The Health Action Alliance is a unique collaboration between leading business, communications and public health organizations to help employers navigate evolving health challenges, improve the health of workers and engage with public health partners to build stronger, healthier communities.
“We could name a thousand ways in which employers have become part of the public health system in the context of this pandemic, and let’s not lose that memory. If we want to be better prepared going forward, we really need to take advantage of the incredible authority, credibility, trust and power, capability and capacity of our private-sector partners.”
Dr. Julie Gerberding
Former Director, US Centers for Disease Control & Prevention
The COVID-19 pandemic taught us that the health of a business and its people extends well beyond the walls of the workplace. Community health is essential to a company’s ability to weather a pandemic.
The pandemic has shown us how businesses depend on the health of their communities.
“Businesses’ preparation in your own work environment is going to be critical to being ready for the next threat. And it’s going to happen—it’s not going to be a once-in-a-century event, it’s going to be more frequent, unfortunately.”
Ezekiel Emanuel, MD, Special Advisor to the World Health Organization’s Director-General and Vice Provost for Global Initiatives, University of Pennsylvania.
Being prepared for a future public health crisis means establishing institutional memory from the COVID-19 response, keeping response systems activated and engaging in community health on an ongoing basis.
“We’re going to continue to have this situation of COVID or something else and we’re going to be a lot smarter about how to respond to it. We need to take this experience and institutionalize it. There are so many things we now have at our disposal to be able to respond.” – Kirk Limacher, Vice President of HR Services, United Airlines
- Trust is built through relationships. And that goes for employees’ trust in public health, too, which employers can cultivate through partnerships in the workplace.
- Companies with existing relationships with state or local governmental public health departments reported that they could lean on those relationships to quickly restore business continuity during the most disruptive moments of the COVID-19 pandemic.
- Those relationships also enabled private sector-driven community health solutions.
- And they’ll be crucial to building the trust in public health guidance necessary to counter misinformation.
- The actions you take now and in the aftermath of COVID-19 are the beginning of your response to whatever threat the future holds. The time to act is now.
- While only a small number of companies had pandemic preparedness plans before 2020, the COVID-19 pandemic has made it abundantly clear why preparing for future public health crises should be a critical part of every company’s operational planning.
- Through better health, employers stand to gain improvements in presenteeism among current employees, as well as cost savings in the health coverage of family members and retirees on employer-sponsored medical plans.
- For larger companies setting environmental, social and governance (ESG) commitments, action on employee health presents an opportunity for progress on managing human capital, as well as reducing risk exposure.
- When a pandemic threatens the health of the most vulnerable people in a company’s orbit, a healthier community bolsters business resilience.
Businesses would do well to see public health departments as another provider of a service that can help companies be successful, i.e., a partner in employee, customer and community health. Doing so means taking a more expansive view of health to consider the conditions in which people—your employees, their families, your customers and suppliers—live their lives.
This Plan for Business is your guide to getting started.
How to Use This Pandemic Preparedness Plan for Business
- Protect employee health in the workplace.
- Develop ready-to-use emergency response plans and company health policies.
- Build or deepen relationships with local public health officials and other local employers.
- Invest in community health solutions in partnership with local public health departments and other businesses.
Our team of experts offers free coaching and training to help employers develop or evaluate their plans. Contact us at hello@healthaction.org to schedule a free consultation.
Community Health Is Essential to Pandemic Preparedness
- Disease management, health screenings, support to quit smoking and programs to improve fitness and reduce stress and burnout are typical offerings.
- They have an important, positive impact on employee health and worksite wellness, but they’re not enough.
- Despite the billions of dollars invested in workplace wellness programs, community conditions often limit their potential.
- Example: It’s tough to log 10,000 steps per day if your neighborhood isn’t safe or lacks sidewalks. It’s difficult to have a good diet when healthy foods are inaccessible or unaffordable.
A New Framework for Business
Social, economic and environmental factors (and systemic inequities within them) are the foundation on which health is built—for your workers and their families, your customers and suppliers, in times of crisis and in more normal times.
- Strengthening this foundation will help your company better weather a future pandemic.
- During pandemics and after, healthier communities will make your company’s investment in employee health more effective and efficient.
