Roundtable #2: Existing Brain Health Initiatives in the Private Sector
The Business Collaborative for Brain Health (BCBH) is a collaborative of private sector partners developing innovative solutions to cognitive health throughout the lifespan. The Collaborative hosts regular Roundtables to learn from experts and stakeholders and refine the work.
Roundtable 2 focused on private sector initiatives that are advancing brain health. The discussion was moderated by Vicki Shepard with Tivity Health. Panelists included Tina Woods, Founder and CEO, Business for Health in the United Kingdom, Karen Moseley, President and CEO of HERO-Health (Health Enhancement Research Organization), Kristal Sexton, Global Health Analytics Manager with Shell, Dr. Marc Watkins, Chief Medical Officer at Kroger Health, and Janis Davis-Street, Manager, Global Public Health, and Special Projects at Chevron. Additionally, Dr. Tisamarie Sherry, Deputy Assistant Secretary for Planning and Evaluation (Behavioral Health, Disability, and Aging Policy) at U.S. Department of Health and Human Services joined the meeting and delivered special remarks.
Many private sector organizations are implementing programs and strategies that positively impact brain health. These approaches include addressing key risk and protective factors for cognitive resilience. Dr. Tismarie Sherry helped to frame this roundtable meeting in the science context –many studies over the past decade have demonstrated it is possible to reduce the risk of developing dementia and Alzheimer’s Disease by addressing issues such as nutrition, physical activity, hypertension, obesity and other lifestyle and chronic health issues. Because of this, employer programs related to healthy eating, fitness, and chronic disease prevention and management can support brain health. The Administration has a goal of “promoting healthy aging and reducing the risk factors for dementia,” and engaging the private sector will “provide an opportunity to help accelerate and coordinate a framework around healthy aging more broadly.” Dr. Sherry also remarked that private sector participation may help to drive more investment and research to identify effective strategies that reduce risk factors for dementia.
Examples of Brain Health Initiatives in the Private Sector
HERO-Health
Karen Mosley, with HERO-Health presented insights drawn from over 25 years of organizational health and well-being experiences that can inform potential brain health initiatives. She challenged the to think about measurement in different ways, not just financial Return on Investment but also the Value of the Worker. She also underscored the significance of establishing a common language and cultural relevance when integrating health initiatives into existing business frameworks. Many organizations are not referring to their efforts as “brain health initiatives,” but they are doing the things that address modifiable risk factors for brain health. She advocated for health plans and vendor provider partners to facilitate access to integrated data for employers to comprehend their workforce factors comprehensively.
HERO, established for over 25 years, aims to connect science with practice to demonstrate the value of a health and well-being employer ecosystem. Mosley highlighted the HERO Scorecard, an online survey tool aligning with foundational building blocks of workplace health promotion. She referred to studies demonstrating how high-scoring companies on the Hero Scorecard outperformed the S&P 500, emphasizing the importance of awards programs like the C. Everett Koop National Health Awards in linking superior health outcomes with business success.
Referring to studies shaping the latest HERO Scorecard iteration, Mosley detailed shifts in scoring towards strategic planning and organizational support. Despite only 17% of organizations possessing a long-term health plan within the HERO Scorecard data set, Mosley expressed hope that initiatives like brain health could address this gap. Highlighting HHS funding HERO received to create the Well-Being Q Clearing House, an individual-level assessment mirroring organizational best practices, she anticipated this public data set would offer insights into health impacts of these practices on the workforce.
Lastly, Mosley introduced three best practice scores: mental health well-being, social determinants of health, and diversity, equity, and inclusion, as an extension of the HERO Scorecard. She proposed the potential development of a brain health best practice score and discussed findings indicating organizations supporting health and well-being policies witnessing improved productivity, engagement, and medical cost impacts. However, she noted there was an observed gap in health support for organizations with older workforces compared to those with younger ones.
Business for Health
In the United Kingdom, Business for Health, a multidisciplinary, multisector social venture, focuses on measuring and incentivizing business contribution to minimizing health inequalities and optimizing health and well-being. Tina Woods, Founder and CEO of the initiative explained that it grew out of the All-Party Parliamentary Group for Longevity, which was established to increase healthy life expectancy and decrease health and wellbeing inequalities in the United Kingdom linked to government manifesto commitments. The Business for Health group takes a three-pillar approach to the development of the Business Framework for Health, focusing on workforce health, consumer health, and community health, with the goal of extending healthy life expectancy among groups regardless of socioeconomic status. Business for Health utilizes saving groups, retirement groups, and third-sector groups to analyze and revitalize the role of employers, businesses and investors across the three pillars. They aim to eventually provide a framework modeled on the climate change ESG (environmental, social, and governance) approach, to influence issues such as the food system at scale, recognizing that the obesity epidemic is driven by ultra-high processed food and harmful marketing and advertising practices that encourage people to eat junk food. In November 2022 Business for Health launched the Work Health Index in collaboration with the Confederation of British Industry (CBI) , a workforce analytic tool used to scale workforce health and provide resources to those who need them the most. Recognizing the massive drag that health-related challenges are placing on a scarce workforce; Business for Health is partnering with a range of organizations aimed at improving employee health and well-being. A number of policy efforts are aimed at retaining older workers, including government supported “returnships” for older workers with a Midlife MOT to provide checkups for midlife workers to help assess their work, health, and money and offer support to help people thrive.
