Small Business, Big Impact: The Untapped Opportunity to Advance Health and Equity

Nov 25, 2019, 10:00 AM, Posted by

New report shows that small businesses create jobs and wealth and are imperative to healthy, thriving and equitable communities. Small businesses represent tremendous untapped potential to promote health equity and create opportunities for everyone to live healthier lives.

Four women laugh around a table in a coffee shop.

On a recent trip to Ferguson, Missouri, I visited a locally owned coffee shop that was filled with people working on laptops, visiting with friends, reading and studying. The walls were covered in fliers with community news and people were connected with neighbors. Sound familiar? It’s like thousands of other coffee shops. Across America, there are businesses like these where the owners and employees have their fingers on the pulse of what’s going on in the neighborhood.  

Small businesses of all types are in just about every community in the United States—in fact, companies with fewer than 100 employees make up 98 percent of all businesses in America and more than 43 percent are in low-income communities. They are helping to create healthy, equitable communities through the assets, income and jobs they create. People walk in their doors every day and share information or ask for advice—from barber shops and hair salons, to hardware stores and corner stores, to accounting firms and yoga studios.  

For those of us working to create a Culture of Health and advance equity, small businesses and their leaders could be ideal partners—so why don’t we engage them more often? 

Our team at Public Private Strategies spent a year interviewing almost 100 small business owners and their associations, along with leaders from philanthropy, community development, economic development, advocacy, and the public sector to explore this.

Growth Rate in Business Starts infographic.

What we found? Tremendous, untapped potential:

  1. Small businesses create jobs, build wealth and help close racial and gender wealth gaps, especially in communities where opportunities have been limited historically. Although the majority of business owners today are white, small business startup rates are highest among black and Latino business owners. And while more men own businesses than women, about one in four businesses is women-owned and the share is growing rapidly, especially among black and Latina women. Success stories from small business are inspiring millennials and other younger individuals to increasingly pursue entrepreneurial paths.
  2. Small businesses are the 2nd most trusted institution in America. In general, small business owners think deeply about community needs, have strong networks and are committed to the places they do business. Employees rely on them as trusted sources of information and many small business owners treat their employees like family, far surpassing the typical employer-employee relationship. Small businesses often provide employment for those who may otherwise struggle to secure good jobs: the formerly incarcerated, immigrants, seniors and others. And their leaders are already sharing knowledge on things like SNAP benefits, EITC, or tuition assistance. As one interviewee told us, “Small business owners can educate employees and help guide decision-making when laws are passed.”
  3. Small business owners can also play critical roles in advancing policy that’s good for business and for their employees. For example, in San Francisco, Los Angeles, and Washington, D.C., small businesses are working with community leaders to support innovative policies such as rent stabilization grants and other real estate financing so small businesses can stay in communities to ensure that jobs aren’t priced out of gentrifying neighborhoods.

Small business owners and employees represent a broad cross-section of American society who depend on and contribute directly and indirectly to health equity and healthy communities. Yet most calls for business to promote health improvements for employees, customers and communities focus on large business. Giving small businesses a seat at the table and asking them what their communities need to improve health and well-being offers a fresh perspective and new approach (yet it’s important to recognize that as entrepreneurs, they are often stretched thin and pressed for time).  

As partners to government, philanthropy, and community development, leaders of small businesses represent tremendous untapped potential to help promote healthy communities and health equity.

Read the full report to learn more about the power of small business and how you can help elevate this untapped partner to advance health, equity, and a more inclusive economy. 


Rhett Buttle is an expert working at the nexus of policy and market change. He is the founder of Public Private Strategies and NextGen Chamber of Commerce. Rhett previously served as a private sector advisor to the Secretary of Health and Human Services and The White House Business Council. He is a Senior Fellow at the Aspen Institute Financial Security Program.