- If employees are sick, they’re either going to miss work or be limited in their performance there and risk infecting others.
- People without paid sick leave had the highest rate of illness during the H1N1 pandemic in 2009. Today, 21% of U.S. workers—and more than half of low-wage workers—still lack access to paid sick leave. This creates pressure for them to show up on the job even when they’re ill.
- Indeed, during the current pandemic, 3 in 10 low-income workers have gone to work despite having COVID-19 symptoms or have knowingly been exposed to the virus at work because they couldn’t take time off.11 Health inequity thus exposes all employees.
- People with underlying health conditions, such as heart disease, diabetes and asthma, are the most vulnerable to COVID-19 and will likely be at the greatest risk in a future pandemic. One in six U.S. adults ages 18 to 64 is at a higher risk of serious illness if they become infected with COVID-19, based on underlying conditions alone.
- Employee health is influenced by more than workplace safety, an employee’s own behaviors or even access to healthcare. Family, community and systemic factors have a greater impact.
- Only about 30% of a person’s health is determined by individual behaviors. Fifty percent is determined by social and economic factors and a person’s physical environment.
- Community conditions, such as limited access to healthy food or an unhealthy built environment contribute directly to chronic disease—which account for 3 of every 4 dollars of healthcare spending.
- Lost productivity due to illness costs employers an amount equal to 60% of their spending on healthcare benefits.
- Community health is a vehicle to offset the risks of a pandemic or localized public health crisis, a way to increase efficiency in health spending and an opportunity to improve a business’ relationship with its people.
- Seventy-seven percent of employees expect their employer to play a meaningful role in good health.
- Seventy-five percent of adults say it is important that the companies they purchase from practice corporate social responsibility, including investing in the health of communities.
More than 2 in 3 adults believe the companies they purchase from should invest in the following areas that influence health:
Creating Your Game Plan
- To maximize your organization’s readiness to respond to a crisis and build up your community’s defenses against a pandemic, there are some internal processes and external partnerships in public health you should consider, too.
- What are the barriers to health for employees in our organization?
- What did we learn from the health impacts of COVID-19 on our business operations? What are the most achievable areas to improve health?
- How can we educate employees on health and create ongoing opportunities to share public health messaging?
- How can we align our company values and commitments (for example, corporate social responsibility activities and ESG goals) with community health goals?
- How can we integrate community health into our core products and services?
- What is the status of our relationships with local health systems and local and state public health departments, and where can we partner with them?
- What issues affect the health of our community? What don’t we know about our community’s health, and who can provide the insight we need to take action?
- Knowing that the COVID-19 pandemic had disproportionate impacts for historically marginalized communities, how can we authentically engage employees from these communities and from all levels of the organization in our planning?
- You don’t have to complete each level before moving on to the next one—some of these actions require continuous attention. But moving up through the levels will help you realize the greatest gains in the health of your community and the resilience of your business.
Your workers are not safe from infectious disease if the people in their own homes are vulnerable due to an inability to get vaccinated or visit a doctor.
- Make sure paid time off allows employees to accompany family members in their care to vaccination appointments and other important healthcare visits.
- If you’re offering vaccine education or on-site vaccinations, consider making them available to family members, too.
Dine Brands promoted child vaccination to its team members and offered four hours of sick leave for parents to vaccinate their eligible children. Within a week of being asked whether it had a policy to offer time off for child vaccination, Uber created such a benefit for its employees worldwide. And AT&T and Land O’ Lakes were among many companies that opened their workplace vaccine clinics to employees’ families.
“We’re coming out of this pandemic with a lot of employees who have not been to the doctor recently. One of our main areas of focus going into the pandemic was annual check-ups. One of our highest expenses [in healthcare spending] is skin cancer. It’s so avoidable, and the expense is so low to catch it early, we were going to drive up these cancer screening vans, do the screening and get after this. Now we have so many people who haven’t gone to the doctor, and we realize the risk this has for our business.” – Kirk Limacher, Vice President of HR Services, United Airlines
- Seventy-eight percent of companies are tracking vaccination status as of March 2022, according to a Mercer survey. Knowing employees’ vaccination status is vital for instituting a requirement in the event of a new surge
“You can’t leave [workplace mental health] to chance. You have to have a program. For us, that ranges from mindfulness techniques to substantial benefits for therapy. And you have to think about all facets, from the light touch that just creates conversations to defined benefits. You have to step back and look at your whole benefit architecture.”
