Are businesses and investors really serious about improving our health? With Catherine Howarth and John Godfrey

Jennifer Dixon: Those of us working in health often focus on the government as the main agent to get things done, particularly when it comes to public health. Think of all the others out there with power, particularly commercial and investment power. To give you an idea, did you know that the total value of pension funds invested in the UK each year is about the same size as the UK economy. And the total assets under management is more than double that. So the power of investing is huge. This power influences the risk factors that can damage our health, like unhealthy food, poor work, pollution, gambling, poor housing, social media and so on, but it can also be used to promote health as well. So often we hear talk about the so-called commercial determinants of health, in the same breath as complaints that companies and investors care nothing but making a profit. Well businesses and institutional investors do seem to be getting more interested in health. Public health, if nothing else, is a significant systemic risk to these sectors as the just-published World Economic Forum's Global Risks Report points out. And ESG, that's environmental and social governance, is also forcing businesses and investors to begin reporting their impact on health as they now have to on carbon. Are we now at a turning point? Or is interest in health temporary? If businesses and investors really want to improve health, how do they best move forwards? And can government do more to support them? Well with me today to discuss all this, I'm delighted to welcome two guests, Catherine Howarth, who is the chief executive of ShareAction. ShareAction coordinates civil society, activism to promote responsible investing across Europe. Among other things Catherine also serves on the Treasury's Asset Management Taskforce. And we also welcome John Godfrey, who is director of corporate affairs at Legal & General. John has worked in the city for over 30 years. And had a brief spell in government, as the head of the prime minister's Downing Street policy unit under Theresa May. Welcome both. I think the first question is really about the pandemic and whether anything's changed. So we've known out the link between health and wealth for some years, but the pandemic has really rammed it home. Do you think we're now a turning point to do something more about it, particularly from the business and investor community?

Catherine Howarth: I very much hope we are. GDP declined by 9.7% last year, which is an absolute historic record. Of course, things are bouncing back, which is fantastic, but it ought to leave a legacy of better understanding across government, business, investment and in civil society about the links between health and wealth and, I hope, create consensus and momentum for real action that ensures we take the steps to prevent chronic and also emergency health situations doing huge damage to our economy, whether in the short-term or in the long-term. But I don't think we can take for granted that people make those links. I think that's exactly why organisations like the Health Foundation, ShareAction and, of course, Legal & General need to collaborate and lead and ensure that the lessons are drawn and we do respond in a wise way for the long-term.

Jennifer Dixon: Thank you. And John, do you think there's a change in the wind for the long term? Or do you really think this is a short-run thing?

John Godfrey: Well, I hope there is because it did demonstrate absolutely that health equals wealth. And that's true at a macro level and a micro level. It's true for countries and communities and for individuals. So my serious hope is that we don't waste a crisis. And the bit of it that I think we really need to focus on, and learn the lessons from and make changes as a result of, are health inequalities. Because what the pandemic absolutely did was widen those inequalities of outcome between different groups and between richer people and poorer people. So we have to take those lessons away. And we'll be continuing to beat that drum as hard as we can.

Jennifer Dixon: Yes. And actually just before the pandemic struck, Michael Marmot produced his 10 Years On report, which showed the widening gap between rich and poor and the north and south of England, actually, as well as stalling life expectancy, that was seemed to be worse in the UK compared to other countries with the exception of the US and Iceland, bizarrely. I don't know what's happened in Iceland. So we knew about it and Marmot's review was all over the press at the time. But somehow or other, it didn't really land in the way that this, I suppose, the pandemic has just affected everybody. Hasn't it? Is this going to stick, is the big question, which we don't know. Are you seeing signs in your communities that people are sitting up and taking more notice?

