How Health Policy Can Help Amazon Find a Prime Location

11/06/2017 07:29 am ET

Dear Mr. Bezos,

You’ve got one heck of decision to make. Choosing the location for Amazon’s second headquarters is surely complex. Between some 200 cities vying for your attention and the potential impact on people and jobs, I’m sure you are really busy right about now. According to your specifications, the “winning” city will be the proud recipient of some 50,000 new jobs and a five billion dollar capital expenditure. Those same specifications say you are looking for tax incentives, access to an international airport, quality high education and several other core criterions that typically make sense for business.

But, you can’t divorce the health of your company from that of the surrounding community where your employees will live, raise their families, and educate their children. For all the tax credits and other incentives being thrown your way, how many of those suitors have discussed their community’s health? Did any of them discuss their success in reducing absenteeism from illness, or how their investment in their community’s health might help lower your health insurance premiums? It’s probably none or not many at best. This is where I think I might be able to help. Mr Bezos, I want to introduce you to CityHealth.

CityHealth is a package of policies that experts say can help millions of people live longer, healthier lives in vibrant, prosperous communities. Not only does it identify specific policies, but it also scores many of the cities vying for your attention based on their commitment to health and wellness.

Let’s take a look…

Paid sick leave. Did you know that while 93% of people in management, business, and financial positions report having paid sick leave, only 46% of workers in the service industry have this benefit? These are the folks we interact with every day, the wait staff at lunch, the grocery clerk, those with whom your employees will share public transportation. If they are sick at work, they can make your employees sick. The spread of communicable illness – like the flu – is easily prevented through social isolation when infectious (which is just a fancy way of saying, “Stay home!”). But, it’s hard to do that if it might mean not making your rent or providing food for your children.

Inclusionary zoning. When you announce the future location of Amazon’s second headquarters, it will immediately and irreversibly change that community. Property values will increase overnight, and developers will begin to acquire property to build homes and condos for all those new, high paid employees. But, what about everyone else? Take Austin, Texas for example. Austin has experienced tremendous growth as a result of its tech boom, but while jobs and incomes increased, so did housing costs. This didn’t just displace low wage earners, it impacted professionals like teachers. As a result of the high housing costs, the Austin Independent School District was losing 800 experienced, seasoned teachers every year. Eventually, developers worked with the city to build affordable housing in Austin, specifically for teachers. If you take note of the housing policies in the cities in which you want to locate, you can address this problem upfront instead of having to react to it later.

Complete streets. With the boost in economic vitality that will come with Amazon’s second headquarters, it is likely that there will be both more traffic and increased population density. “Complete Streets” policies unlock opportunities for residents to safely walk, bike, drive, and take public transit around their community. Complete streets policies also keep people active, which, ultimately, will mean lower health care costs for you. If we are being honest, aren’t walkable, bikeable cities precisely the environment that the young, educated talent you need at Amazon is looking for?

High-quality, universal pre-kindergarten. Simply put, for every $1 invested in early education, there is a $5 return. Children who attend high-quality pre-k are more likely to succeed in school, go on to stable jobs, and earn more as adults – all of which are linked to better health and stronger communities. Wherever you choose to locate your new headquarters, ensuring access to early pre-k is an investment in that community, in the families you will employ, and in your company’s future workforce. Unlike the other CityHealth policies, ensuring the availability of universal pre-k has a cost. To offset this cost, cities have been creative. For example, Philadelphia’s soda tax was specifically proposed to pay for universal pre-k. You might consider the possible impact that the availability on universal pre-k could have on recruiting talent and the potential future workforce in the community. You could even consider redirecting some of the tax breaks cities are earmarking for Amazon to help support universal pre-k policy.

Food safety and restaurant inspection rating. When your employees go out to lunch, I am sure you want them to do so without the threat of salmonella, E. coli, or some other food-borne illness. A wide spread food-borne illness could really hamper productivity and have a serious impact on the health of your employees. Cities can help guard against such outbreaks with policies requiring food establishments to publicly post safety inspection “grades,” which can empower consumers while also reducing foodborne illness rates and health care costs. Next time you are visiting one of the cities competing for your second headquarters, see how easy it is to find the restaurant inspection grade.

The other four policies are alcohol sales control to reduce the concentration of alcohol outlets in a neighborhood, tobacco 21 to further curb tobacco use among young adults to reduce the number of people who start and continue to smoke, healthy food procurement policies ensure that healthy food options are available on public property, and clean indoor air policies to protect non-smokers from secondhand smoke and reduce smokers’ consumption of tobacco. Amazon may already follow some of these best practices voluntarily, but not all businesses are as progressive. Ultimately, we know that a healthy workforce is more productive workforce and has fewer absences. It is undeniable that employee health is indelibly tied to the health of the community. These policies demonstrate a community’s commitment to establishing a healthy environment for all residents and, in turn, contributing to a healthy workforce.

As I mentioned, CityHealth didn’t just outline these policies, it also reviewed and awarded cities gold, silver, or bronze medals based on the number and strength of their policies in these nine areas. These ratings could be really helpful as many of the cities competing for your second headquarters were rated. The unfortunate part is that of nation’s 40 largest cities, fewer than half have enough strong policies to even warrant a medal at all.

Tax breaks, cheap real estate, and existing corporate talent are just some of the enticements city leaders think are important when recruiting a business, and, honestly, they are important. But, Mr. Bezos, choosing a prime location for your business should be about much more than just the dollars and cents. What if you started asking about health, about policies like those in CityHealth? If you don’t choose one of CityHealth’s gold medal cities – Los Angeles, Boston, Chicago, New York, or Washington, DC – what if part of the recruitment package was to be a gold city within a negotiated period of time? It would definitely benefit Amazon, but it could signal a game change in how businesses prioritize and encourage the health of the communities where they choose to locate. And, let’s face it, can we really have a thriving economy in the absence of healthy people and communities?

Mr. Bezos, you changed how we buy and sell products. You changed the business world, but I bet that isn’t enough for you. By including the presence of specific policies that are business-friendly and that support health in your decision-making process, you have an opportunity to set a new standard for how businesses interact with and influence the communities where they are located; how businesses can impact and improve the health of the nation. Good luck on your decision, and feel free to give me a call if I can be of any further help.

Sincerely,

Brian Castrucci

Brian Castrucci is the Chief Program and Strategy Officer at the de Beaumont Foundation. Prior to joining the Foundation, Brian spent a decade working in state and local health departments. Brian is currently pursuing his doctorate in public health leadership at the University of North Carolina at Chapel Hill Gillings School of Global Public Health. You can follow Brian on Twitter at @BrianCCastrucci and the de Beaumont Foundation at @deBeaumontFndtn.

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