– Brian Moynihan, CEO, Bank of America
During the COVID-19 pandemic, Best Buy increased its minimum hourly wage to $15 per hour, offered all hourly full- and part-time employees a “gratitude bonus,” provided financial assistance to employees who suffered financial hardship from contracting COVID and offered grants of up to $2,500 for personal hardships beyond employees’ control, whether related to COVID or not. CBRE made 11,000 financial grants through its employee resilience fund to employees who suffered financially from COVID-19. Giving mid-level managers discretion to allocate grants may do more to make the program sustainable and build employee loyalty.
- Even small fixes, like opening windows and using higher MERV filters, can help achieve even more air changes per hour.
- Overall, 74% of companies with a worksite clinic report a return on investment of at least 1.5:1, 2:1 or greater, according to Mercer.
“As an employer who is concerned with their population’s health and well-being, it’s really hard to address healthy lifestyle strategies when people are working 10 to 12 hours per day”—a challenge that can be mitigated with an on-site clinic.
“The burden of not having a healthcare provider has become a glaring risk to health and the operations of an organization. COVID in particular seems to prey on people in poor health and those who are not taking care of chronic conditions, which could be better managed by a provider who knows an individual’s history and condition.
I would give anything to have on-site clinics at all our locations with direct primary care for every person. It is a win-win situation where the employee has access to timely, individualized solutions, and the doctor has access to resources they may not normally have if working in community practice.
– Ginger Miller, Director of Health and Benefits, Utz Brands
Companies tell us their non-pandemic emergency action plans weren’t enough to keep pace with a pandemic’s scale, duration and complexity.
- The fast-evolving public health recommendations and local government orders required companies to play catch-up with their own safety and communications plans.
- Standard plans for alternate-site working, backfilling labor and getting support from third-party providers likely won’t be relevant in a pandemic, which is not localized, and which creates wide and long-term workforce shortages.
- Fifty-five percent intend to keep those committees in place, as of March 2022.
- An in-house health expert—frequenty an epidemiologist or public health practitioner—is valuable for managing all organization-wide health matters, including providing a healthy workplace free of disease and improving employee well-being.
- That’s why some companies find “chief health officer” to be a more appropriate title—their work goes well beyond medical care.
PepsiCo, Tyson Foods, Delta Air Lines, Constellation Brands, Dollar General, Stanley Black & Decker and Royal Caribbean were among the many companies that hired a chief medical officer or chief health officer during the pandemic.
- Better yet, include some of these employees on your emergency preparedness team.
“We have very good cross-functional work. Regardless of where it originates, once there is alignment with leadership, we will put resources into it, and it will happen. Everybody who wants to work on it, can. So you can work on projects that are maybe not necessarily tied to your role but that are important to you.”
- Zoraida Rodríguez Montenegro, Senior Manager, Federal Affairs, Uber
“Thinking about things when they’re happening is too late. You’ve got to be prepared. Make sure you’re communicating frequently with your employees. That was another key action we learned.
This employee engagement helped us get back to work quickly and helped our employees to feel safe and comfortable when they returned. Employees told us, ‘I feel safer here than I do going to the market.’”
– Jeffery Hess, MD, Corporate Medical Director, General Motors
- Consider making clinics available to workers’ immediate family members or even the wider community in order to improve the health of people your employees come in contact with.
Among the many ways companies assisted public health agencies in the early stages of the COVID-19 pandemic, Starbucks applied its expertise in human-centered design operations to assist Washington State health officials with creating more efficient and scalable vaccine centers. General Motors applied its manufacturing capabilities to the creation of 30,000 ventilators in 154 days and produced and distributed 8.7 million masks and pieces of protective gear, including face shields, gowns and aerosol boxes across the U.S. In addition, GM shared the recipe for manufacturing masks with other companies. Northrop Grumman used 3D printers to produce tens of thousands of face shields. Uber and Lyft donated tens of millions of free rides to vaccination centers, and Uber adapted the technology behind its in-app polling place finder from the 2020 election to guide riders to vaccination distribution centers. Disney Parks, Experiences and Products donated 1 million face coverings to MedShare and profits from the sales of Disney cloth masks raised an additional $1 million for MedShare to support the medical community’s ongoing efforts to provide lifesaving care to those in need.