John Godfrey: Well, I think it's very interesting that the economic experience we're seeing now, which is in a large part about labour shortages is something which has a direct bearing on health. And this is about enabling people to work for longer because we needn't and we shouldn't be losing people in their fifties through ill health. That's a direct tie back to economic performance. So even when the immediate pandemic recedes, the aftermath of it will still be, I hope, fruitful territory for pushing those lessons.

Catherine Howarth: What we've seen over the last 10 years in the investment community is this incredible rise of interest in sustainability, so-called ESG, environmental, social and governance, factors being taken really seriously by investors. And it is true to say is that health has been rather a missing issue within the landscape of environmental and social factors that investors take seriously. And I do think the pandemic could prove to be an incredible catalyst for the investment community taking seriously health as a factor that is relevant both to the health of the population, obviously, at large being relevant to economic health, and ultimately the health of investment portfolios. But at companies, individual companies are subject to significant risks around regulation that might come in, for example, to tackle obesity. And so all in all, I do think that a combination of both the pandemic and this long-term trend within the investment community sets the scene for organising investors to bring their weight to bear in a really valuable way on long-term health challenges in the wider population. But I don't think it'll happen just by accident. And I do think there's a really key role for progressive investors like Legal & General, but also NGOs and funders, NGOs like ShareAction, where I am and funders like yours, to coordinate and really organise and ensure that this issue does get shoved up the investor agenda because it's, of course, competing with issues like climate change and other things which are very pressing too. So, I'm quite excited about this moment, but I don't take for granted that we'll see the changes, we'll mobilise the power of investors without quite a bit of conscious coordination, but it's coming.

Jennifer Dixon: Great. We'll get onto a strategy a bit later and what might be the elements of that. But I wonder if you can both give our listeners an idea of the kinds of action that's already taken, perhaps with the collective action really in the business community. What's the state of play? And also in the investor community, John?

John Godfrey: The All Party Parliamentary Group on Longevity concluded that it would be a good idea to have a business-led organisation pushing this agenda. And that's what we're trying to do with Business for Health. I've been incredibly encouraged, for example, by the CBI taking up this issue, which is something they haven't historically done. It's great. I would like to see those who speak for smaller businesses, typically like Chambers of Commerce and others doing it. And I think there's a lot more we can do as investors to make sure that health outcomes and economic outcomes are seen as being aligned. I think the ESG framework should be even more explicit and we should call out the health piece and it should be, EHSG. And the reason I say that is because with ESG, what we've seen is the E is getting better and better because people have agreed metrics for climate and it's well understood. The G-bit is fairly binary, in most cases. The S-bit is very vague. And if we can put a bit of granularity around the S by focusing it to a pretty large extent on H, calling out H separately, I think we'd see the focus level go up.

Jennifer Dixon: In the recent briefing from ShareAction and Business for Health, you draw attention to what the Treasury has just produced, which is sustainability disclosure requirements. And what that is, is guidance to help disclosures on green for investors and others. Catherine, do you think the same needs to happen now on health?

Catherine Howarth: Oh, absolutely. So part of the rise of sustainable investing, which we've been talking about, has quite rightly focused on the need for much more standardised and stretching disclosures and reporting by companies to investors, so that investors are equipped to understand how companies compare on sustainability. But all of that at the moment is very, very, very climate focused. And I think there's a big, big opportunity to ensure that at a global level, and certainly domestically here in the UK, regulators and policymakers are setting standardised frameworks for corporate reporting on health to stakeholders at large, but particularly to investors. There's a new body being set up, which was launched at COP26 called the International Sustainability Standards Board whose task at a global level is to focus on setting standardised frameworks for companies to undertake reporting on sustainability issues. At the moment again, very climate focused, but big opportunity at to grab that agenda and make sure that health is not missing in action, and that health emerges, quite rightly, for companies in the food sector, for companies in the chemical sector, for companies in all sectors, in relation to their role as employers. That we see reporting to investors and other stakeholders, that really allows a much better scrutiny of which companies are making an effort and doing well in the impacts they have on human health and which have a long way to go. It's very difficult for investors to play that role of challenging the companies in their portfolios to do better on health if they can't see how companies compare. So, that's a key agenda. And I think those of us that care about these issues as they pertain to health need to make sure that we are pushing treasury to think about this agenda from this corporate reporting, again, from a health angle. And now is the moment to pounce on that.

