Thursday, September 3, 2015

Guidance, Please: My Profits or Your Health?

Many of my pre-packaged retirement portfolio options include holdings in tobacco companies. It seems the majority include investments in oil. What's a self-proclaimed advocate of public health to do?

Guidance, Please: My Profits or Your Health?

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I must be a grown-up. It’s 12:30 A.M. and I’m reviewing my 401(K) retirement options, contemplating what life will be like when I’m 60. In addition to providing me with an unpleasant reminder of my mortality, this process has highlighted the tension between private interests and the public’s health.

Many of my pre-packaged portfolio options include holdings in tobacco companies. It seems the majority include investments in oil. What’s a self-proclaimed advocate of public health to do? Go with the blue chips stocks, which would in effect mean hoping that more people smoke and drive instead of bike or walk, or stay true to my values and take my chances on soy bean futures? I’m betting on the bean, but some other, much larger, self-proclaimed advocates of health and well-being have taken the other route.

A 2009 study in the New England Journal of Medicine showed that many major health and life insurance companies in the U.S., the U.K., and Canada invested heavily in tobacco companies. Over $4.4 billion to be precise. In a 2010 study, researchers discovered similar investments in the fast-food industry—with 11 health and life insurance companies holding over $1.8 billion in fast-food stock.

Such corporate behavior seems contradictory. If health and life insurance companies ostensibly promote themselves as stewards of health and well being, how can they legitimately invest in industries that have proven so harmful to public health?

Well, as the authors of these studies point out, we shouldn’t be that surprised. By nature of their existence, corporate entities are driven by one thing and one thing alone: profit. This is not amoral; it is just the nature of the beast. Furthermore, the ability of health insurers to selectively deny policies to people who smoke and are overweight enables them to avoid paying for the downstream health consequences of their billion-dollar investments. (Health insurers will no longer be able to do this when key provisions of the Affordable Care Act are scheduled to take effect in 2014).

What the authors of these studies do not discuss, however, is how such competing interests play out at the individual level, in effect giving people who work in health and wellness a choice: their own long-term financial security vs. the health of the larger community. The health sector is a major source of employment in the U.S. According to the Bureau of Labor Statistics, over 14 million people work in health care. In Philadelphia, health and education services are the largest sectors of employment. A large proportion of these jobs offer retirement benefits.

What do you think? Are you a doctor, nurse, or other type of health care worker who has a professional, and personal, interest in public health? Do your retirement investments include stock in tobacco, fast food, or other such industries? Do you consider this to be a conflict? What can be done about it?


Read more about The Public's Health.

What the authors of these studies do not discuss, however, is how such competing interests play out at the individual level, in effect giving people who work in health and wellness a choice:  their own long-term financial security vs. the health of the larger community.

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About this blog

What is public health — and why does it matter?

Through prevention, education, and intervention, public health practitioners - epidemiologists, health policy experts, municipal workers, environmental health scientists - work to keep us healthy.

It’s not always easy. Michael Yudell, Jonathan Purtle, and other contributors tell you why.

Michael Yudell, PhD, MPH Associate Professor, Drexel University School of Public Health
Jonathan Purtle, DrPH, MSc Assistant Professor, Drexel University School of Public Health
Janet Golden, PhD Professor of history, Rutgers University-Camden
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