massage therapists who assess and treat people who may be at risk for injury; an on-site clinic for health maintenance, wellness coaching and acute care; counseling and support programs; and social and fitness events.
“Getting cigarettes out of our stores is a first step to making pharmacies a place where health happens,” said Troy Brennan, Executive Vice President and Chief Medical Officer of CVS Caremark Corporation, of the company’s decision earlier this year to stop selling tobacco products in its stores. In a Spotlight: Health session at the Aspen Ideas Festival last week, Brennan and other business CEOs discussed how making health a priority can lead to better business outcomes.
By decreasing the number of places that consumers are exposed to cigarettes and eliminating the convenience of tobacco, he said that CVS is actively trying to reduce smoking rates in the areas it serves. However, the healthy decision is also good for the company’s bottom line—already the decision has had positive business results that it didn’t anticipate, including an increase in the company’s stock price following the announcement.
“Companies that make health a priority—consumers gravitate toward that,” he said. “That’s the business incentive.”
Joining Brennan in the conversation, Vitality Institute Executive Director Derek Yach added that the private sector needs to complement public efforts when it comes to health and prevention. For example, taxes and increased prices must work in concert to discourage consumers from unhealthy products or behaviors.
“There may be an economic hit in the short term,” said Yach of companies that make healthy choices easier. “But in the long term, businesses are going to get an inflow of customers who know that their values are aligned.”
Yach also encouraged using County Health Rankings data to understand the underlying risks in each local area, as businesses are uniquely positioned to tailor their interventions to what the surrounding community needs.
A new climate change report, Risky Business: The Economic Risks of Climate Change in the United States, suggests that the American economy could face significant and widespread disruptions from climate change unless U.S. businesses and policymakers take immediate action to reduce climate risk. The report was released by former New York City Mayor Michael Bloomberg and former Treasury Secretary Henry Paulson.
The assessment of the committee that wrote and reviewed the report is that communities, industries and properties across the country face profound risks from climate change, but that the most severe risks can be avoided through early investments in resilience, as well as through immediate action to reduce the pollution that causes global warming.
The public health findings of the report were reviewed by Al Sommer, MD, Dean Emeritus of the Bloomberg School of Public Health at Johns Hopkins University. NewPublicHealth spoke with Sommer about the report.
NewPublicHealth: How did the report come about?
Al Sommer: The report came about because of the primary interest of the three co-chairs—Hank Paulson, investor Tom Styra and Mike Bloomberg—who felt that there was a need to better understand and better describe the possible public health impacts of climate change on businesses and labor productivity. Their goal is to engage the interest of business leaders so that they begin to think about the ramifications and perhaps see the problems of climate change from a totally different perspective than we usually talk about it.
I think from my own personal perspective that one of the great advantages of this report is that the group that did the analyses stuck with the data and the assumptions, and used sophisticated modeling and statistical analyses to give a range of outcomes. The most important part of the report from my perspective is that it has a granularity that most of the [climate change] reports don’t have, so it looks at likely outcomes in different regions of the country simultaneously.
In some instances, it looks like there is no change. There is reduced mortality in the northern part of the country because there is less freezing. But at the same time in the southern part of the country there’s dramatically increased mortality because of increased heat and humidity.
The announcement by CVS Caremark this morning that it will stop selling cigarettes and other tobacco products at its more than 7,600 CVS pharmacy stores across the United States by October 1, 2014, does more than just end an outlet for smokers. It also removes a highly effective marketing tactic from those stores, the tobacco "power wall," which is aimed at enticing current and would-be smokers—especially children and teens—to smoke.
Most retail food and sundry stores include the colorful display walls, which are usually designed by tobacco companies who also often provide financial incentives to store owners to keep the walls stocked. A report, updated in 2012, by the Center for Public Health and Tobacco Policy which is funded by the New York State and Vermont departments of Health, says the power walls “are highly engineered by tobacco companies to maximize visual intrusiveness and instigate impulse purchases.” The report adds that the walls “function as a subtle kind of advertising, conveying the message that cigarettes are popular and desirable."
A 2006 study in the journal Heath Education Research found that “[t]he presence of cigarette displays at the point-of-sale... has adverse effects on students’ perceptions about ease of access to cigarettes and brand recall, both factors that increase the risk of taking up smoking.”
And, according to a November report on point of sale displays by the Campaign for Tobacco-Free Kids, exposure to point of sale tobacco product displays “influences youth smoking, promotes the social acceptability of tobacco products, increases impulse tobacco purchases and undermines quitting attempts.”
While San Francisco and a few other cities have passed laws that ban cigarette sales in pharmacies, and the advocacy group Americans for Nonsmokers' Rights is working to expand that ban, no U.S. jurisdictions have ended displays of tobacco products according to tobacco control legal experts, generally because of concern that they might be sued by tobacco companies claiming an infringement of the companies’ right to commercial free speech under the U.S. Constitution. Recently, tobacco control legal experts have said tobacco company suits likely have less merit since the 2009 law giving regulation of most U.S. tobacco products to the Food and Drug Administration.
But tobacco control advocates hope other major pharmcies will follow the CVS example, since leveraging the power of private companies to support a culture of health may be a far more effective way to bring down those walls.
>>Read a statement by Robert Wood Johnson Foundation president Risa Lavizzo Mourey on the CVS Caremark decision to stop selling cigarettes in its stores.
The business sector is a critical partner when it comes to promoting the health of a community. Employment, income and overall economic stability greatly impact employee and community health. Increasingly, businesses are expanding their efforts from worksite-based health promotion programs to community-wide initiatives to ensure their employees’ access to healthy choices and environments.
Next Tuesday at 3 p.m., a County Health Rankings webinar will take a look at how local health leaders and businesses can work together to advance the health improvement efforts in their communities. The webinar will feature guest speaker Cara McNulty, Senior Group Manager for Prevention and Wellness at Target Corporation, which according to webinar organizers is “known for its commitment to community giving.” McNulty will share examples and lessons learned from her experience at Target to answer key questions:
- What kinds of partnerships are businesses looking for?
- What do communities and businesses need to understand about each other in order to forge successful partnerships?
>>Join the webinar to learn how to build common ground with businesses in your community and advance community health together.
A recent vote by the Washington D.C. City Council requires large retailers to pay a minimum hourly wage of $12.50 an hour—$5.25 more than the current minimum wage of $7.25 nationally and $8.25 in D.C.— and the decision received wide attention, especially when retailers planning to build new stores in the city said they’d pull the plug on the projects if required to pay the higher salaries. But at least two recent magazine articles explain why there’s been a fervent recent push to try to push up the wages of those in low-paying jobs. New York Magazine recently surveyed 100 fast food restaurant employees in that city and asked, among other things, “can you live off your paycheck?” The answer appears to be no. The average pretax monthly pay for the surveyed workers was $984 while average monthly expenses including rent, utilities, groceries and cell phone bills was $1,115—which adds up to $131 more in expenses than pay.
>>Bonus Link: Why does income matter to health? See a NewPublicHealth infographic on how stable jobs and income lead to healthier lives.
And last weeks’ New Yorker Magazine added heft to the need to look at the current minimum wage rate, in light of just how critical that income is to many households. According to the article, while low-wage retail jobs were once squarely aimed at high school students looking for pocket money and those looking for supplemental income, in the last few years of stiff unemployment, studies find that current low-wage workers are responsible for 46 percent of household income. According to the New Yorker article, “Congress is currently considering a bill increasing the minimum wage to $10.10 over the next three years…still a long way from turning these jobs into the kind of employment that can support a middle-class family.”