Jennifer Dixon: Just to get a flavor of this Business for Health group, John, and how extensive is it. I was reading the other day that there are 5 million jobs in the UK pay less than the living wage, which is going to injure health, isn't it, quite considerably. Are some of those companies that are paying people so little in that group? Or is your Business for Health really just a nascent group that is going to grow?

John Godfrey: It is fairly early days at the moment. Our membership is growing though quite fast. Delighted that we've had a couple of corporates joining up in the last fortnight since the beginning of the new year. So that is good. We have a much longer tale of civil society and other interested parties and a very big group of academics who will help us with the formulation of an index to measure this, which be a useful tool, we hope, for investors. The announcement at COP, which was mentioned about international standards was one of the geeky bits of COP, but it was incredibly important. And we need to get to the same place really in health. And the parallels, if you like, between climate and health are quite striking. And this is one of the things we're working on at Business for Health, because we see the equivalent of scope 1 and 2 and 3 carbon emissions in the health space. And we want to focus therefore on, first of all, what companies and businesses do for the good or bad health of their employees. Secondly, for what the impacts are on their customers. And then thirdly, in the broader community. So we're starting really with the employee-bit, just because it's the easiest bit at initial stage to get our hands around. But climate, I would argue, spent probably a decade squabbling about metrics. And that lost some time. And we don't want to fall into that trap with health, hence the importance of developing a well-backed and understood index. And it's got to be usable by companies. It can't be so complicated that it just goes straight in the too-difficult box.

Jennifer Dixon: Yeah. And just going on to relative oomph here in the investment community versus the business community, if I can separate those two out, can you give us an idea where some of the energy is? Is it mostly on the investor side? Or mostly on the business side? Really both are obviously needed, aren't they?

Catherine Howarth: Yes, they are. I mean, what's quite powerful about galvanising investors is that they tend to have very diversified portfolios with a little bit of exposure to every sector and to companies in many, many sectors. So once a big investor has got that health lens in its approach to sustainable investing, there's huge scope for those investors to push the agenda with a very, very wide range of companies in their portfolios. So we do think there's a lot of sense to educating investment community to understand how relevant health is, and then building coalitions of investors that enable really forceful and effective action to push companies that really need to step up in terms of their health impacts. And I would say the big investors in our economy are pension and funds. And since we had pensions automatic enrollment in the UK, millions of people on very modest incomes are in the pension system. And every month some money goes out of a paycheck into a pension fund and it's buying shares in lots of companies. And we think it's really important that pension funds think in an enlightened way about the investments they hold, and the behaviors of companies in the way that they affect those people, whose money they're looking after, the pension funds are looking after. And you mentioned living wage, which I think is a wonderful example of an area where investors have had a hugely positive impact. Over the last 12 years or so at ShareAction, we've coordinated coalition of investors on the living wage in the UK, and we've now hit more than 50% of the largest companies on the London stock market. Our accredited living wage employers as a result of that investor pressure. And actually it's a lot of the same investors, including Legal & General and Nest, which is a huge pension provider who are engaged with the living wage, who are now also really thinking in this broad way about health impact and who were very supportive of the campaign that we ran at Tesco, pushing Tesco to adopt much more ambitious targets on the health and nutrition content of the food it sells. So there's some really tremendous examples of investor action, now leading to behavior change in the company, in the corporate sector, that that has a really positive impact on health and on welfare and on people's lives. So I think there's every reason to be quite optimistic, but just to really press home that point about coalitions of, and coordination and working together, which of course is a really fun thing to do.

