During the third panel of the workshop, examples of the positive role business can play in preventing and reducing obesity were described by four
representatives of business organizations: Becky Johnson, executive director of the Healthy Weight Commitment Foundation; LuAnn Heinen, vice president of workforce well-being, productivity, and human capital for the National Business Group on Health; Ryan Shadrick Wilson, chief strategy officer and general counsel of the Partnership for a Healthier America (PHA); and Elyse Cohen, director of the Health and Wellness Program at the U.S. Chamber of Commerce Foundation’s Corporate Citizenship Center.
When the Healthy Weight Commitment Foundation was established by food and beverage companies in 2009, its members committed themselves to removing 1.5 trillion calories from the nation’s food supply, explained Johnson. According to an independent evaluation by the Robert Wood Johnson Foundation, those companies exceeded their goal by 400 percent, removing 6.4 trillion calories from the nation’s food supply (Ng et al., 2014). Today, the coalition consists of more than 300 organizations and is engaged in a wide variety of activities, such as the following:
- It has partnered with Discovery Education, the education branch of the Discovery Channel, to create a wellness curriculum that teaches children about the importance of social and emotional wellness, nutrition, self-esteem, physical activity, goal setting, and resilience. According to Johnson, the curriculum materials are freely available to schools, and already more than 38 million students from prekindergarten to fifth grade have been reached through these materials (Healthy Weight Commitment Foundation, 2016). Recently, the program expanded to Latin America.
- It has created incentive programs that have provided more than $1.3 million in grants and prizes, many going to at-risk schools (Healthy Weight Commitment Foundation, 2016). “Many of these schools either didn’t have safe places for kids to play or they needed to update their food service equipment to encourage more healthful eating,” said Johnson.
- It has joined in a research partnership with the City University of New York School of Public Health to assess the impact of its corporate members’ community initiatives, explained Johnson. She reported that an initial assessment of 10 companies’ community-based programs on hunger and obesity prevention showed that the companies had donated more than 55,500 hours of their employees’ time to these efforts, had partnered with more than 660 organizations, had invested $30.5 million, had donated more than 54 million pounds of food, had facilitated 1.6 million hours of
exercise, had reached 34,700 schools and 11.2 million individuals, and had provided more than 420.6 million servings of food.
Johnson asserted that the impact these companies have had through the foundation “provides clear evidence as to why and how businesses can be a part of the solution.” And she stated that “our efforts continue.”
The National Business Group on Health represents many of the largest self-insured employers in the United States, explained Heinen. She went on to note that its more than 400 members, which include many Fortune 500 companies (National Business Group on Health, 2017), together purchase health care services on behalf of about 50 million employees.
Member companies participate to network and share best practices in improving workforce well-being, Heinen continued. The organization has been helping to lead a shift toward a more holistic view of employee well-being that encompasses dimensions beyond physical health, such as financial security, emotional well-being, social and community connectedness, and job satisfaction, she observed. She reported that members are also expanding how they measure the success of their wellness programs to include employee engagement, recruitment, and retention in addition to such more traditional metrics as absenteeism and safety incidents.
Heinen focused on the physical health programs that employers have been developing in recent years. Since she began working on the obesity issue in 2003, she said, there has been “a great expansion in the breadth, depth, and sophistication of what is being offered by large employers.” According to a recent survey of Business Group members, these efforts include physical activity challenges, smoking cessation assistance, weight management programs, and fitness classes (Fidelity Benefits Consulting and National Business Group on Health, 2016) (see Figure 4-1). Companies are also looking to include families in such programs, Heinen said. Of the 78 percent of member companies that offer weight management programs, for example, 84 percent offer them to spouses and domestic partners (Fidelity Benefits Consulting and National Business Group on Health, 2016).
Wellness programs are often associated with incentives, Heinen observed, but the use of outcome-based incentives has been declining. “While incentives are still important,” she said, “they’re being redefined to include, in many cases, not just individual financial rewards but nonfinancial rewards, group incentives, group rewards, and donation of awards into the community.”
Shadrick Wilson noted that PHA was launched in 2010 on the same day that First Lady Michelle Obama announced her Let’s Move! initiative. It is an independent, nonprofit, nonpartisan organization with more than 200 members, she reported, with the mission of improving children’s health and fighting the childhood obesity crisis. “We say that our goal, each day, is to make the healthy choice the easy choice, in all communities, with an eye toward those communities most in need,” she explained. PHA brings together people, such as industry CEOs, within and across sectors to create innovative solutions. “It gives me faith that we’re going to have a breakthrough in this crisis,” Shadrick Wilson said.