When schools shut down during the pandemic but children still needed a way to pick up their free lunches and other meals, Sodexo created public pick-up and drive-thru locations, making deliveries in school buses and passing out bagged lunches through car windows to feed 25 million children. While legal reviews are implemented, the “risk tolerance goes way up if the reason is to serve the greater good,” says Drew Nannis, Senior Vice President, Communications.
What Do Public Health Departments Do?
- ASSESS and monitor population health.
- INVESTIGATE, diagnose, and address health problems and hazards.
- INFORM and educate people about health, factors that influence it, and how to improve it.
- STRENGTHEN, support, and mobilize communities and partnerships to improve health.
- CREATE, champion, and implement policies, plans, and laws that support impact health.
- UTILIZE legal and regulatory actions designed to improve and protect the public's health.
- ENSURE equitable access to the services and care needed to be healthy.
- BUILD a diverse and skilled public health workforce.
- IMPROVE and innovate through ongoing evaluation, research and continuous quality improvement.
- BUILD and maintain a strong organizational structure for public health.
Don’t be afraid to ask questions about health measures you may not be familiar with. Those answers will help your company choose the best path forward.
- Likewise, knowing what you need from public health partners will help them tailor their response to your business.
- Be open about the assets your company can bring to a long-term partnership, understanding that public health departments are under-resourced.
After Utz Brands leveraged an existing close relationship with a local epidemiologist for a presentation to employees, there was a new sense of trust that the company was providing reliable answers to difficult questions. In turn, local public health workers sought the company’s input for tailoring content relevant to the wider community.
“In all the communities where we operate, I asked the medical docs to reach out to the local community health departments to make sure they have connections there. These relationships were built long before COVID came along. We’d reach out to know what’s going on and ask for support. They’re a really good conduit of local information. When vaccines first became available, these relationships were also the key to getting vaccinations in our facilities, whether we were offering them ourselves or asking the county health departments to come in.
These relationships are twice as important now. It's important for us to be assessing guidance from the top—OSHA and CDC, external partners at other companies—but also going to the local health departments on up to make sure we’re all connected and aligned.”
– Jeffery Hess, MD, Corporate Medical Director, General Motors
“Our business is a collaborative one: we will need deeper relationships that can help us understand and support our people while also preventing future community health issues.”
– Lois Kolada, CFO, Priority Designs (Columbus, OH)
- Americans who feel that way say confusing, contradictory and lacking health information is nearly as big an obstacle to better health as cost.
- Employers are trusted to fill the information gap. “My employer” is the second-most trusted source of health news, trailing only national health authorities, and ranked ahead of the national government, media or “my social media feed.”
- Among people with low trust in the healthcare system, “My employer” is the most believed channel for health information.
- To address the unique health concerns of employees from historically under-resourced communities, invite trusted public health speakers from those communities to speak on health-related issues.
– Kevin Allen, Senior Vice President, ASHLIN Management (Atlanta, GA)
- Make clear to your employees that the “public” in public health are themselves, their families and neighbors.
Large corporations with extensive public health resources freely shared COVID-19 information, public health messaging, vaccine education and safe workplace protocols with smaller companies in their supplier and vendor networks.
When rapid COVID-19 testing was hard to come by, Kia Georgia banded together with larger local companies and the local branch of the state public health department, where it already had a close relationship. They identified a small lab that could provide PCR test results in 36 hours instead of the usual hree to five days, which allowed Kia to be among the very first sites to offer the same testing capabilities as the local hospital.
Most people admit they do not take care of their health as well as they should, according to the Edelman Trust Barometer.
- Americans who feel that way say confusing, contradictory and lacking health information is nearly as big an obstacle to better health as cost.
- Employers are trusted to fill the information gap. “My employer” is the second-most trusted source of health news, trailing only national health authorities, and ranked ahead of the national government, media or “my social media feed.”