Jennifer Dixon: Yes. I mean, in terms of keeping this momentum up, I mean, there's obviously motivation, at least self-interested motivation in the commercial and investors sector, with respect to managing risks. Isn't there? There's also some pressure coming from consumers as well and individual investors, as you were saying there, Catherine. But there's also pressure coming from government, or at least potential pressure from government as the government has knelt on the green agenda to try to have progress. In terms of the government, how much appetite do you think that they have at the moment to really act in this way? I mean, green is a international must-do. Isn't it? Although it's going to cost there's no similar international must-do on the health inequalities. What's your thinking, both of you, on this where government will and could act? And how much of it are you seeing at the moment?

John Godfrey: Well, I think the first point is that government does have a manifesto commitment to extend healthy life expectancy by five years, and to try to narrow health inequalities. So they're on a promise, if you like, to try and do something about this. There is a real hook here for government in the leveling up agenda, because it is in many ways shocking that some of the towns and cities that most need leveling up, need leveling up also in health terms. So I think there is certainly pressure on the government here to do something. The government will, as usual, be concerned to avoid doing things which are unpopular because they sound too much like being a killjoy or being a nanny, whatever it may be. Not all nannies are killjoys, by the way. But the nanny-state argument still resonates in some parts of the political world. So they need to be careful. My advice would be to set up a series of nudges if you like, and then make sure that businesses and investors actually do respond in a self-interested way. And part of that is about risk management. If you are investing in something you want that investee company to get ahead of any changes that might impact them through regulation, through legal action, through tax changes and so on, whether that's about sugar or alcohol, just as it was about cigarettes. If we had all been shareholders in Purdue Pharmaceuticals in the states, if it had been a public company, boy would we have lost a lot of money because they were egregious offenders on opioids. So I think that self-interest point is important and government should set a framework.

Jennifer Dixon: Catherine?

Catherine Howarth: The parallels with the climate agenda are quite instructive in the sense that it was far from a given that that governments all over the world would face into the climate agenda in the way they have. It's really because of building public pressure, whether Greta Thunberg or very sophisticated NGOs, and of course, climate scientists. And I think we do need to marshal a similar coordinated coalition of pressure on government to make them see that we need a really ambitious approach to public health, as we have solely adopted a really ambitious approach to climate action in this country. But it was never a given that we would see such ambition. And it was very helpful, of course, that the UK government hosted the COP26, a global conference. And that really helped to push the climate agenda. But I think that we do have amazing health charities, amazing medical profession and academics. We've got all the same ingredients. We just need to think really big about have government see the opportunities around public health and the need to mobilise business and investors. But they do have a self-interest. I mean, when we think about health spend and the commitments to be made to finance the NHS, that's tremendous. And again, that is because of public pressure. On the public health agenda as we know, the government has less of a good record of committed spend. But there is an opportunity, I think, to make the case to government that actually mobilising the investment community and mobilizing the business community to address the causes of public health challenges. For example, by addressing the diet of the nation and making sure that companies are operating in a responsible way in terms of nutrition and diet. That's a real opportunity for government to avoid spend, if you like, and to avoid public spend. So I think there's a business case to be made. There's a fiscal case to be made, if you like to, government on this. And there's also of course, a need for concerted coordinated and creative campaigning that builds the political pressure for things like the leveling up agenda to take health seriously.

John Godfrey: Just two very quick post-scripts on that, if I may. I mean, one thing government can do is to show an example. It's quite a big employer itself. And it would be good to see them leading through the NHS workforce, the police, the prison service, the military, et cetera. Is the first point. And then the second point is when we talk about government, we tend to talk just about government at the center. I think there's a big role here for Metro mayors and for local government and city authorities and so on because they actually also have budgets. And they can do stuff in their local communities, which would help.

Catherine Howarth: And indeed they're investors in their own right. Aren't they?

