Community Health and Economic Prosperity Engaging Businesses as Stewards and Stakeholders— A Report of the Surgeon General U.S. Department of Health and Human Services Persons using assistive technology may not be able to fully access information in this file. For assistance, please contact the Office of the Surgeon General at [email protected]. Community Health and Economic Prosperity Engaging Businesses as Stewards and Stakeholders— A Report of the Surgeon General JANUARY 2021 This report identifies, for illustrative purposes, the names of businesses and organizations and highlights business practices and performance. Such identification does not (a) suggest that every aspect of the business, organization, practice, or performance is exemplary or (b) constitute endorsement by the U.S. Department of Health and Human Services. Further, any views expressed by such businesses or organizations do not necessarily represent the views or positions of the U.S. Department of Health and Human Services. National Library of Medicine Cataloging-in-Publication Data Names: United States. Public Health Service. Office of the Surgeon General, issuing body. Title: Community Health and Economic Prosperity: Engaging Businesses as Stewards and Stakeholders—A Report of the Surgeon General. Description: Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General; Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2021. | Includes bibliographical references. Subjects: MESH: Community Health Planning—Economics. | Population Health. | Economic Development. | Public-Private Sector Partnerships. | Economic Factors. | Commerce. | United States. Classification: NLM WA 546 AA1 U.S. Department of Health and Human Services Centers for Disease Control and Prevention Office of the Associate Director for Policy and Strategy For more information about Surgeon General’s reports, visit http://www.surgeongeneral.gov. To download copies of this document, go to http://www.hhs.gov/surgeongeneral/reports- and-publications/index.html. Suggested Citation U.S. Department of Health and Human Services. (2021). Community health and economic prosperity: Engaging businesses as stewards and stakeholders—A report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Office of the Associate Director for Policy and Strategy. Message From Alex M. Azar II Secretary, U.S. Department of Health and Human Services The past year was one of the most challenging that America has faced in modern times. The COVID-19 pandemic is one of the greatest public health threats ever to confront our country. It has devastated our economy and driven unemployment to record highs. These challenges remind us that health and the economy are so often linked together. Congress passed historic levels of support to address the economic costs of the pandemic and to fund the public health response, but low-income Americans have not seen the full benefit of the economic recovery and continue to suffer more severe illness from COVID-19, in part because of preexisting health conditions they experience at rates that are higher than those among Americans who are better off. Health disparities arise not just from unequal access to healthcare but also from unequal access to economic opportunity, meaningful work, stable families, livable housing, reliable transportation, quality education, and thriving communities. Healthier people means a stronger economy, but a stronger economy also means healthier people. Those of us who care about both health and prosperity—in the public and private sectors—must recognize this connection and engage on both causes. That is the core insight of this historic publication, Community Health and Economic Prosperity: Engaging Businesses as Stewards and Stakeholders—A Report of the Surgeon General. This effort emphasizes the inextricable and mutually reinforcing link between physical, mental, and community health and economic prosperity. It calls on private sector businesses, in particular, to engage with and invest in communities to improve health and foster prosperity. Of the social determinants of health that our department focuses on, one of the greatest is simply access to economic opportunity. We know that economic opportunity—as well as the stable families, healthy environments, and strong communities it supports (what this report calls the “vital conditions”)—is good for health. But too many Americans are born into and grow up in low-opportunity neighborhoods. This creates costs for businesses and for society, as so many Americans never achieve their potential in the workforce, are unable to reach independence, and see their health and the health of their loved ones suffer as a result. By working together, with deep engagement from the private sector, we can build a healthier society that is rich with opportunity for everyone. This Surgeon General’s report offers a way forward for the United States to recover from the COVID-19 pandemic and to build a healthier, more prosperous future for all Americans. MESSAGE FROM ALEX M. AZAR II iii Acknowledgments This report was prepared by the U.S. Department of Health and Human Services under the general direction of the Centers for Disease Control and Prevention, Office of the Director, Office of the Associate Director for Policy and Strategy. Vice Admiral (VADM) Jerome M. Adams, MD, MPH, Surgeon General, U.S. Public Health Service, Office of the Assistant Secretary for Health, Office of the Surgeon General, Office of the Secretary, U.S. Department of Health and Human Services, Washington, DC. Robert R. Redfield, MD, Director, Centers for Disease Control and Prevention, Atlanta, Georgia. Robin M. Ikeda, MD, MPH, Associate Director for Policy and Strategy, Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention, Atlanta, Georgia. Richard W. Puddy, PhD, MPH, Director, Policy Research, Analysis, and Development Office, Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention, Atlanta, Georgia. Peter Briss, MD, MPH, Medical Director, Office of Medicine and Science, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia. James E. Kucik, PhD, MPH, Deputy Director, Policy Research, Analysis, and Development Office, Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention, Atlanta, Georgia. Diane M. Hall, PhD, MSEd, Senior Scientist for Policy and Strategy, Policy Research, Analysis, and Development Office, Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention, Atlanta, Georgia. Martin J. Vincent, PhD, MBA, Health Scientist and Senior Advisor, Policy Research, Analysis, and Development Office, Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention, Atlanta, Georgia. Senior Scientific Editors Ursula Bauer, PhD, MPH, Senior Advisor, Office of the Deputy Director for Non-Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia. Greg Fairchild, PhD, MBA, MPhil, Isidore Horween Research Associate Professor of Business Administration, Associate Dean for Washington, DC, Area Initiatives and Academic Director ACKNOWLEDGMENTS v of Public Policy and Entrepreneurship, University of Virginia Darden School of Business, Charlottesville, Virginia. Doug Jutte, MD, MPH, Executive Director, Build Healthy Places Network; Associate Professor, University of California, Berkeley, School of Public Health; San Francisco, California. Contributing Authors Salma M. Abdalla, MBBS, MPH, Research Fellow, School of Public Health, Boston University, Boston, Massachusetts. Dolores Acevedo-Garcia, PhD, Professor of Human Development and Social Policy and Director of the Institute for Child, Youth and Family Policy at the Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts. Lawrence Bowdish, PhD, Senior Director, Research and Issue Networks, U.S. Chamber of Commerce Foundation, Washington, DC. Antony Bugg-Levine, MPA, Chief Executive Officer, Nonprofit Finance Fund, New York, New York. Laura Choi, MPP, Senior Research Associate, Federal Reserve Bank of San Francisco, San Francisco, California. Elyse Cohen, MPH, Senior Director of Food, Health, and Wellness Programs, U.S. Chamber of Commerce Foundation, Washington, DC. Kimberlee Cornett, MA, Director, Impact Investments, Robert Wood Johnson Foundation, Washington, DC. Marc DeCourcey, Senior Vice President, U.S. Chamber of Commerce Foundation, Washington, DC. Karen B. DeSalvo, MD, MPH, MSc, Chief Health Officer, Google Health, New Orleans, Louisiana. Annie Donovan, MBA, Executive Vice President and Chief Operating Officer, Local Initiatives Support Corporation, New York, New York. Tory Flynn, MA, Vice President of Communications, Athene, West Des Moines, Iowa. Sandro Galea, MD, MPH, DrPH, Dean, Robert A. Knox Professor, School of Public Health, Boston University, Boston, Massachusetts. Marcela Hawn, MA, Senior Vice President, Chief Communications Officer, Centene Corporation, St. Louis, Missouri. Maurice Jones, JD, President and Chief Executive Officer, Local Initiatives Support Corporation, New York, New York. vi Community Health and Economic Prosperity: Engaging Businesses as Stewards and Stakeholders—A