- Among people with low trust in the healthcare system, “My employer” is the most believed channel for health information.
- To address the unique health concerns of employees from historically under-resourced communities, invite trusted public health speakers from those communities to speak on health-related issues.
“Let us give you the data you need to understand the issue and the evidence-based programs to address it. And we can show you how you did or did not move the needle.” – Dr. Kristina Box, State Health Commissioner, Indiana Department of Health
- You might also aim for achievable wins that build buy-in and momentum, for example, expanding successful company wellness programs into community programs.
- Recall the metaphor of the river where people are frequently drowning. Pulling them out of the water can save them—if you can reach them in time. Putting up protective barriers and warning signs can keep people from falling into the river in the first place. The most transformative change happens upstream.
- An example in health: to lower rates of diabetes, explore how your company can address food security and access to healthy food options.
CVS Health recognized that having safe and stable housing is fundamental for people to focus on their wider health needs. Since 1997, the company (and its subsidiary Aetna) have helped create 97,000 affordable rental units. In 2021, CVS Health launched its Health Zones program to provide job placement assistance and access to healthcare around its affordable housing investments in five cities. Likewise, Kaiser Permanente has pledged $400 million to affordable housing and economic development, which the company says will support people in getting medical care when they need it.
“As I thought about the creation of [a new program], I wanted to be very strategically aligned with the business. I really looked at shared value, using business as a force for good, driving economic success and simultaneously driving impact on a social issue.
Our next program is focused on school nutrition. Why school nutrition? Campbell creates products that go into that K-12 sector, and we think we can drive product innovation around healthier products for our children.”
– Kim Fortunato, President, Campbell Soup Foundation
- Ask your public health department contacts where they could use support, assess your capabilities to help and formalize a partnership agreement outlining your accountabilities to addressing priority issues.
“Improving community health by addressing underlying social and economic conditions requires a long-term commitment—but that’s how to move beyond band-aid responses and into transformative solutions. Attention on community health has maybe never been higher than during COVID, so one positive outcome from this pandemic would be increased investment in people’s well-being and our collective ability to weather a future pandemic.”
– Peter Lee, MD, Global Medical Director, Amazon
- Involve residents, government officials, philanthropic organizations and your workforce to help establish the right targets and increase buy-in.
- Define the metrics collaboratively from the beginning of the project and include both short-term and long-term goals and benchmarks.
- Consider issuing an annual health impact report card to hold your company accountable for progress and share your results with employees and the community.
From the start of Campbell’s 10-year Healthy Communities initiative for youth in Camden, NJ, the company and its partners co-designed metrics across all the program’s strategy areas, including new areas of healthy food access, minutes of physical activity, minutes of nutrition education and “public will”—a measurement of the community’s participation.
- You may need to urge your local chamber of commerce to make health a priority. Some states have independent or chamber-affiliated wellness councils whose convening power and focus on employee health could make them valuable allies.
- Significant progress on the underlying drivers of community health is more than any one company can take on alone, making collaboration all the more important.
Bank of America launched a four-year, $25 million initiative with the American Heart Association, American Cancer Society and American Diabetes Association that includes a focus on helping those organizations advocate for local and state support to improve health outcomes for communities of color in 11 cities.
- For example, dispensing COVID-19 vaccines at pharmacies (not only doctors’ offices or government facilities) was a game-changer for the public and the pharmacies.
The Kansas City Chamber brought businesses together with the local health department and others to advocate for raising the legal age to purchase tobacco products to 21—a successful effort that spread to 30 cities in the Kansas City area. And to support its impact investments in affordable housing, Kaiser Permanente has advocated for federal tax credits for low-income housing, state and local housing bonds and inclusionary zoning at the city level.
Conclusion
- The best time to capture the learnings, shortcomings and breakthroughs from your company’s COVID-19 response is while they are fresh in the minds (and active policies) of your company’s leaders and departments.
- Your company can institutionalize pandemic-era habits, policies and programs around health that could be critical during a crisis, including on-site vaccination, steady communication of public health guidance and support for employees’ mental resilience.
- The scale and scope of the COVID-19 pandemic were difficult to imagine in 2020. Don’t let a failure of imagination increase your company’s risk in a future crisis.