PHA works directly with the private sector to negotiate meaningful commitments to improving the nation’s health and wellness, Shadrick Wilson noted. For some companies, she explained, this means reformulating foods and making healthy foods more accessible. PHA has garnered commitments to improving hospital food from more than 10 percent of the nation’s hospitals, for example, and has worked with convenience store chains to increase the accessibility and affordability of healthy choices available in their stores. Other companies, Shadrick Wilson noted, have committed to investing in communities to create healthier places for both children and adults. For example, she explained, PHA is working with developers across the country to incorporate active design principles into the construction, design, and management of affordable housing developments. In addition, it has launched a Healthier Campus initiative to encourage universities and colleges to meet certain nutrition and physical activity objectives. “We’re working with a diverse array of industries and, frankly, trying to pull levers wherever we can,” said Shadrick Wilson.
The 200 member organizations have agreed to have their commitments and activities verified by an independent third-party evaluator, explained Shadrick Wilson, which allows PHA to publish its progress annually. “This is not a PR moment,” she noted. “This is a real commitment that will be tracked and verified.” Companies “are hearing consumer demand, they’re hearing the voices of their employees, and they’re wanting to do what they can to create healthier products and healthier workforces,” she said.
Shadrick Wilson reported that PHA has also begun working on the demand as well as the supply side of healthier choices. For example, she said, it has launched a campaign called Drink Up to promote water consumption and a campaign called FNV (Fruit and Vegetable) to promote the consumption of fruits and vegetables. She noted that, based on research associating popular media characters with eating patterns in children, PHA negotiated a partnership with Sesame Workshop to provide its licensed characters for free to any fruit or vegetable grower for 2 years, which was later extended to 5 years. PHA has also worked with celebrities and athletes to provide their names for a fruit and vegetable marketing campaign.
While the partnership does not engage in policy advocacy, Shadrick Wilson observed, it was created in part to continue the work begun by the first lady beyond the Obama administration. She concluded by saying, “We are poised and ready to continue the shift.”
Cohen explained that the Health Means Business Campaign, which is being led by the U.S. Chamber of Commerce Foundation, the Robert Wood Johnson Foundation, and local and regional chambers of commerce across
the country, has the goal of engaging the business community in the wellness of the nation’s communities. It is seeking, first, to educate the business community on the feedback loop between health and economic growth and, second, to inspire businesses to invest in their communities. “This isn’t just about what health care and health insurance companies can do,” Cohen said. “This is about the role that every business, large or small, can play in impacting community health.”
Cohen noted that the campaign has three overarching themes. The first is creating the movement by building the case for why businesses should care about investing in the health of their communities. “More than $220 billion per year is lost in worker productivity,” observed Cohen. “When folks in the room hear this, that’s when their ears and eyes perk up.”
The second theme is building momentum. The campaign has been working to create champions, Cohen reported, in part through an awards program that recognizes businesses and tells their stories. The campaign also asks companies to take a wellness pledge. “Businesses don’t often take these pledges, because they don’t know that they play a role and don’t know what they have to do,” Cohen noted. “Creating this community has enabled them to make a commitment to this work.”
The third theme is accelerating the movement and building long-term sustainability. Cohen explained that the campaign has created an online resource center and has fostered opportunities for dialogue. “We provide resources, toolkits, and open communication platforms, [and] there’s also a research component,” she said.
The anchor of the campaign, Cohen noted, has been a series of forums in 11 cities designed to bring together the business and nonprofit communities to build relationships and form partnerships. “By creating this community,” she said, “it enables businesses to actually make a commitment to this work.” At the time of the workshop, the campaign was gathering feedback from the forums to share more widely.
Companies are no longer separating health and wellness programs from the rest of their activities and are treating them as a corporate social responsibility, Cohen observed. Companies are “embedding social impact around health, wellness, and food access into who they are,” she said. She reported that the campaign has been compiling case studies to help build the business case for investing in health. When it comes to food companies, she observed, the campaign has been able to show that profit in many cases is staying the same or increasing because consumer demand is shifting, and many consumers want to see quality, access, and transparency in the foods they purchase and consume.
In response to a question, each of the four panelists commented on how their organizations address the disparities that exist in obesity. Cohen noted that the Health Means Business Campaign can work directly with specific communities. The people in the room “are the businesses, the stakeholders, the nonprofit organizations, and the government officials within that community,” she said. “We’re able to foster and tailor everything community by community, region by region, and state by state, as opposed to a broad stroke that may not be transferrable across communities.”
Johnson responded that the Healthy Weight Commitment Foundation is focused on reaching underserved communities. In the previous year, for example, two-thirds of the prizes the organization awarded went to Title I schools, which have high numbers of children receiving free and reduced-price lunches.
According to Shadrick Wilson, PHA has made a major commitment to equity. For example, its affordable housing and convenience store initiatives leverage the influence of large companies that are already in disadvantaged communities. “We’re constantly challenging ourselves to do better and to do more with an equity lens,” she asserted.
Finally, Heinen pointed to the importance of incentives in aligning corporate policy with social change. “When you’re recruiting Target in Minneapolis to build their headquarters downtown,” she observed, “it’s not just about job creation. It’s also about a healthy workforce.”
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