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.
Follow NewPublicHealth this Week for News from ‘Spotlight: Health’ at the Aspen Ideas Festival and the Winners of the RWJF Culture of Health Prize
The Robert Wood Johnson Foundation (RWJF) is a lead sponsor for this week’s Spotlight: Health meeting, a two-and-a-half day expansion of the Aspen Ideas Festival, convened annually by the Aspen Institute in Colorado.
Spotlight: Health will bring together world leaders, corporate executives, innovators, entrepreneurs, policy experts, media, philanthropists and thought leaders from many sectors to showcase what health and health care can look like a decade from now.
On Wednesday, RWJF CEO Risa Lavizzo-Mourey will deliver a keynote address: “We Will Have A Powerful Story to Tell: Building a Culture of Health in America,” which will be live-streamed at 10 a.m. (EDT). She will also announce the six winners of the RWJF Culture of Health Prize, which honors communities working at the forefront of health improvement.
NewPublicHealth will live tweet and live blog from the event, as well as post interviews with key thought leaders presenting at the conference. They will include investor/entrepreneur Esther Dyson on “The Way to Wellville,” a wellness competition that’s looking for the key metrics to help improve population health; Cleveland Clinic CEO Toby Cosgrove, MD, on bringing business best practices to health care; and Michael Murphy, of the Boston-based MASS Design Group, on better design ideas for hospitals and health systems.
Follow RWJF and NewPublicHealth coverage of Spotlight: Health using the hashtag #AspenIdeas.
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.
Bithlo, Fla. is a town of 8,000 that is just 30 minutes outside Orlando and not much farther from the “happiest place on Earth” — but is beset by poverty, illiteracy, unemployment and toxic dumps that have infiltrated the drinking water. The water is so bad that it has eroded many residents’ teeth, making it that much harder for them to find jobs. Streets filled with trash, frequent road deaths and injuries from a lack of transportation options and safe places to walk, and dropping out before 10th grade were all the norm.
In just a short time, a collection of partners and volunteers have begun to reverse some of the decades-old problems Bithlo has faced. And earlier this week, the town that had been forgotten for almost a century was the scene of a hubbub of activity as hundreds of volunteers descended on the town to continue work on “Transformation Village,” Bithlo’s future main street, which will sport a combination library/coffee shop, schools, shops and many other services, all long missing from Bithlo.
Over the last few months, NewPublicHealth has reported on initiatives of the participating members of Stakeholder Health, formerly known as the Health Systems Learning Group. Stakeholder Health is a learning collaborative made up of 43 organizations, including 36 nonprofit health systems, that share innovative practices aimed at improving health and economic viability of communities.
>>Read more on the Stakeholder Health effort to leverage health care systems to improve community health.
One of the Stakeholder Health members is the Adventist Health System, a not-for-profit health care system that has hospitals across the country. Recently, Adventist’s flagship health care provider, Florida Hospital in Orlando, began supporting United Global Outreach (UGO), a non-profit group aimed at building up communities in need, in their four-year-long effort to transform the town of Bithlo.
NewPublicHealth recently spoke with Tim McKinney, executive vice president of United Global Outreach, and Verbelee Neilsen-Swanson, vice president of community impact at Florida Hospital, about the partnerships and commitment that have gone into Bithlo’s transformation into a town that is looking forward to new housing stock, jobs, stores, better education and improved health outcomes for the its citizens.
BSR: More and More, Private Sector Being Asked to Improve Population Health
Traditionally, health efforts fall under the purview of human resources—not corporate social responsibility (CSR)—in the business world. However, companies are playing an increasingly important role in not only health improvement efforts for their own employees, but also in population health for their larger communities. Increasingly, consumers are demanding this from companies to support their CSR work, as reported by Fast Company. That's also the subject of a BSR report, A New CSR Frontier: Business and Population Health. The report looked at the role of businesses in overall public health for more than 350 major companies, including Coca-Cola, Walmart, Microsoft, Chevron, and General Mills. The report found three major trends:
- Society expects companies to play a bigger role in population health
- Companies are responding to those expectations, but primarily with employees and customers
- Health and wellness are still largely the domain of human resources, even though departments such as philanthropy, marketing and research & development should be involved
"The pullback of government as an influence for population health has created gaps and stakeholders are expecting more from the private sector," said Mark Little, director of health care advisory services at BSR. "The overarching single headline is that business now has new responsibilities that are recognized by stakeholders. We do believe there is a new frontier for CSR."
Support for this report was provided by a grant from the Robert Wood Johnson Foundation. Read more on business.
AAP Offers New Guidelines to Reduce Risk of Antibiotic Resistance
This week is “Get Smart About Antibiotics Week,” and the American Academy of Pediatrics (AAP) has released new guidance that would limit the over-prescription of antibiotics that is contributing to the growing public health issue of antibiotic resistance. The guidance, formulated in collaboration with the U.S. Centers for Disease Control and Prevention (CDC), focuses on the three common upper respiratory tract infections in children that are unlikely to be helped by antibiotics: ear infections, sinus infections and sore throats. The report includes clinical criteria to help physicians determine whether an upper respiratory tract infection is viral or bacterial, which will improve care while limiting opportunities for bacteria to become resistant to antibiotics. “Our medicine cabinet is nearly empty of antibiotics to treat some infections,” said CDC Director Tom Frieden, MD, MPH. “If doctors prescribe antibiotics carefully and patients take them as prescribed we can preserve these lifesaving drugs and avoid entering a post-antibiotic era.” Read more on prescription drugs.
