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Health in Business: A Leadership Framework for the New Normal

Wendy M. Purcell1 and Amanda M. Rischbieth Harvard T.H. Chan School of Public Health, 401 Park Drive, 4th Floor West, Suite 406, PO Box 15677, Boston, MA 02215  1Author for correspondence [email protected]               COVID-19 is an economic and humanitarian crisis re-shaping our world in real-time with an ‘unknown unknown’ ending.  And, it’s placing unprecedented demands on […]

Leadership - ahead
Leadership - ahead

Wendy M. Purcell1 and Amanda M. Rischbieth

Harvard T.H. Chan School of Public Health, 401 Park Drive, 4th Floor West, Suite 406, PO Box 15677, Boston, MA 02215 

1Author for correspondence [email protected]              

COVID-19 is an economic and humanitarian crisis re-shaping our world in real-time with an ‘unknown unknown’ ending.  And, it’s placing unprecedented demands on leaders at all levels as they seek to navigate these volatile, uncertain, complex and ambiguous times – so-called VUCA conditions.  As the pandemic teaches us what it takes to lead into the new normal, we’ve drawn out practical steps from our research with senior business leaders [1-3]. 

Post-COVID leadership pays closer attention to the expectations of employees and customers, as well as the broader societal issues of community and the environment.  The Health in Business Leadership Framework (Figure 1), the H-Framework, outlines key insights that reflect the hyper-connected inter-dependence of business and health; companies leading the way are given in Table 1.  A new social contract with business is being forged in real time.


Figure 1:          Health in Business Leadership Framework: the H-Framework
  • Heroes: In a take on Proust’s famous quote “The real voyage of discovery consists not in seeking new landscapes, but in having new eyes”, leaders are seeing their teams afresh as COVID uncovers hidden heroes and heroines.  Stepping up to the crisis, people have been released from the shackles of narrow job descriptions and the burdens of bureaucracy.  Leaning in to meet new customer needs, such as delivery services or re-tooling production lines to meet demands for personal protective equipment, leaders have been reminded of the incredible resourcefulness and agility of their people.  So too a rather uncomfortable lesson, as we face head on some of our biases as we see the heroes among us are often those in low wage, receiving zero benefits, and gig economy jobs.  These unsung networks of ‘hero leaders’ have stepped up at greater risk to themselves, their colleagues and families – as previously undervalued ‘front-line workers’ – cleaners, supermarket checkout staff, delivery drivers, hospital staff and logistics workers.  Leaders with the humility to see true heroes will see with new eyes where value is created in their business.
  • Humanity: Covid-19 data is shining a light on inequities at scale and revealing fissures in our society – divisions we have lived with, ignored or turned a blind eye to are more visible and elevated as structural inequalities place more people at risk.  Women and people of color who earn significantly less than their white male counterparts, and communities ravaged by rampant unemployment.  Poverty coupled with over-crowding, food insecurity and poor nutrition, social disadvantage by location and/or generation, higher pollution and serious co-morbidities all expose people to a heightened risk of infection and poorer health outcomes.  These inequalities are brought into sharp relief by COVID-19.  Leaders who are human-centered, act with kindness and focus on creating a world where no one is left behind emphasize long-term value creation.
  • Honor:  Undertaking a de-costing exercise without recognizing the simultaneous de-valuing underway fails to appreciate people as an asset versus a cost.  Leaders who treat people around them and in their wider stakeholder community with the honor and respect they each deserve, and are empathetic to their particular circumstances, set their business up for success over the long-term.  With a siege mentality gripping some Boardrooms, leaders are being challenged to secure savings in the short-term.  Those whom behave honourably, who back their moral statements with actions to protect their people (employees, customers, supply chains) and seek to mitigate negative financial impacts by shielding vulnerable workers and insulating supply chains, are better poised to withstand systemic shocks.  False virtuousness will be easily spotted, with employees and customers likely to penalize dishonourable leaders and reward those businesses that are perceived as powers for good.
  • Health:  If ever a crisis could teach the world about public health and the fragility of our economic model, COVID-19 has done so, as we collectively repress the economy to save lives.  The impact of the pandemic demands we consider new ways to sustain health inside and outside business.  Our Culture of Health [2] study is exploring health and business across fours domains: customer; employees, including supply chain; community; and environment.  Its action areas include (i) making health a shared-value; (ii) fostering cross-sector collaboration to improve well-being; (iii) creating healthier, more equitable communities; and (iv) strengthening the integration of health services and systems.  We propose that leaders elevate the health domain in Environmental, Social, Governance (ESG) metrics, broadening it to a priority lens to envision more sustainable business practices.  In a post Covid-19 world, and in consideration of the next pandemic, elevating health into the Boardroom and C-Suite makes business, societal and political sense.  Indeed, we can learn lessons from the sustainability movement as we re-balance the priorities of people, planet and prosperity.  Those businesses that take the health of people and the natural world as core strategic business agendas are poised to pivot more powerfully from the pandemic and emerge more strongly into the new normal. 
  • Horizon:  A key attribute of leaders is the ability to inspire others, to connect head, heart and hand and create a sense of hope, articulating enough certainty amid the uncertainty to signpost a path ahead.  Leaders who can sustain this approach can convince others that we will get through this period, recover and emerge stronger together.  A leader who can help us raise our eyes to a new horizon, can support us through these unprecedented times.  In articulating a powerful vision of the future, leaders can sustain the human spirit and release the creativity and innovation needed to thrive.
H-Framework AttributeExamples of Leadership Behavior
HeroesFord forged a collaboration with one of its suppliers, Joyson Safety Systems, for airbag materials and Beaumont Health for design, to manufacture reusable medical gowns and is working with GE Healthcare to produce thousands of ventilators [1].  Marriott International has elevated its cleaning staff and established a Global Cleanliness Council to champion health and safety for all guests and staff [3].
HumanityMastercard is teaming up with the Gates Foundation and Wellcome to ensure funds are channeled into drug development [1]. Apple donated $15 million to the global Covid-19 response and 10 million masks to the medical community. It also matched its employees’ donations and is continuing to pay all its hourly workers (in all offices and stores) even though they can’t work [5].
HonorInvesting in workers is one of the best uses of capital for companies seeking to emerge in a stronger position. Seven companies – AT&T, Chipotle, Kroger, Lowe’s, Target, Walmart and XPO are providing bonuses and wage increases to hourly employees. Charter Communications will permanently increase its hourly workers’ wages [4].
HealthGM mobilized first for ventilators, working in partnership with Ventec Life Systems, and is reconfiguring its manufacturing facility in Indiana to scale up production with a federal contract to produce 30,000 ventilators [1].  HP is partnering with its digital manufacturing community to provide 3D printing resources around the globe and help with validation – e.g. for  a hands-free door opener, mask adjuster, face shields, field ventilators and FFP3 face masks [4].
HorizonCompanies that cared for their workers in the past are seeing financial results.  Just Capital’s top quintile ranking (using best performing worker scores) saw a 5-year average ROE of 14% vs their bottom quartile at 12.5%, and a higher cumulative return in the first 4 months of 2020 by 5.3% [4].

