10 Sep 2019

New Survey Shows U.S. Businesses Taking Steps to Foster Culture Of Health, But Room to Grow

In New Journal Article in The Milbank Quarterly, “Toward a Corporate Culture of Health (CoH): Results of a National Survey,” Researchers from Harvard Business School and Harvard T.H. Chan School of Public Health Identify Metric to Help Measure CoH, Establish Baseline Depiction of Activities

BOSTON—In a new article published today in The Milbank Quarterly, a multidisciplinary journal of population health and health policy, researchers from Harvard Business School (HBS) and Harvard T.H. Chan School of Public Health, discuss the results of a recently conducted study that assessed the current levels of engagement by businesses in a corporate Culture of Health (CoH). Through the research, a tool was developed to measure private sector engagement in health and well-being across four dimensions and a baseline depiction of CoH activities was established.

The national survey of 1,017 private sector organizations assessed current levels of engagement in a CoH, measured in terms of four dimensions, employee, environmental, consumer, and community health, and the extent to which businesses promote these dimensions through a series of possible actions. The study also explored potential explanations for advancements in each area.

“The private sector has the opportunity to play a large role in advancing health and well-being, but to date most research on this topic has focused on large companies and just a few issues,” said Robert Huckman, Albert J. Weatherhead III Professor of Business Administration at HBS, and one of the paper’s authors. “Finding a way to systematically describe the private sector’s engagement in health and well-being is a critical step in understanding where we are today and creating a roadmap for businesses in the future.”

Based on the results of the survey the paper stated that ultimately, creating a CoH—like all culture change—is an evolutionary process. Such culture change requires visible artifacts, such as language in a mission statement and inclusion in a strategic plan, to highlight health as an organizational priority that shapes beliefs and leads to action.

“Examining the actions companies take related to the four dimensions in light of their stated company missions and strategic plans allows us to better measure their commitment to creating a culture of health,” said Michael Anne Kyle, a PhD Candidate in Health Policy, the first author of the study. “Having a tool to better quantify the perceived value of a culture of health to companies will enable more robust research and analysis in this area moving forward.”

“Corporations can have a major impact on societal health, but so far we have had a very limited understanding of the steps businesses take to promote health and well-being among their employees, consumers and communities,” added Sara Singer, Professor of Organizational Behavior at Stanford Graduate School of Business, and Professor of Medicine at the Stanford School of Medicine, who was another of the paper’s authors. “Through the survey, we were able to gain valuable insights, including seeing a variation in activities across the four dimensions by companies, with on average only 38% of possible CoH actions being taken, suggesting a fair amount of room for growth on the part of corporations.”

Additional findings from the research include:

- For each dimension, variation was found among businesses in the number of actions taken; on average, there were almost fourfold differences between the bottom and top quartiles of businesses in terms of action-taking.
- Size, industry, mentioning health and well-being in the corporate mission, having a strategic plan for a CoH and perceiving a positive return on CoH investments were all associated with businesses’ action taking.
- Fewer than half of businesses, however, perceived a positive return on their CoH investments.
- The most common action taken to achieve employee health was to offer rewards or reimbursements for positive activities, such as obtaining fitness club memberships (42%). A lack of employee buy-in was the top choice as an obstacle in employee health, cited by 56% of businesses.
- For environmental health, almost 40% of businesses engaged in formal efforts to offset negative environmental impacts associated with production or consumption of their services, and about one-third actively pursued opportunities to switch to renewable sources of energy.
- The specific actions taken most often by businesses aiming to promote consumer health were also most directly connected to a potential positive financial return: pursuing opportunities to make products and services healthier (59%) and pursuing markets for healthier products and services (58%).
- Engagement in community health actions exhibited the widest range, with a high of 75% of businesses hosting social events in the community and a low of 10% of businesses investing in affordable housing development.

“Overall, the private sector is taking steps to foster health and well-being, but there is still room for growth, even among those companies that are already extremely active in this area,” said Harvard Chan School’s Robert Blendon, the Richard L. Menschel Professor of Public Health, a Professor of Health Policy and Political Analysis, the Senior Associate Dean for Policy Translation and Leadership Development, and a co-author. “By strengthening the business case for a corporate CoH we should see an increase in private sector investments in health and well-being, but it will take a group effort, with individual businesses, groups, industries and regulators all having the potential to improve corporate engagement and impact.”

Other authors included Lumumba Seegars, a PhD candidate in Organizational Behavior from HBS and John Benson, a Senior Research Scientist from Harvard Chan School. Additional analysis, including details on the actions taken by businesses in each of the four dimensions, obstacles to action and variation in action among business can be found in the full article on The Milbank Quarterly online.


Mark Cautela


Founded in 1908 as part of Harvard University, Harvard Business School is located on a 40-acre campus in Boston. Its faculty of more than 200 offers full-time programs leading to the MBA and doctoral degrees, as well as more than 70 open enrollment Executive Education programs and 55 custom programs, and Harvard Business School Online, the School’s digital learning platform. For more than a century, HBS faculty have drawn on their research, their experience in working with organizations worldwide, and their passion for teaching to educate leaders who make a difference in the world, shaping the practice of business and entrepreneurship around the globe.


Harvard T.H. Chan School of Public Health brings together dedicated experts from many disciplines to educate new generations of global health leaders and produce powerful ideas that improve the lives and health of people everywhere. As a community of leading scientists, educators, and students, we work together to take innovative ideas from the laboratory to people’s lives—not only making scientific breakthroughs, but also working to change individual behaviors, public policies, and health care practices. Each year, more than 400 faculty members at Harvard Chan School teach 1,000-plus full-time students from around the world and train thousands more through online and executive education courses. Founded in 1913 as the Harvard-MIT School of Health Officers, the School is recognized as America’s oldest professional training program in public health.