The COVID-19 pandemic reminded us that the intertwined factors of race, class, geography, education, and income mean that responsibility for the health of Americans cannot and should not sit primarily with individuals or even within the domains of health care or public health.
“This is a problem everyone needs to be involved in.” -Dr. Lisa Cooper
The Centers for Disease Control and Prevention defines health equity as the state in which “every person has the opportunity to attain his or her full health potential and no one is disadvantaged from achieving this potential because of social position or other socially determined circumstances.”
In light of this framework, businesses are truly anchor institutions of health, as opportunities to be healthy (or lack thereof) are greatly tied to economic stability. Beyond direct effects of employment and wages, business leaders can also influence many of the social conditions that contribute most to community health.
The Hopkins Business of Health Initiative convened two experts in this work, Dr. Lisa Cooper and Ebony Thomas of the Bank of America Charitable Foundation, in a recent conversation to discuss best practices for health equity in business and where they see opportunities for growth.
Lisa A. Cooper, MD, MPH is the James F. Fries Professor of Medicine and a Bloomberg Distinguished Professor at Johns Hopkins University Schools of Medicine, Nursing, and Bloomberg School of Public Health. She is also the Founder and Director of the Johns Hopkins Center for Health Equity. Dr. Cooper studies how race and socioeconomic factors shape patient care, and how health systems, with communities, can improve the health of populations that experience health disparities.
Ebony A. Thomas is President of the Bank of America Charitable Foundation, whose mission is to help advance economic mobility for individuals, families, and communities to create thriving communities across the company’s global footprint. Thomas leads the company’s signature philanthropic programs, Neighborhood Builders®, Neighborhood Champions and Student Leaders®, which recognize the community leadership and service of nonprofit organizations and students across the U.S. In 2021, Bank of America announced a $1 billion, four-year commitment to help drive economic opportunity, health care initiatives, and racial equality.
Together with our moderator, HBHI journalist-in-residence Joanne Kenen, they shared ways they see equity advancing in the corporate world, along with promising avenues for change. Here are 9 ways businesses can become champions for health in their communities.
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Equity begins on your payroll. Businesses can begin by simply understanding who their employees are and what they need, from wages and housing to transportation and food access. “We know that a lot of the employees that work for a business come from the surrounding community, so it's a good place to start,” said Cooper. “Companies that are actually taking care of their own people, making sure that they have a living wage and that they have access to resources that can address their social needs, are demonstrating authentic commitment to health equity.”
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Start small. Think first about what is manageable for your business and your staff. “I think that small things really make a difference,” said Thomas. “Find the smaller grassroots work that matters to your employees and start there. It's really about choosing an area in which you want to focus in and try not to be so broad, and then bring others with you along the way.”
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Create a positive feedback loop. Dr. Cooper shared a simple three-point playbook for business leaders: Step One: Collect data around race, ethnicity, primary language, income, and relevant health risk factors to understand the population you’re serving. Step Two. Select a particular problem based on what you've learned from the data. Step Three: Use metrics to track the success of your efforts.
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Be guided by lived experience. One of the most important best practices for health equity is continuously engaging people from affected communities. “Having community advisory boards and employee action groups inform your work ensures that you're clear about what the priorities are,” said Cooper. “You can collect data through surveys, but you also need to give people a seat at the table to help you design and implement some of these programs so that they are relevant and appropriate.”
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Let employees contribute. It’s not all about funding, so create other pathways for involvement. “I get emails every day from our employees who say to me, ‘Ebony, how do I get involved? Health care and what we're doing in the community is so important to me.’ Another business element of this work is the engagement that it brings to your employees, this sense of purpose and connectivity,” said Thomas.
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Tell the story. Along with the data, storytelling on impact can create broader narrative change. “Once they’re involved in this work, leaders can see how clearly health is the linchpin that creates communities and makes them run and function," said Thomas. “So if we put that at the center of our narrative, then we start to rally other anchor institutions around this notion that health and dignity go hand in hand.”
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Use your leverage. Business leaders always have the opportunity to wield influence at the local, state, and national levels. “Oftentimes we think about anchor institutions as hospitals and universities but companies are anchors that provide not just income and employment, but advocacy and positions and voices,” said Thomas.
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Promote the revenue case. To ensure the longevity of health-promoting programs, make sure your stakeholders understand that “it’s not only the right thing to do,” said Cooper, “but improving employee outcomes actually does improve the bottom line for businesses. Investing in primary care and prevention doesn't necessarily cost as much money as waiting for people to get sick and then having to pay for all of the complicated healthcare services on the other end.”
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Connect the dots. Health is interconnected with issues like safety, civil rights, and economic viability; inequities affect everyone negatively, not just disadvantaged groups. “If people can see the connections between all these things, then it will help them understand that when some groups have worse outcomes, we actually all do worse,” said Cooper.