Jennifer Dixon: Just thinking of, again, about the green agenda. You had all sorts of reports, didn't you, global reports, and looking at what was happening to climate and global warming, and so on. And then soon had some target that was set. And then you have all sorts of international eyes on different countries, seeing how progress or isn't being made or not. So there's some international or pressure. With health all the dials are pretty screaming at home, aren't they, with the Marmot's work and then obesity being almost out of control. And even if you look at places in the country, like the Northeast, where I was reading the other day, that 25% of the working-age population is prevented from work because of ill health. It's there in lights, isn't it? So I'm just wondering whether those indicators are screamingly awful enough to prompt the action that we saw on green absent and international target with international comparisons? It's a different environment. Isn't it? So do we have to manufacture that noise nationally, do you think, more to really change the weather a bit more on this?

Catherine Howarth: Yes, I'd say so as a seasoned campaigner. Politics at the moment feels incredibly 24-hour. And political attention seems to lurch from one crisis to another. And I think what's needed is a really long-term perspective. And that requires focused campaigning to build that pressure for retention on the long-term issues that will really affect the quality of life and quality of health of people in this country. So, I mean, the pandemic so instructive in that sense in that the pandemic came along and was an emergency issue. And suddenly you see this focus by government, and a willingness to shut down the economy to save lives. And yet in the face of more chronic and long-term public health challenges, which are equally detrimental to people's lives and indeed cause great loss to our economic prosperity, drip by drip by drip, but they're not as urgent. And so I'm left thinking, yeah, we really need very creative campaigning, very creative coalition building to ensure that government creates the right frameworks for business and investors to step up and do their bit on public health.

Jennifer Dixon: There's a long story here. Isn't there? About the long-term policymaking and how weak it is in countries like ours, particularly when it comes to long-term resilience of health systems, as we've seen. Long-term health issues, well, long-term any issues, perhaps with the exception of infrastructure. I don't know whether that's a fair characterisation. And if it is, what do we have to learn from long-term investors?

Catherine Howarth: I think it is a fair characterisation. And it's a truism that in government, the urgent always beats the important, and the attention span is quite short usually. So we definitely do need to do more, and we need to do it in a sustained way. I think as well as making more noise about health and about some of these truly awful outcomes that we're seeing and disparities that we're seeing, we need to do that alongside proposing solutions. Because this may be one of the reasons Michael Marmot's 10 Years On report, despite the fact it showed we'd move backwards on most measures, didn't really land, was that the solutions were simply more government spending. And it was a difficult message for the government. If there were other solutions in there, then I think there's a more chance that the government would say, 'Yes, we accept there is a problem. Let's do something about it. And we quite like what you are suggesting.'

Jennifer Dixon: In fact, some issues affecting health can be righted by discrete interventions. Can't they? But quite a lot can't be. Quite a lot is to do with the fabric of the public support, which Michael was pointing to, even though austerity wasn't the only reason to injure health in those last 10 years. So are you saying, John, that really, you can't just have one set of solutions that's talks about public spending levels? It's got to be a broader spectrum of solutions, short, medium, long-term for which there are other agents apart from government.

John Godfrey: That's absolutely it. And having worked both in business and in government, the approaches to government that always seem to work best are those which say, 'We business would like you to do the following. And in return, we business will take these five actions.' Rather than just a request for more money or for simpler rules. There has to be a consequence of what the government decides to do. So it's got to come from both sides at the same time.

Jennifer Dixon: So let's talk about those priorities from the business and investor side. I mean, I think, John, you just mentioned that there were three categories of things, really things that in, let's say, businesses can do directly with their employees, things that they do or sell services and goods to customers, food, drink or whatever it is. And then the broader community impacts of their activity, whether that's positive, corporate responsibility, I suppose, or making an environment better or negative, which is pollution and trying to stem that. Do you have a sense of priorities in the business and the investor community that you can act on and want to act on to improve health?