- Trusted relationships between the private sector and public health partners paid immediate dividends during the pandemic, but those relationships are best built (and deepened) before you need them in a crisis.
- Misinformation thrives in a vacuum, so leveraging the trust your employees have in you and extending it to local public health representatives through informational sessions, clinics, programs and visible investments that benefit your community will help build a culture where misinformation can’t take root.
- Improving the community conditions that influence health requires a long-term commitment, clear-eyed planning and close collaboration. But its potential—to make your healthcare spending more efficient and your business and communities more resilient for the next pandemic—can’t be overstated.
- Health Impact in 5 Years (Centers for Disease Control and Prevention)
- CityHealth (An initiative of the de Beaumont Foundation and Kaiser Permanente)
- Seven Ways Business Can Align with Public Health for Bold Action and Innovation (de Beaumont Foundation)
- Good Health Is Good Business (de Beaumont Foundation)
- Preparing for the New Normal: Employer Readiness Assessment (Health Action Alliance)
- Business & Public Health: Making the Case for Stronger Collaboration (Health Action Alliance)
- Metrics Guide (Healthy Business Coalition)
- Learning from COVID-19: Reimagining Public-Private Partnerships in Public Health (Milken Institute)
- National Health Security Preparedness Index
- National COVID-19 Preparedness Plan (White House)
CDC Foundation
de Beaumont Foundation
National Safety Council
Robert Wood Johnson Foundation
Kevin Allen, Vice President, Regional Operations, ASHLIN Management
Bradley Barber, Executive Director, Global Workplace Safety, General Motors
David Beier, Managing Director, Bay City Capital
Kristina Box, MD, State Health Commissioner, Indiana Department of Health
City of Long Beach (California) Department of Health and Human Services
Ezekiel Emanuel, MD, Special Advisor to the World Health Organization’s Director-General and Vice Provost for Global Initiatives, University of Pennsylvania
Kim Fortunato, President, Campbell Soup Foundation
Franklin County (Ohio) Department of Public Health
Georgia Chamber of Commerce
Julie Gerberding, MD, Director, US Centers for Disease Control and Prevention (2002-09)
Mark Herbert, Chief Strategy Officer / Managing Director, California, Small Business Majority
Jeffery Hess, MD, Corporate Medical Director, General Motors
Lois Kolada, Chief Financial Officer, Priority Designs
Peter Lee, MD, Global Medical Director, Amazon
Kirk Limacher, Vice President, HR Services, United Airlines
Dora Lutz, GivingSpring | Purdue University
David Michaels, Professor, George Washington University School of Public Health, and Assistant Secretary of Labor, OSHA (2009-17)
Brian Moynihan, Chief Executive Officer, Bank of America
Drew Nannis, Senior Vice President, Digital Marketing, Content, Brand and Communications, Sodexo
Jennifer Nuzzo, Senior Scholar, Johns Hopkins Center for Health Security Senior Fellow for Global Health, Council on Foreign Relations
Ginger Miller, Director of Health and Benefits, Utz Brands
Zoraida Rodríguez Montenegro, Senior Manager, Federal Affairs, Uber
Lisa Smith, Senior Director of Clinical Operations and Strategy, Walmart Pharmacy
Sallie Taylor, Medical Center Operations Program Manager, Kia Georgia
Wellness Council of Indiana
Whitehall (Ohio) Chamber of Commerce
This Plan provides an overview of pandemic preparedness practices, and is not intended to be, and should not be construed as, legal, business, medical, scientific or any other advice for any particular situation. The content included herein is provided for informational purposes only and may not reflect the most current developments as the subject matter is extremely fluid.
This Plan contains links to third-party websites. Such links are only for the convenience of the reader, user or browser; the Health Action Alliance does not recommend or endorse the contents of third-party sites.
Readers of this Plan should contact their attorney to obtain advice with respect to any particular legal matter. No reader, user, or browser of this material should act or refrain from acting on the basis of information in this Plan without first seeking legal advice from counsel in the relevant jurisdiction.
Only your individual attorney can provide assurances that the information contained herein – and your interpretation of it – is applicable or appropriate to your particular situation.
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