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3 Linking Performance and Investments in Health
Pages 29-48

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From page 29...
... Specifically, Rebecca Weintraub focused on value generation in global public health; Frederic Sicre presented on socially responsible investing; Ray Fabius addressed the benefits of workplace health programs; Ron Goetzel discussed the common themes in workplace health programs; and David Wofford addressed both workplace and community health. Key messages from their presentations are included in Box 3-1.
From page 30...
... ity in the value chain, redesigning of products and markets, and building supportive industry clusters. To illuminate the opportunities within these areas of value generation, Weintraub summarized four cases: Botanical Extracts Ltd.'s investments in local economies in the supply chain for artemisinin-based combination therapy; Olyset's development of longlasting insecticide nets; Wolters Kluwers's UptoDate software; and CVS Health's shift from selling products to improving health outcomes.
From page 31...
... Weintraub continued that the second part of the value generation was redefining productivity in the value chain through the production of an antimalarial with Artemisia plant sourced from local farmers. In 1994, BE explored the cultivation of the Artemisia plant by bringing together a group of farmers from Tanzania.
From page 32...
... , the manufacturer of the nets in Tanzania. Weintraub described how the PPP was developed, its use of an incentive-based supply chain, A to Z's business model and impact, and the sustainability of the venture.  Weintraub explained that Sumitomo Chemical, a Japanese chemical company, developed the Olyset® bed net, a type of long-lasting insecticidal bed net (LLIN)
From page 33...
... Weintraub concluded that CVS has doubled its monthly smoking cessation visits, has increased its investment in mini-clinics, and is implementing the new enterprise brand across all its business units. CORE BUSINESS PRODUCTS AND SERVICES Frederic Sicre, The Abraaj Group Frederic Sicre, Partner at Abraaj Capital, presented opportunities for investments in health in emerging markets, also referred to as global growth markets.
From page 34...
... While efforts have been made in the past 10 years to lift millions of people in these emerging markets out of poverty, as a result, many of them are now subjected to NCDs associated with new lifestyles changes. Sicre noted that the lack of affordable, high-quality health care services in some of these emerging markets is pushing populations lifted out of poverty back into it.
From page 35...
... This investment hopes to address a range of issues from diagnostics to training of nurses, to building and making sure that procurement costs on equipment are lowered by having an approach that has 10 cities at stake, and use a "hub-and-spoke" model and training programs for community workers to try to address rural communities with limited health care access. Sicre emphasized that business can play a huge role in addressing global health challenges and, more broadly, the Sustainable Development Goals.
From page 36...
... Goetzel and colleagues found that "high" HERO scoring companies experienced better health care cost trends compared with "low" HERO scoring companies. After studying these benchmark companies, HealthNEXT identified 218 elements in 10 categories, and can now go into any company and score them out of 1,000 points, identifying their gaps from the benchmark and helping them to build a culture of health by scoring around 700, which is what the benchmark companies appear to score.
From page 37...
... He emphasized that employers who focus only on health care costs do not realize the true impact of poor health. Sherman and Lynch (2014)
From page 38...
... He noted that it is important for the investment community to know about the health and illness burden of the workforce in which they invest and supported efforts to develop health metrics as part of sustainability reporting. COMMON THEMES UNDERPINNING WORKPLACE HEALTH PROMOTION PROGRAMS Ron Goetzel, Johns Hopkins University and Truven Health Analytics Setting the stage for his presentation, Ron Goetzel, Senior Scientist at Johns Hopkins University and Vice President of Consulting and Applied Research at Truven Health Analytics, referenced a study that supports prior and ongoing research demonstrating the business value of employing exemplary workplace health promotion and health protection programs (Goetzel et al., 2016)
From page 39...
... While some workplace health promotion programs do not work, and may in some cases cause more harm than good, others do work, and work remarkably well. For example, programs in place for many years like the winners of the Koop Award have many of the elements necessary for success, and they also collect data documenting improved population health and cost saving.
From page 40...
... Companies' environs are surrounded by messages to be healthy and facilitators for a healthy lifestyle. Goetzel stated that those messages need to be consistent, con stant, engaging, and targeted; and he suggested that it is essential to have a two-way communication dialogue so that employees have a chance to get back to the people who are designing these programs, and importantly to have "wellness champions" within the workforce who are committed to and supportive of health promotion, acting as local ambassadors for health improvement programs.
From page 41...
... He noted that workplace health promotion programs can work if they are done right and if they follow the best practices to which he alluded. He emphasized that workplace health promotion programs can lead to the following: • Positive financial outcomes internally as well as externally: in terms of reduced medical cost, absenteeism, short-term disability, workers' comp, safety, and "presenteeism," which is on-the-job engagement.
From page 42...
... Figure 3-3 David Wofford, Vice President for Public−Private Partnerships at Meridian Group International, presented a business case for health investments by multinational companies in their supply chains in low- and middle-income countries. He began by arguing that a new way of thinking about worker and workplace health beyond the traditional approach of occupational health and safety is essential.
From page 43...
... It should not be surprising that many workplace infirmaries do not follow basic public health practices and protocols for hand washing, handling of hazardous materials, having Sharps containers, or confidentiality, but this is required of the public health or private health clinics outside the gates of those factories, he added. Building on his argument, Wofford mentioned that although WHO estimates that health providers in industry may comprise a surprisingly large percentage of the health workforce in developing countries, no one knows the real numbers because the data for an accurate
From page 44...
... The practical side of this divide is demonstrated in the fact that there is no good estimate of the number of doctors, nurses, and other providers hired by industry. "Imagine the shared value proposition to communities and business alike if there were better data on company health workers, better workplace services, and consequently better linkages between workplace health and public health systems when there are outbreaks for diseases like Ebola in the future," Wofford said.
From page 45...
... However, the business case alone is not sufficient to get many companies to walk through that door. Because business can play a vital role in efforts to strengthen systems and expand services, the growing number of women in the global workforce demands a rethink of workplace health policies and practices as traditional occupational health fails to address the impact of work on their reproductive and general health and the health of workers overall.
From page 46...
... And it may seem daunting, but in fact the public health side deals with these levels all the time," Wofford concluded. PANEL DISCUSSION When asked how improved workplace health policies and practices will help create shared value for the community and beyond the workplace, Wofford answered that although he believes that what happens in workplaces around health and behavior change is transmitted in the community both by people sharing information and changing values and health behaviors among others, more research is needed to see whether that is actually true.
From page 47...
... When asked if the incredible demand for U.S.-like benefits in the emerging markets should be met, Fabius explained that maybe what is needed to set a goal is not necessarily flat health care cost, but at least the achievement of decreasing health burden over time. Goetzel agreed with Fabius and added that it is not the company that decides the health and well-being of the workforce, but ultimately it is the individual worker who says "this is something that's going to benefit me and my family, something I'm going to adopt because it's a good idea for me." Goetzel suggested that different interventions and approaches need to be tested to see which ones work for the company and the workforce.
From page 48...
... In his opinion, they have control over the workforce in terms of policies, programs, incentives, communication, and data which is the starting point for creating population health. Goetzel mentioned that the government will never try to provide health education and health promotion to the 155 million Americans going to work every day and spending most of their day at work.


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