John Godfrey: I think the balance of those three things is going to be different by business sector, and it's going to be a bit different by businesses within those sectors. So there isn't a very straightforward template where one-size-fits-all, but I do think we can start with a focus on employees. Because it is very obvious to a company that if they have excessive sick rates or absence rates or if their productivity is being harmed because they have presenteeism and people unable to work well, then there is a direct interest in actually making things better. One of the interesting initiatives of the last few years, I think, was to pick up the issue of mental health with employers. And that I think is yielding results. I mean, if you look at the causes of absence from the workplace, they're typically a 40-something percent of musculoskeletal and 40 something percent just behind it is to do with mental health issues, typically mild depression, stress, things like that. And companies have acted to put in place mental health first aiders. They've acted to improve workplace conditions, in some cases. Sometimes whole industries have worked. I mean, the construction industry has made a real effort on suicides, which was a problem because they have a lot of young men in their workforce. So there are equivalents to that. And I think starting with employees is the easier way to do it. The customers and community-bit needs to come later. And for the customer-piece, I would suggest that we need to start really with a focus on the food chain and obesity as a component of that. And you want to do it not in a brutal way, I suspect, and not in a threatening way, but in a way that encourages companies to compete with one another and to improve their own scores year by year, as sensibly measured. And they can then pat themselves on the back for doing it. So carrot as much as stick.

Jennifer Dixon: And Catherine, what's your sense about investor action and where the priority should be?

Catherine Howarth: Yeah, I felt very similar, I think. Every company has employees by definition. So it's a very universal way of getting into this. Every investor can think about how the companies in its portfolios are managing health-related issues as they affect the workforce. If you think about something like diabetes prevention, there are really, really good evidence that if you've got a good preventative screening actions and programmes, that can be fantastic for employees. But also really great payback for employers in the sense that if you catch things early and you address them, you can stop people falling out of the workforce or becoming sick. And so absolute win-win for all concerned. So there are some, I think, really good bits of low-hanging fruit in terms of issues that relate to employee health. Totally agree also with John on healthy diets. And that's the place where ShareAction really got cracking the terms of public health. There's some really interesting investor-led action globally at the moment on challenging the vaccine producers to ensure equity in relation to international access and access by people in the global south to affordable COVID vaccines. So really commend the work that's been done. Quite clever work, for example, to propose that the big vaccine producers of the world, the executives in those firms are incentivized so that they get more money if they produce more access to vaccines in an affordable way for all across the world. So you really align the incentives of the people that run pharmaceutical companies making vaccines, and the global public health need for equitable and universal access to COVID vaccines. I think very important in that third category, thinking about environmental health, is to look at air quality and pollution, where, again, there's probably really good business case for action by companies to address air quality. So those are some of the issues that we're looking at as we think about investors and public health.

Jennifer Dixon: We've got the Office for Health Improvement and Disparities. We've got the UK Health Security Agency, who's got a remit to also to reduce inequalities. We've got the Secretary of State's taskforce on health promotion. We've got a white paper on disparities coming up. We've got the leveling up white paper as well, which may or may not include health. So there's quite a lot of action, or at least on paper at least, swirling around improving health and reducing inequalities. I guess that one of the questions is if you move around government, the discussions about what business and investors can do, in my experience, is not foremost. It doesn't really come into the conversation, which is quite interesting. Is that your feeling? And how much education do you think needs to be done here to really help public servants, if you like, understand the role of business and investors and quite what it can do?

John Godfrey: I would agree with that assertion actually. And it was an interesting observation that previous COPs had been very business-light. I think this most recent one in Glasgow was pretty business-heavy. And the work that Mark Carney and others did to assemble, if you like, a $130 trillion pledge was a real wake up call for governments, that governments can't do this on their own, and that the institutional investment world and the pensions world and so on is where an awful lot of the money is. So why don't you try and leverage it in? And so I think we need to do exactly that in the health space. I don't know who the obvious Mark Carney of the health world is going to be, but we do need one.

