UCL News


Opinion: Business must play a positive role in the nation’s health

4 April 2022

The private sector has been conspicuously absent from efforts to make the UK healthier and more productive, says Professor Sir Michael Marmot (UCL Epidemiology & Health).

Professor Sir Michael Marmot

Relations between public health and industry have always been uneasy. The former tends to see the latter as pursuing profit at the expense of people’s health and the environment — but they have ways of fighting back. The food industry is a case in point. When I chaired a UK government committee on diet and heart disease, we were beaten up, figuratively, for representing the public health cause. Even before our report was published, headlines attacked “the nanny state”. Food industry representatives boasted that they were behind it. A later report on healthy eating was greeted as “the food Leninist’s new onslaught”. 

Industry across the board tends to look askance at policymakers imposing limits on their freedom to operate, perceiving it as interference with the market. Free market apostle Milton Friedman argued that “there is one and only one social responsibility of business . . . to increase its profits”. It is not clear whether Friedman was ignorant of the downsides of unfettered markets — rising inequality, environmental degradation and deindustrialisation as companies relocate to where taxes and regulations are low — or simply didn’t care.

It is high time, 50 years after Friedman, that we looked again at social responsibility, and stopped pitting profit against the common good. There is ample evidence of how the interests of business and public health come together — at present, both sides are losers. According to one estimate, for example, 30 per cent of the productivity shortfall in the north of England compared with the rest of the country is due to ill health.

At the UCL Institute of Health Equity we have collaborated with insurers Legal & General to show how business can improve health and reduce avoidable health inequalities. Our report on the business of health equity, published on Monday, sets out three areas where industry can make a difference and has an interest in doing so: employment and working conditions, the quality of goods and services, and the wider impacts on society and the environment.

Health inequalities stem from divergences in the conditions in which people are born, grow, live, work and age. I have been working with cities and regions all over England and Wales to implement the recommendations of my 2010 review, Fair Society Healthy Lives. Since the start of austerity, just over a decade ago, central government has done far too little to promote fairness. But we have found real commitment at local level to improve the conditions that would create greater health equality. Our work involves local government, the voluntary sector, integrated care systems, and other public sector bodies. But business has been conspicuously absent. Until now.

It is in the clear interest of business to provide good working conditions and at least a real living wage, as we argue on Monday. A healthier workforce is likely to be a more productive one. A survey by the Living Wage Foundation found that 86 per cent of living wage employers say this has improved their reputation, and three quarters of businesses with fewer than 500 staff say it has improved employee motivation and retention.

It is time to demand goods and services that will make people healthier: this includes housing, infrastructure, financial services and many consumer goods. Where goods damage health and the environment, large investors must use procurement and financial clout to influence companies in sustainable and health-enhancing directions. Making sure business has a positive impact on society will include requiring high standards from businesses along their supply chain, and ensuring they are environmentally sustainable.

We have the opportunity to demonstrate that social justice and good business are one and the same mission. Without this understanding, and action, levelling up will remain a pipe dream.

This article first appeared in the Financial Times on 4th April 2022.