Chevron
Janice Davis-Street from Chevron discussed the company's approach to advancing wellness, healthy aging, and brain health. Chevron's focus has centered on promoting wellness and healthy aging. Janice highlighted the Total Worker Health framework as the foundation of their approach. They acknowledge that workers bring their complete selves to work, emphasizing that healthier workers are safer workers. This framework integrates protection from work-related hazards with the promotion of injury and illness prevention to enhance worker wellbeing. Janice illustrated how Chevron's programs align with this framework by considering various factors, such as employee engagement, health of an aging workforce, leadership commitment to health, and more.
Their programs target multiple dimensions of wellbeing, including nutrition, physical activity, mental and emotional health, resilience, sleep, social connectedness, and musculoskeletal health. They take a multi-dimensional view of wellbeing, addressing not only physical and emotional aspects but also social, intellectual, occupational, spiritual, societal, and financial dimensions. Chevron uses measurement tools like the enterprise health index to gauge how well their organizations support workforce wellbeing. Additionally, they leverage employee resource groups to address specific health issues impacting different groups, including discussions on Alzheimer's, dementia, and the risk factors associated with them.
Chevron firmly believes that integrating health and safety through the Total Worker Health framework is crucial. They emphasize the importance of a systems approach to understand and improve human and organizational performance, considering factors like stress and fatigue that can contribute to human error. Especially during the pandemic, Chevron has given greater consideration to the psychosocial work environment, recognizing its direct impact on wellbeing at any age. They actively use their Employee Assistance Program (EAP) to support individuals, teams, and organizations while prioritizing all wellbeing factors in tandem with safe operations, stating that good health is not just good but smart business.
Kroger Health
Dr. Marc, Kroger Health’s Chief Medical Officer, discussed Kroger's approach to addressing modifiable risk factors, focusing on poor nutrition as a key element. He emphasized that poor nutrition contributes significantly to diseases like dementia and Alzheimer's, stressing that nutritional security plays a vital role in preventing such conditions. Dr. Marc highlighted the importance of educating people about healthy eating and emphasized Kroger's approach to healthcare solutions, especially in impacting brain health.
He pointed out that chronic diseases, influenced by modifiable factors like lack of physical activity, smoking, excessive alcohol use, and poor nutrition, account for a significant proportion of the nation's health issues. Dr. Marc explained the economic impact of chronic diseases, stating it amounts to a substantial portion of the GDP. He underscored the necessity of shifting from a sick care system to a preventive healthcare approach, using food as medicine to prevent illness before it starts.
Kroger's multifaceted strategy involves a telehealth solution, patient education through tele-nutrition services, and personalized dietician content aimed at simplifying food labels, making nutrition culturally relevant, and providing pro-tips for healthier choices. He emphasized the significance of healthier communities for societal productivity, engagement in the workforce, and overall well-being, aligning with Kroger's mission for healthier communities and fostering a positive impact on both business and society.
The profitability of healthier food options is a significant question, with discussions centered on whether selling more of these items could yield greater profits compared to processed foods. Dr. Marc highlighted findings from both internal and external research spanning over two and a half decades, revealing that approximately 90% of Americans express a desire to eat healthier. However, the challenge arises as only around 50% of consumers are willing to pay more for such foods. Kroger acknowledges this gap and has initiated internal efforts to expand the availability of healthier food options in their stores, collaborating with their consumer-packaged goods partners to introduce more nutritious items on their shelves in response to consumer demand. The discussion indicates that while there are benefits associated with selling healthier foods, the direct link to profitability remains a complex consideration, especially with the balance between consumer demand and willingness to pay a premium for healthier options.
Shell
Dr. Krystal Sexton discussed the improvements that Shell has made to promote brain health among their employees. Originally starting as a “stress program” designed to combat the challenges of financial downturn of 2008-2009 and the toil of the oil and gas industry, Shell has transformed under the creation of a resilience program. This program included the Shell People Survey to discover which business aspects were contributing to employee physical and occupational health. Using this survey, Shell was able to weigh employee engagement as it is highly influential on employee safety. Shell continuously surveyed for six years and found that the implementation of the Resilience Program positively impacted the overall resilience and engagement of the workforce. After their survey findings, Shell implemented changes based on employee feedback. They revitalized mental health space for employees, created new leadership initiatives that fostered caring environments, and utilized a new emphasis on holistic health, targeting five health hazards to avoid employee burnout. Shell has historically had quite a young retirement age because of predominantly field workers. They are now seeing a shift; workers are retiring five to ten years later.
Promoting brain health is an essential national goal and the private sector has a stake in ensuring it is achieved by encouraging business to use their workforce policies, product innovations, consumer reach, and community influence. Russ Paulsen, with UsAgainstAlzheimer’s summed up the conversation with a call to action, noting that the discussion has illuminated the opportunities and complexities in achieving our goals, particularly in driving system change and altering individual behaviors. The emphasis on the practical implications of promoting health—how it extends market potential and enhances productivity—underscores the importance of this initiative not merely as a corporate social responsibility but as a strategic business imperative. Sustainability lies in embedding these efforts within existing systems and leveraging capitalist structures. By collaborating and uniting partners, the aim is a transformative impact in reducing dementia cases and promoting overall well-being. This plea for unified action and continued dedication is an invitation to collectively change the world and make a lasting difference.