Profits vs Public Health: Why Business Leaders Must Rethink Their Role in Society
Most business leaders probably don’t lie awake worrying about public health. They are likely focused on profit margins, sustainable growth, market share, investor expectations, and keeping their team productive. Health, especially the health of people outside the company, can feel distant or like someone else’s job. It’s easy to see why we might think public health isn’t our problem. Individuals make their own choices. Governments are responsible for healthcare systems.
Yet, every business influences public health, whether it intends to or not. The question is no longer whether businesses impact health, but whether they choose to understand that impact and shape it intentionally. Businesses play a powerful role in shaping the health of individuals and communities, through everyday decisions: how a product is marketed, how employees are scheduled, how products are sourced, how data is used.
Businesses are shaping the wider ecosystems that determine whether people can live healthy lives. These decisions may seem operational on the surface, but it has long-lasting ripple effects on public health. The notion that profit is the sole measure of success is rapidly losing ground and there is a growing understanding that businesses must contribute to society, not just extract value from it. For leaders, this shift is both a risk and an opportunity. Poor public health can’t be viewed solely as a government responsibility. When health deteriorates, every organisation will feel the impact, from higher absenteeism to rising costs, stricter regulation to eroded brand trust.
This week, we explore why business leaders should start thinking like public health partners and how acknowledging our role in shaping health outcomes is ethically sound and commercially strategic. This article explores why aligning corporate interests with public health goals is necessary for building a business that thrives in an era of heightened social and environmental consciousness.
What are the Commercial Determinants of Health?
The term “commercial determinants of health” (CDoH) describes how corporate practices, through marketing, pricing, product design and labour conditions, shape global health outcomes. Businesses across sectors are unintentionally (and sometimes intentionally) fuelling health burdens that governments and individuals struggle to manage. As leaders, it’s crucial to recognise the impact of the CDoH. We usually think of the CDoH in terms of the usual suspects: tobacco and ultra-processed food. Yet, in the modern economy, every commercial decision is a public health decision. Businesses no longer just sell products, they design the environments, incentives, and digital defaults that dictate how billions of people move, eat, sleep, and manage their stress every single day. Even financial institutions influence health outcomes through their investment decisions, directing capital toward certain industries and innovations over others.
This concept moves beyond the traditional view of health to include how your company’s products, marketing strategies, and influence on policy directly affect the well being of consumers and communities. Data-driven algorithms now know when we’re stressed, lonely, or financially vulnerable which shapes the timing and type of content delivered to users. This radically increases the ability of commercial products and digital experiences to shape health-related behaviour. Frictionless consumption reshapes how we eat, shop, and rest. Having one-click delivery drives impulsive decisions, turning logistics and e-commerce into central determinants of population-level inactivity and overconsumption.
How Business Decisions Shape Health
While the health of populations are often shaped by personal choices or public policy, it is also shaped by the invisible hand of commerce: how it’s produced, how it’s marketed, and how it’s consumed. It is clear that business decisions shape health outcomes at scale. Consider your weekly grocery run: what’s available on supermarket shelves, how it’s priced, and how it’s marketed are all decisions made by corporations. At the same time, employment practices also impact employee health through low wages, precarious contracts, or high-pressure environments.
For tech companies, product design choices can have significant consequences on an individual’s mental and physical well-being. Key features like endless scroll, auto-play videos, and push notifications are often designed to maximise engagement and screen time, a model optimised for advertising revenue. While this may increase short-term user metrics, it can also contribute to sleep disruption, anxiety, and social comparison that leads to poor body image and loneliness, especially in adolescent users. People experiencing emotional strain often have a diminished capacity for complex decision-making, increasing their susceptibility to predatory marketing and pre-set, unhealthy choices. Consequently, commercial decisions often reinforce pre-existing social vulnerabilities and actively contribute to the widening of health inequities.
