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Introduction and Organization of the Workshop1
A critical component of the nation’s economic vitality is ensuring that all Americans can contribute and prosper. Such contributions presuppose an intentional focus on achieving the highest levels of health possible, which requires that conditions in communities, schools, workplaces, and other settings promote health and address the social determinants of health for all community members. Health-promoting opportunities include healthy housing; revitalized and healthy neighborhoods with low crime; access to healthy and affordable foods; safe places to play and promote physical activity; transportation that is reliable, affordable, and easily accessible to all; safe water systems; strong social networks; and good jobs that provide living wages and benefits as well as opportunities to move up a career ladder. These opportunity-rich environments can buffer the onslaught of toxic conditions that many people face every day and promote better health for all.
Many organizations, in both the private and public sectors, have been establishing partnerships to further healthy workplaces and health equity in general. Many are taking the lead in producing economic growth that is inclusive and responsive to the nation’s diverse needs and populations. Increasingly, private–public partnerships are emerging as ways of doing business. Additionally, a variety of new developments in health, health care,
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1 The planning committee’s role was limited to planning the workshop, and the Proceedings of a Workshop prepared by the workshop rapporteurs as a factual summary of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants; they are not necessarily endorsed or verified by the National Academies of Sciences, Engineering, and Medicine and they should not be construed as reflecting any group consensus.
and community benefits obligations that are part of the Affordable Care Act have contributed to this interest in economic growth and health and in the creation of new partnerships.
To examine both past successes and future opportunities, the National Academies of Sciences, Engineering, and Medicine’s Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities held a workshop on November 5, 2015, at Northwestern University in Chicago, Illinois, titled “The Private Sector as a Catalyst for Health Equity and a Vibrant Economy.” As is evident from the title, the workshop focused on the potential of the private sector to produce a triple bottom line: economic opportunity (including workforce development) and growth, healthy work and community environments, and improved employee health. At the same time, the workshop looked beyond the private sector to public–private partnerships and to public-sector actions that combine opportunities for economic growth and good health for all. Potential audiences for the observations made at the workshop include businesses and corporations, government agencies, sectors outside of health (including housing, education, planning, and transportation), philanthropy, policy makers, and new emerging leaders in health.
BACKGROUND FOR THE WORKSHOP
“Some businesses are really getting it,” said Mildred Thompson, senior director of PolicyLink, in her introductory remarks.“ They’re understanding that it is in their own best interests to take care of their employees and invest in their communities. . . . We are going to ground this day in understanding why businesses are critical partners in advancing health equity, and that the economy is tightly linked to the health of not only individuals but communities.”
A major goal of the workshop was to produce cross talk, observed Melissa Simon, the George H. Gardner Professor of Clinical Gynecology and vice chair of clinical research in the Department of Obstetrics and Gynecology at Northwestern University’s Feinberg School of Medicine. “We want to build bridges and not stay in our own health equity silo. Businesses across all sectors impact health equity in many ways. It’s just not directly what they say they’re doing,” she added.
In many of the presentations and in a “World Café” held during lunch, private- and public-sector organizations showcased what they are doing to promote health at the individual, community, and workforce levels. (Appendix A contains brief descriptions of the organizations that presented information during the World Café session.) In addition, representatives of Northwestern University and the City of Chicago highlighted some of their many local actions being taken to achieve health equity. In his welcoming
remarks at the workshop, Clyde Yancy, vice dean for diversity and inclusion and Magerstadt Professor of Medicine at the Feinberg School of Medicine, said that the institution is at “the epicenter of change” in health care in the United States. “We can’t be the top-tier institution to which we aspire unless we recognize that we live in a very different world,” he said, adding “Heterogeneity is the rule of the day now. We need to be aware, we need to embrace, we need to include, and we’re working very diligently to make that happen.”
Achieving this goal requires that organizations embrace what Clancy called “Diversity 3.0.” The term acknowledges the need for comprehensive health, where people who are ill, disabled, or at risk of adverse health outcomes can have these issues addressed regardless of their circumstances. Comprehensive health “is not just physical health,” Yancy insisted. “It is emotional health, spiritual health, your ability to come to work and be fully engaged without being distracted by other issues. I would argue that one of those attributes of health is to feel comfortable that you are accepted in your work environment without requiring any caveats, explanations, or issues.”
Finally, Jabbar Bennett, the associate provost for diversity and inclusion and associate professor of medicine at Northwestern, observed “Inequality truly hurts humanity, and I believe that’s why we’re all here today.” Northwestern is committed to promoting health equity and eliminating health disparities, not just in greater Chicago but beyond, he said. As an example, he cited the Chicago Cancer Health Equity Collaborative that was recently established by Northwestern University, the University of Illinois–Chicago, and Northeastern Illinois University, which will be working with underserved communities to foster cancer research, education, training, and outreach. Such initiatives “do important work in our communities and among those who are truly underserved,” Bennett said.
ORGANIZATION OF THE WORKSHOP
This report summarizes the presentations and discussions held at the workshop “The Private Sector as a Catalyst for Health Equity and a Vibrant Economy.” The order of the presentations has been changed slightly from the workshop agenda, which appears in Appendix B, and observations made in the discussion sessions appear both in the summary of presentations and in separate sections within each chapter. Appendix C provides biographical sketches of the moderators and presenters.
Chapter 2 summarizes the keynote talk of William Spriggs, professor of economics at Howard University and chief economist at the AFL-CIO. Spriggs pointed to economic trends that have been widening disparities and contributing to adverse health outcomes. Public policies can reduce dispari-
ties, he argued, but policy makers need to pay attention to disparities and focus explicitly on reducing them.
Chapter 3 looks at workforce development initiatives in the Chicago area that address some of the concerns raised by Spriggs. Even in communities beset by high levels of unemployment and health problems, people can be given the skills and knowledge they need to succeed in the workplace, the speakers in this chapter observed.
Chapter 4 turns to the health care system, examining a large health care provider, the health and well-being program of a major employer, and the training of health care providers. Each of these organizations can affect not just the health of its own employees and customers but the health of partner organizations’ members and surrounding communities.
Chapter 5 explores three community initiatives that have prominent health equity components. In each case, local initiatives not only serve community members but provide models and lessons learned for similar efforts elsewhere.
Finally, Chapter 6 provides a brief summary of the major topics raised at the workshop and touches on possible future actions.