Jennifer Dixon: Maybe it's Andy Haldane. I don't know. He's helping out with leveling up. Isn't he? And he developed when he was in the Industrial Strategy Council the health metrics that would help to measure the impact of the industrial strategy, I seem to remember. So maybe he's on our list. So I guess the final question to end on is what in your view really now needs to happen next? It sounds as if there's a lot of opportunism and there's a lot of potential action. But is it time for a strategy to develop? Or are we not at that stage yet? What needs to happen next to really push this forwards in the best way?

John Godfrey: Yeah, I think the development of agreed metrics is hugely important. I mean, that's a big lesson of climate, and we need to carry that across into this sphere as well. I think as much as a strategy is important, we also need really good case studies and examples. And I think what ShareAction are doing, putting pressure on companies or organizing investors to put pressure on companies about food, for example, is terrific. Because in my experience, there's nothing that quite motivates a company as much as the idea that there may be some awkward questions or an awkward resolution at their AGM. And I think this coming AGM season is quite a good moment to make sure that health is to the fore and that companies don't take their eye off the ball now that we hopefully are moving through COVID.

Catherine Howarth: I very much think we do need a strategy. And we need quite a bold approach to bringing together like-minded and forward-thinking players in the business community, in the investment community, in government and in civil society to put health right at the heart of the sustainable business revolution. And to bring that to life with some really dynamic campaigns and programs that demonstrate just how much major investors and the companies in their portfolios can do to support people to live healthy lives, good lives. Because there's lots of benefit for investors and companies to be seen publicly to do the right thing by public health people are very aware of coming out of the pandemic, how the pandemic has exacerbated inequalities in our society, how the pandemic hit people with poorer health harder. They were more vulnerable. I think there's a real desire for something bold and visionary that addresses public health in a strategic, long-term way, that galvanises all of society, and particularly makes the most of what the business and investment community have to offer. So we are very positive. We are launching a program called LIPH, which stands for Long-term Investors in People's Health. And very excited to work with many partners across the business community and the investment community on that program.

Jennifer Dixon: The Health Foundation is very proud to be engaged in that as well. Just last thing, do we need a UK CCC equivalent, the Climate Change Committee, which oversees a climate strategy, doesn't it, and does carbon audits and so on. Do you think we need something like that?

Catherine Howarth: Potentially very interesting idea. I do think we've said it a number of times in the conversation that there are some really clever parallels and lessons to be drawn from the climate arena. And I think the Climate Change Act of 10 years ago or so, which established the Climate Change Committee, which is a standing body to hold the government accountable, to set the agenda to set ambitious targets could be a brilliant thing to have for public health.

Jennifer Dixon: So we must leave it there. Thank you so much to our guests, Catherine and John, for all their insights and for their leadership on this issue as we go forwards. And thank you to all of you for listening at home. Meantime as ever, please check out the show notes for further reading on all the subjects we covered today. And while you were there, have a look at our previous podcasts. And if you like this, you probably like them. Next month we'll be exploring a running sore in health policy, why we have a growing drugs problem and what to do about it. And we've got two very interesting guests from the UK and from Portugal to discuss different approaches to tackling drugs. Meantime, stay well and see you next time.

• APPG on Longevity, Levelling up health, (April 2021). 

• British Academy: The Future of the Corporation programme and reports Policy & Practice for Purposeful Business (2021), Principles for Purposeful Business (2019) and Reforming business for the 21st century (2018) 

• Business for Health, Business Framework for Health: Supporting businesses and employers in their role to enhance and level up the health of the nation (October 2021) 

• Health Foundation, Using economic development to improve health and reduce health inequalities (2020)

• Institute of Health Equity, Health Equity in England: The Marmot Review 10 Years On (2020)

• ShareAction, Health: An Untapped Asset – How investors can strengthen returns by improving health outcomes (September 2021)