Study: Half of Teens with Mental Disorders Receive No Treatment
Despite ever-increasing knowledge about psychiatric conditions and their links to other health issues, more than half of American teenagers with psychiatric disorders do not receive treatment, according to a new study in the journal Psychiatric Services. The study found that treatment rates varied by disorder. For example, adolescents with ADHD received care more than 70 percent of the time, while adolescents with phobias or anxiety disorders were the least likely to receive mental health care. The analysis also found racial disparities, with white youths far more likely to receive care than black youths. The lack of qualified child mental health professionals also hinders access to care, with pediatricians, school counselors and probation officers being asked to provide care for which they are not actually trained, according to E. Jane Costello, a Duke University professor of psychology and epidemiology and associate director of the Duke Center for Child and Family Policy. "We need to train more child psychiatrists in this country," she said. “And those individuals need to be used strategically, as consultants to the school counselors and others who do the lion's share of the work." The study included data from the National Comorbidity Survey Adolescent Supplement, as well as a survey of more than 10,000 U.S. teenagers. Read more on mental health.
During a town hall meeting in Minnesota last month, the Target Corporation, one of the largest employers in the United States, announced that the company will remove the criminal history question from its initial employment application. While Target has already removed this question in states where it is legally prohibited, this announcement will apply to all U.S. Target locations, even in areas where asking the question is permitted by state or local law. In Minnesota, the Ban the Box law will go into effect January 1, 2014.
“Over the past year, members of the Target team have had many productive conversations with TakeAction Minnesota,” says Molly Snyder, a spokesman for the company. “Many of our discussions have focused on Minnesota’s racial jobs gap and the barriers individuals with criminal records face when seeking employment.”
The decision by Target is in part the result of efforts led by the TakeAction Minnesota Education Fund, a Robert Wood Johnson Foundation (RWJF) Roadmaps to Health community grantee, to address job discrimination based on criminal background. Often tied to significant unemployment throughout the country, studies show that having a criminal record is a barrier to employment opportunities and depresses wages. And data from Minnesota finds that half of all former offenders are unemployed, with the rate higher for ex-offenders of color who disproportionately make up the prison population.
The Roadmaps to Health Community Grants are collaborations that have received two year funding of up to $200,000 to work with diverse coalitions of policy-makers, business, education, health care, public health, and community organizations. The grantees and their partners are pursuing policies or system changes that address the social, economic, and environmental factors that influence how healthy people are and how long they live. The Roadmaps to Health Community Grants project is a major component of the County Health Rankings & Roadmaps program—a collaboration of RWJF and the University of Wisconsin Population Health Institute.
TakeAction Minnesota is using its grant to promote new statewide fair hiring standards for businesses, such as persuading prospective employers to consider criminal records only when they directly relate to the position rather than asking questions on applications that promote blanket rejections. Earlier this year, the Minnesota legislature passed the “ban the box” legislation and it was signed into law in May, making Minnesota the third state in the nation to adopt “ban the box” in both the public and private sectors. Under the new law, an employer will no longer be allowed to include a check box about criminal background on the initial employment application.
NewPublicHealth recently spoke with Justin Terrell, manager of the Justice 4 All program at TakeAction Minnesota, about the intersection of employment and health.
NewPublicHealth: What are the ways in which employment impacts health?
BSR: New Ways U.S. Companies Can Improve Population Health
U.S. companies can improve population health by improving how they engage with employees, customers, local communities, suppliers and the general public, according to a new BSR report supported by a grant from the Robert Wood Johnson Foundation. BSR interviewed 40 leading authorities on health and wellness, public health, corporate social responsibility and corporate affairs, as well as reviewed more than 35 corporate CSR reports across 10 industries and surveyed nearly 30 U.S.-based BSR member companies about their current activities on health and wellness. The report emphasizes how CSR teams can help lead the charge in improving population health. “Within business, the corporate social responsibility (CSR) teams are well-positioned to lead this work—helping their companies look carefully at the positive as well as negative impacts on health and wellness, and helping them identify opportunities to deliver better business results and health outcomes,” said Mark Little, BSR’s healthcare director. Read more on business.
CDC: Colorectal Cancer Screening Rate Remains Low
Despite continued research showing that colorectal cancer screening tests saves lives, as many as one in three adults ages 50 to 75 have not been tested, according to a new Vital Signs report from the U.S. Centers for Disease Control and Prevention (CDC). The cancer type is the second-leading cause of death for both men and women in the United States, and screening can help prevent it or even detect it early, when treatment is more effective. “There are more than 20 million adults in this country who haven’t had any recommended screening for colorectal cancer and who may therefore get cancer and die from a preventable tragedy,” said CDC Director Tom Frieden, MD, MPH. “Screening for colorectal cancer is effective and can save your life.” the United States Preventive Services Task Force recommends that all adults age 50 and older be screened by at least one of three tests, which can variously be performed at home or by a doctor, and once every year, three years or decade. Read more on cancer.
Study: Eating Disorders in Young Men Often Different Than Those in Women
While not as widely discussed or researched, young men—just like young women—can become obsessed with their appearance and develop dangerous eating disorders, according to a new study in the journal JAMA Pediatrics. The problem can resemble a traditional eating disorder such as anorexia nervosa or bulimia nervosa, or involve the use of drugs and supplements. The disorders are often paired with depression, binge drinking and recreational drug use. The researchers’ survey of 5,527 boys, ages 12-18, found that 31 percent had at some point binged on food or purged, 9 percent had a high level of concern with their body's muscularity and about 2 percent were both concerned about muscularity and had used some type of supplement, growth hormone derivative or anabolic steroid to enhance it. "The results of our studies would suggest we need to be thinking more broadly about eating disorders and consider males as well," said Alison Field, the study's lead author and an associate professor of pediatrics at Boston Children's Hospital. "For a lot of males, what they're striving for is different than females. They're probably engaged in something different than purging." Read more on pediatrics.