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Expanding the Business of Public Health

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New York City's controversial proposal to limit the size of servings of sugary sodas offers a classic case of business fighting public health -- with the soft drink industry ultimately prevailing in court and the epidemic of obesity as virulent as ever. But America's public health challenges -- from the prevalence of diabetes to poor nutrition to air pollution to climate change to the health that cities foster -- require the active participation of business if they are to be overcome.

What's needed is the creation of shared value, as envisioned by Michael E. Porter and Mark R. Kramer in their classic 2011 article in Harvard Business Review. "The concept of shared value," they wrote, "can be defined as policies and operating practices that enhance the competitiveness of a company while simultaneously advancing the economic and social conditions in the communities in which it operates. Shared value creation focuses on identifying and expanding the connections between societal and economic progress."

A good example is the advent of Fitbit and other products that monitor physical activity. They integrate fitness into daily life; they're relatively inexpensive (as little as $60), and they make it fashionable to be conscious of your range of physical activity throughout the day.

The changing role of drugstores from convenience stores to healthcare providers is another promising trend. CVS's recent decision to stop the sale of cigarettes and tobacco products, because it runs counter to this new role, is especially laudable. As CVS's CEO Larry Merlo said, "Put simply, the sale of tobacco products is inconsistent with our purpose." That's particularly notable, since it's a business decision that will cause the company to forgo $2 billion in annual revenue, which it expects to more than make up for as a healthcare provider.

The Vitality Institute -- a global research organization working to illuminate what works and what doesn't work in health promotion and disease prevention -- recently released a report on ways to reduce unsustainable levels of preventable disease. The report included five recommendations from a Commission on which I serve, and those recommendations focus heavily on collaborations between government and business.

The recommendations are: (1) place prevention at the center of healthcare decisions within government and business; (2) strengthen and expand leadership to deliver a unified message for health and prevention; (3) make markets work for health promotion and prevention; (4) integrate health metrics into corporate reporting; and (5) promote strong cross-sector collaborations that generate a systemic increase in health promotion and prevention across society. Further, the report calls for investing more significantly in the science of prevention.

Writing recently in the New York Times, former U.S. Treasury Secretary and Goldman Sachs CEO Henry Paulson offered further encouragement. In his op-ed, he urged Americans and the business community specifically to address climate change and its public health implications. "Farseeing business leaders are already involved in this issue," he writes. "It's time for more to weigh in... We need to craft national policy that uses market forces to provide incentives for the technological advances required to address climate change."

Collaborations involving business and social needs are the key. Businesses need to line up to support our common good -- we all depend on that. As Porter and Kramer wrote:

Businesses acting as businesses, not as charitable donors, are the most powerful force for addressing the pressing issues we face. The moment for a new conception of capitalism is now; society's needs are large and growing, while customers, employees, and a new generation of young people are asking business to step up.

The soda industry's victory over public health is not a model for the future. Viewing public health through the lens of creating shared value is.