Even our built environment reflects a series of commercial choices. Office buildings, shopping centers, and urban spaces are influenced by real estate developers, architects, and construction firms. These businesses decide everything from walkability and ventilation to light exposure and green space. Even within a single building, commercial decisions can override health-promoting design. In many offices and malls, the most visible and attractive route is the elevator or escalator, which makes physical activity the exception rather than the default. Fast-food joints and vending machines offering quick, less nutritious options are often located in the most high-traffic areas, subtly steering individuals toward unhealthy choices. All these decisions have measurable effects on mental health, physical activity, and even disease risk.
This is the essence of CDoH: the ways in which private-sector actions and incentives influence the conditions that make people sick or keep them well. Many modern businesses and industries are linked to rising rates of chronic illness, mental health crises and environmental degradation. The question isn’t whether business should engage with health, but how deeply and how responsibly.
The Hidden Health Costs of Modern Business Models
Modern business models often generate a range of hidden health costs that are not reflected in a company’s financial statements but are borne by society. These costs arise from a variety of sources, including both internal operations and external influences. For example, businesses that contribute to environmental degradation through significant emissions or waste impose health costs on communities, which may experience higher rates of respiratory diseases and other illnesses. Similarly, poor working conditions or occupational hazards can lead to employee injuries or mental health issues, all of which are costs externalised to workers and public health systems.
The algorithms that drive social media feeds and the “attention economy” are designed to keep users engaged for as long as possible. By promoting a state of “continuous partial attention”, it gradually erodes our ability to engage in deep focus and critical thinking. This affects individual workers and the quality of public discourse, as algorithms are often designed to prioritise emotionally charged content that drives engagement, leading to the spread of misinformation and the creation of echo chambers. In essence, the attention economy operates by consuming the cognitive resources, i.e., our focus and time, that are essential for a healthy and well-functioning society, all while externalising these hidden costs to public health systems and communities.
Businesses also engage in strategies to control the political and informational landscape. This includes lobbying efforts to block health regulations or taxes, such as those on sugary drinks or alcohol, thereby undermining public health policies and increasing long-term health risks for the population. This externalisation of costs is a core feature of many business models. Environmental damages, tax avoidance, and the promotion of harmful products or services shift the financial and health burdens onto communities and public systems rather than being accounted for by the company.
Some companies may employ information management tactics to shape public narratives, funding research that supports their interests and discredit evidence that suggests their products are harmful. When faced with regulation, some businesses resort to legal strategies to challenge or delay policies designed to protect public health. Furthermore, some corporate social responsibility (CSR) initiatives are used to improve a company’s image rather than making substantive changes, diverting attention from the very practices that are causing harm. Collectively, these actions demonstrate how a narrow focus on commercial gain can lead to a systemic and detrimental impact on the health of communities and the environment.
Why Does This Matter?
The hidden health costs of modern business are a direct threat to a company’s future. We’ve been operating under an outdated business model, one where the well-being of our employees, our communities, and our planet are seen as external costs rather than core assets. It’s time to move past a narrow definition of success and embrace a more holistic, long-term perspective. As public awareness and regulatory scrutiny increase, businesses that externalise these costs risk losing consumer trust and facing costly penalties. What if we redefined success? What if the ultimate bottom line was a healthy and thriving society? By shifting our focus, we can build a more resilient, innovative, and sustainable business model. This is about making public health and societal well-being a foundational part of our business strategy.
The modern consumer is more informed and values-driven than before. They are increasingly choosing to spend their money with companies that align with their personal values. Businesses that are seen as actively harming public health or the environment are at a significant risk of reputational damage, consumer backlash, and loss of brand loyalty. Conversely, companies that lead with purpose and demonstrate a genuine commitment to societal well-being build a competitive advantage. By internalising health-positive practices, we can build a business model that fosters brand loyalty, attracts top talent, and aligns with the global movement toward social justice and sustainable development. In a world that is increasingly demanding more from its leaders, the choice is clear: we can continue to create hidden costs for society or we can choose to create lasting value for everyone.
This shift requires moving from a narrow, transactional mindset to a systems-level perspective. It means understanding that your company is a living part of a broader ecosystem that includes your employees, your customers, the environment, and the community. The decisions you make about your supply chain, marketing, and organisational policies ripple outward, influencing the health and stability of that entire system. It’s an opportunity to build a business with a dual purpose: to be profitable and to be a force for good.
