Meet our experts
Sir Nigel Wilson
Group Chief Executive
In 2010, internationally renowned epidemiologist Professor Sir Michael Marmot published a landmark study titled Fair Society, Healthy Lives. The Marmot Review, as it became known, found that social, economic and environmental conditions had a much greater impact on public health than healthcare.
Since then, Sir Michael has been at the forefront of the campaign to improve living conditions globally, as director of the Institute of Health Equity (IHE) at UCL. Sadly, however, health equity has worsened since 2010, and the Covid-19 pandemic has only exacerbated the situation.
At Legal & General, our work is underpinned by a longstanding social purpose to improve the lives of our customers and build a better society for the long term, as well as creating value for our shareholders. That’s why we’ve entered a four-year partnership with IHE, motivated by our desire to enhance society and reduce health inequality in the UK.
Together, we’ve produced a report investigating the role businesses have to play in bringing about this change. A focus on business makes sense because, until now, the debate around public health has been seen as the government’s responsibility, with the private sector excluded or even seen as part of the problem.
In fact, as our CEO Sir Nigel Wilson explains in his foreword to the report, “business needs to lean in and take action”. Not only is improving health equity a social good, but “businesses are more productive if we have workforces that are physically and mentally well”. At a time of tight labour markets, he says, “it is not just a human tragedy but a lost opportunity if experienced workers are forced to leave the workforce for health reasons before they want to”. In his own foreword, Sir Michael says that “a society in which people can lead flourishing lives is a healthy society, literally and metaphorically.”
In our joint report, titled “The Business of Health Equity”, we’ve created a framework illustrating what businesses can do to positively impact the health of their employees, clients and customers, and the wider community. For each of these three, the report makes three recommendations.
To improve the health and wellbeing of their employees, businesses must create good quality work. The first way to do that is by focusing on pay and benefits. Pay for all employees – including contractors – should be set at a level that supports healthy living. In practice, this means going beyond the statutory minimum wage and committing to a higher standard such as the Joseph Rowntree Foundation’s minimum income standard. Companies must also do all they can to reduce pay disparity. In-work benefits should be as comprehensive as possible, and smaller businesses should consider collaborating with each other to pool risk and share resources.
Healthy working conditions are just as important. There are lots of things to address here, including working hours, workplace safety, and job security. Employers should also foster a sense of stability and autonomy in their staff, as well as giving them the chance to make their voices heard.
Businesses can also have a direct positive impact on the physical and mental health of their employees. One way to do this is through incentivising healthy behaviour like active travel to work, providing healthy food options, and funding mental health support services. Employers can also support staff in doing purpose-driven work, through volunteering leave or by matching charitable donations.
Businesses have an important role to play in supporting the health of their clients and customers, as well as their staff. Perhaps the most obvious example of this is the products they produce.
Companies in the food industry, for example, can develop healthier recipes, promote nutritious options – particularly when marketing to children – and provide nutritional information to help customers make informed choices. Businesses selling financial products, meanwhile, can make financial advice as widely available as possible, lend responsibly, and share expertise with charitable organisations.
Businesses developing housing and infrastructure can also make a big difference. Poor quality housing is known to cause respiratory problems, delayed cognitive development in children, and increased mortality. Housebuilders should begin their projects by undertaking a health equity impact assessment. On a wider scale, developers should ensure that neighbourhoods offer green space, active travel infrastructure and access to amenities within walking distance.
Companies that invest should carefully consider the social impacts of those investments and should be transparent in their investment policies. They should avoid funding companies that provide products and services which are harmful to health, instead supporting socially responsible ventures.
Turning the tide on health equity is “a big challenge”, but there is nobody better qualified to work with on it than Professor Marmot.
Businesses can influence the communities in which they operate by operating sustainably to protect their shared natural environment. Through collaboration with local and national planning systems, they can play a crucial part in protecting biodiversity, reducing pollution, and tackling climate change.
Acting as anchor institutions for local communities, businesses should reach out to voluntary and public sector organisations to identify areas of inequality and provide support. Large companies in particular can advocate nationally for government policies that address inequality, as well as voicing support for a well-funded public realm that is empowered to enact these policies.
To have a meaningful impact, we need to understand the challenges faced across the country. Our partnership with the IHE has established a UK wide place-based network and are inviting businesses and the public sector to join and we are inviting people interested to register their interest.
Going forward, guided by the IHE we will develop more guidance and tools, including a set of metrics for businesses to measure their health equity impact, guidance tailored to small businesses, and recommendations for international businesses that will take into account differing health priorities around the world.
Turning the tide on health equity is “a big challenge”, says Sir Nigel, “but there is nobody better qualified to work with on it than Professor Marmot”.