Table 1 :           Companies with leaders reflecting the dimensions of the H-Framework

Time is of the essence – no time to wait for the memo.  No time for ‘green-washing’, ‘health-washing’, or ‘purpose-washing’ – and those companies who try this risk facing a backlash.  The new normal leadership qualities that are emerging in these extraordinary times are setting us up for a ‘build back better’ recovery ahead [4]. More and more investors are on board too – valuing long-term non-financial investment.  Doing the right thing with humility; having empathy and a caring culture; building meaningful connections and collaboration, and developing new alliances to scale impact. 

While forecasting is hard – especially the future, we can agree that the only certainty is more uncertainty.  With life feeling more complex, less predictable and more confusing than ever before, leading in VUCA situations is the ‘new normal’.  With more choices to make and fewer ready-made paths, leaders are being called upon to do things they had never imagined.  And in navigating this new terrain, adopting health focused leadership tools can help us balance the tension and opportunities of new challenges where the past is little guide for the future.  In a world demanding we move beyond business as usual, and where we will be unlikely to  ‘revert back’, leaders at all levels and CEOs in particular, are making important decisions as they react to this global crisis. 

Drawing on the H-Leadership Framework can help leaders show the resilience and agility needed for recovery and sustained success in a post-COVID world.  Although there is no short-term fix, contemporary leaders are best positioned to protect people and planet over the long-term as health in business becomes the new normal – the idea that stakeholders, such as employees, consumers, suppliers, other business partners and communities, are as important as shareholders in both managing risks and opportunities, and creating and sustaining shared value [2].

References

[1]        Leaders on Purpose https://www.leadersonpurpose.com

[2]        Culture of Health https://www.hsph.harvard.edu/news/hsph-in-the-news/companies-culture-of-health/ is a study supported by the Robert Wood Johnson Foundation under the grant No. 74275 ‘Building a Culture of Health: A Business Leadership Imperative’ and is a joint initiative between the Harvard Chan School of Public Health and the Harvard Business School.

[3]        Responsible Travel and Tourism a project sponsored by the World Travel and Tourism Council https://wttc.org/News-Article/WTTC-ushers-in-new-critical-collaboration-with-Harvard-T-H-Chan-School-of-Public-Health

[4]        Just Capital https://justcapital.com/reports/the-covid-19-corporate-response-tracker-how-americas-largest-employers-are-treating-stakeholders-amid-the-coronavirus-crisis/, accessed 18th May 2020

[5]        Forbes https://www.forbes.com/sites/moorinsights/2020/03/30/the-most-outrageously-awesome-ways-tech-companies-are-helping-in-times-of-the-covid-19-crisis/#197bd49d796c, accessed 18th May 2020

Acknowledgements

The authors are grateful to Professor Howard Koh (Harvard T.H. Chan School of Public Health), Professor Mitch Weiss (Harvard Business School) and Lisa Dreier (Advanced Leadership Initiative) for their work and thought leadership concerning the role of business in responding to COVID-19 undertaken across efforts at Harvard University.

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