How Can We Build Healthier Companies?
Business leaders have a unique opportunity and responsibility to create healthier companies by embedding health into their core strategies across operations, marketing and internal culture. Health is no longer a concern confined to hospitals or government agencies. With corporate influence extending across products, capital flows, workplace conditions, and political engagement, business leaders hold a level of power that carries proportional responsibility for the health impacts their organisations create. Leaders must broaden their definition of success to include health impacts, both within their organisation and in the communities they serve. Framing health impacts along a spectrum (positive, neutral, and negative) can encourage us to see this as an opportunity to create value.
A compelling example of a company integrating health into its core strategy is Nike, a brand intrinsically linked to sport. Nike has positioned itself as a partner in a global movement toward a more active and healthier world. This is achieved through a multi-faceted approach, its Nike Training Club (NTC) and Nike Run Club (NRC) apps provide free access to hundreds of workouts, training plans, and expert coaching, effectively making fitness accessible to millions. Nike, in collaboration with ukactive, also addresses health inequalities through community partnerships such as its “Open Doors” programme. It provides sport, physical activity, and nutritious food to underserved children and young people in various UK cities by unlocking school sports facilities during summer holidays. By using its brand identity and resources to actively promote physical activity and well-being, Nike demonstrates how a company can link its commercial success to positive public health outcomes, positioning itself as a force for a more active society.
What does it look like for leaders to build healthier companies? This starts with responsible product development and marketing. Leaders must challenge their teams to create and invest in healthier alternatives through reformulation, clear labelling, and transparent communication. Leaders should be aware of how organisational practices shape the political and knowledge environments e.g., through lobbying or funding biased research, and take steps to mitigate negative impacts.
Building a healthier company also starts from within, by prioritising employee well-being and ensuring leadership reflects health-oriented values. Leaders should design workplaces that support mental and physical health through ergonomic design, comprehensive wellness programs, and policies that encourage healthy eating or active lifestyle. When leaders personally model health-conscious behaviour and champion initiatives that prioritise well-being, they set the tone for the entire organisation.
For Johnson & Johnson, employee health is a long-term business strategy. Its “Live for Life” programme, launched in 1979, exemplifies how companies can drive performance through well-being. They invested in a comprehensive approach to health promotion and offered resources for physical activity, stress management, and preventive care. The integration of on-site fitness facilities, dietary education and preventive screenings signals a shift from basic benefits to holistic health promotion. Over the years, it has produced clear results, slowing the growth of healthcare costs and improving employee engagement. By embedding well-being into its strategy, Johnson & Johnson demonstrates that employee health drives business health. The result is a healthier team, lower healthcare spending, and stronger performance.
Lastly, companies should use their influence to support policies that improve societal well-being. Businesses can use their influence constructively by partnering with public health stakeholders and advocating for health-promoting policies. Rather than using CSR initiatives as a tool for image management, leaders should invest in evidence-based programs that address community health needs. Cross-sector collaboration, with public health experts and civil society, can help align business practices with societal health priorities and drive systemic change. This holistic approach, from products and people to policy and purpose, is how leaders can build a business that is profitable and a powerful force for a healthier world.
Conclusion: Building Businesses That Make Society Stronger
The choices businesses make today shapes the public health of the future. Every decision we make, every policy we influence, and every service we launch is a choice that affects the well-being of the communities we serve. The choices made in boardrooms and marketing departments ripple outward, affecting what people eat, the air they breathe, and the information they consume.
The commercial determinants of health reveal a clear picture: the health of a company and the health of society are one. This presents a pivotal moment for leadership. Leadership today demands a systems-level perspective, an understanding that our companies are one component within a complex ecosystem of communities, economies, and public health. By embedding health and well-being into our core strategy, companies can transcend the old paradigm of profits versus people. This is an invitation to build a new kind of business with a durable, strategic purpose. It’s about leading with a deeper sense of responsibility, crafting a business that is fundamentally indispensable to a healthy society.
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