Communities in Action

Pathways to Health Equity

Opportunities for the Business Sector

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When it comes to important health metrics, your zip code may matter more than your genetic code.

Map of life expectancy disparities in Kansas City, Missouri.
Map of life expectancy disparities in Kansas City, Missouri.
SOURCE: RWJF. Used with permission from the Robert Wood Johnson Foundation.

Map of life expectancy disparities in New Orleans, Louisiana.
Map of life expectancy disparities in New Orleans, Louisiana.
SOURCE: RWJF. Used with permission from the Robert Wood Johnson Foundation.

For example:

  • life expectancy in the U.S. can vary by 15 years, depending on income level, education, and where a person lives.
  • while the mortality rate for non-Hispanic white babies is 5 in every 1,000, that rate jumps to 11 in every 1,000 for African Americans.
  • rates of serious conditions like obesity, heart disease, cancer, and stroke are substantially higher in the poorest parts of the country.

Disparities like these stem from systems and structures that make it a lot harder for poor people to live healthy lives. Health inequities are a problem for us all, adversely affecting our nation’s children, our business efficiency and competitiveness, our economic strength and national security, and our standing in the world.

Communities are able to take action on the factors that shape health, but they can’t do it alone. Community-based solutions rely on multi-sectoral collaborations ensuring varied approaches to improving community health equity and well-being. A report from the National Academies of Sciences, Engineering, and Medicine offers promising approaches for promotion of health equity. What is the role of the business sector?

What’s at Stake for Businesses?

A healthy, productive workforce is a prerequisite to a thriving economy.
The work businesses do to promote health equity (e.g., through workplace wellness and safety and as producers of goods and services in their communities) can stabilize and strengthen the U.S. economy.

Work done to promote health equity enhances the reputation of a business.
When pursued systematically, efforts to promote health equity in the community are seen as being “good for business.”

Businesses can attain cobenefits in partnership with other community actors.
Practicing a shared values approach places profit and sustainability and social benefit in a mutually reinforcing relationship.

A Key Partner: How Can the Business Community #PromoteHealthEquity?

Businesses can affect health in many ways.
They are payers, who may offer health care benefits to employees. They’re employers, who have a role in ensuring workplace health and safety. They may promote sustainable technology or fund public health-promoting efforts through their philanthropy. An emphasis on health care, workplace wellness, and corporate and social responsibility can promote health equity.

Businesses can focus on health beyond the factory or office walls.
A recent report by the Vitality Institute highlighted links between an unhealthy workforce and the communities in which those workers live. That report called for communities and businesses to work together and for employers to “use market-driven solutions to create shared value and address health disparities.”

Business leaders and community leaders can collaborate.
When both groups—who are concerned about worker productivity, economic vitality, and political stability—work together effectively, meaningful improvements in health equity can take place.

Examples of Action

Community-driven solutions can take into account the range of factors that contribute to health inequity in the United States, such as income and wealth or employment. These factors are the social determinants of health. The Mandela MarketPlace example below works in the areas of physical environment, employment, income and wealth, and social environment.

Mandela MarketPlace

Mandela MarketPlace, based in West Oakland, CA, works with local residents, community-based businesses, and family farmers to create sustained economic development by investing in a host of local solutions to food system challenges.

Mandela MarketPlace’s model for a community-owned food system and outcomes data. SOURCE: Mandela MarketPlace. Used with permission.

Mandela’s programs work to increase food security, expand local employment opportunities, and build wealth for individuals and the community.

One example is the Mandela Foods Cooperative, a grocery store operated by worker-owners of color in the community. Half of the produce sold is sourced from local farmers, who in turn are members of the Mandela Foods Distribution Network.

James Berk (left) with employees of Mandela Foods Cooperative.
SOURCE: Mandela MarketPlace, 2016. Used with permission.
James Berk (left) with employees of Mandela Foods Cooperative. SOURCE: Mandela MarketPlace. Used with permission.

This model works to improve local workforce development by hiring and training local residents and supporting local farmers. Residents, farmers, business owners, and entrepreneurs benefit through opportunities to earn better incomes, expand customer bases, and receive training and microfinance loans.

Since its founding, Mandela has made available more than 600,000 pounds of produce—mostly sustainably grown—in food insecure communities, with 76 percent of community shoppers reporting increased consumption of fruits and vegetables.

Mandela has generated nearly $6 million in revenue by the local businesses they have incubated, keeping wealth in the community.

The integration of economics and health forge natural partnerships among otherwise seemingly different sectors—we do business together, we support improved community health through education and food access, and we promote community ownership of the food system and the economies that develop within and around that system.
—Dana Harvey, Executive Director, Mandela MarketPlace

Campbell’s Healthy Communities Initiative

In 2011, the Campbell’s Soup Company committed to reducing childhood obesity and hunger by 50 percent in its hometown of Camden, New Jersey. As part of its commitment to improving the community, Campbell’s kept its corporate headquarters located in Camden. The company has focused on four strategic areas: ensuring access to affordable and fresh food; increasing physical activity in a safe environment; supporting healthy lifestyles through nutrition education; and partnering with the community to advance positive social change.


The systemic root causes of health inequities in this country can seem overwhelming to local communities working to tackle unemployment, concentrated poverty, and school dropout rates. System-level changes are needed to reduce poverty, eliminate structural racism, improve income equality, increase educational opportunity, and fix the laws and policies that perpetuate structural inequities. Yet effective and enduring interventions depend on collaboration across multiple sectors. All actors in the community—businesses, state and local government, and other community residents—have the power to change the narrative and help promote health equity.

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Copyright 2017 by the National Academy of Sciences. All rights reserved