OVERVIEW
A thriving economy requires a healthy workforce. Ongoing public health threats—like addiction, obesity, and rising midlife mortality among working-age Americans—create obstacles for businesses to have a healthy workforce. This chapter shows how a web of social and economic conditions contributes to poor health and connects the health and prosperity of everyday people to a competitive economy.
KEY TAKEAWAYS
- ➤
The health of Americans is poor relative to residents of other wealthy nations. This is referred to as “the U.S. health disadvantage.”
The prevalence of poor health conditions, from diabetes to alcohol-related car crashes, is higher in the United States than in other wealthy countries, which has clear implications for U.S. healthcare costs, labor productivity, and labor availability.
On average, people born in the United States have lower life expectancies than those born in other wealthy countries.
U.S. workers are less healthy and have less access to and pay more for healthcare than workers in other wealthy countries.
- ➤
The U.S. health disadvantage
Increases costs for businesses, lowers productivity and competitiveness, and compromises business success and growth; and
Has its roots in poor conditions in neighborhoods and communities where the vital conditions that shape health are unmet for some residents.
Introduction
Many Americans believe they enjoy better health than people in other wealthy countries and have access to the best healthcare system in the world. Neither assumption is true. On average, people in the United States have poorer health—shorter lives and more illness—and experience greater health inequity (avoidable differences across groups) than their counterparts in other wealthy countries. In the United States, the difference in how long Americans live and how healthy they are, among various groups (such as racial/ethnic or income groups), is greater than that of populations in many other wealthy countries, and that difference is widening with time. Furthermore, many Americans cannot fully access the U.S. healthcare system, including 28.9 million non-elderly Americans who lacked health insurance in 2019. A person’s ability to receive quality healthcare in America is not universal, even as the United States spends more on healthcare than any other country. The gap between U.S. spending on healthcare and that of other wealthy nations has widened over time. In 2018, healthcare expenditures were 2.6 times higher in the United States ($10,586 per person) than the average of healthcare expenditures of member nations of the Organisation for Economic Co-operation and Development (OECD) ($3,994 per person) (Figure 1.1). The high level of U.S. spending on healthcare is ineffective, inefficient, and costly. OECD countries that spend less on healthcare than the United States have healthier populations and greater life expectancies.
Figure 1.1
Health expenditure per capita, 2018 (or nearest year) by country and the OECD average. Note:OECD = Organisation for Economic Co-operation and Development. b “Purchasing power parity is a conversion rate that shows the ratio of the prices in national (more...)
The paradox of poor health in a country that spends far more on healthcare than any other country is partly explained by the lack of access to healthcare, but is more fully explained by the fact that health is about more than just healthcare. The conditions that shape health are outside the clinic—where people live, grow, learn, work, and age—and not inside the clinic, where clinicians and staff do their work. In fact, healthcare is estimated to account for only 10–20% of health outcomes. The takeaway for employers is clear: The health of workers and the costs of their healthcare are shaped by the conditions in which employees live and return to after work—in their homes and neighborhoods. Today’s business leaders can play a meaningful role in the lives of their employees, consumers, and community members. By investing in the health and well-being of communities across the country, businesses have the potential to change the trajectory of wellness for generations to come.
Health is about more than just healthcare … [it’s about] where people live, grow, learn, work, and age.
The health of Americans is vital to individuals, families, communities, businesses, the economy, and national security. U.S. employers depend on a healthy workforce to maximize productivity and minimize healthcare costs. In a global marketplace, an unhealthy workforce and high healthcare costs put U.S. businesses at a competitive disadvantage with businesses located in countries with healthier people. Population health also affects the consumer market, whereby the demand for nonessential products and services suffers when families are struggling with illnesses and much of their disposable income is required for medical expenses.
The U.S. health disadvantage threatens the country’s global competitiveness and national security, as well as the hopes and prospects of future generations.
The term “U.S. health disadvantage” refers to the lower health status of Americans and the uniqueness of the United States among populations of wealthy nations. Although leaders in public health and medicine have been concerned about the consequences of an unhealthy population, the consequences are increasingly drawing the attention of business leaders, economists, and public officials. Today’s business leaders are concerned about the larger economic impacts of a workforce that is dying prematurely, suffering from high rates of disease and disability, and generating high healthcare costs. The U.S. health disadvantage threatens the country’s global competitiveness and national security, as well as the hopes and prospects of future generations.
Scope of the U.S. Health Disadvantage
In 2018, news outlets reported that U.S. life expectancy (how long a newborn can expect to live) was decreasing for the first time in generations. The reports grew out of studies from the Centers for Disease Control and Prevention that U.S. life expectancy had decreased for three consecutive years. This news highlighted the reversal of a longstanding trend of increasing life expectancy for much of the past century1due to improvements in the conditions that shape health and to advances in medicine and medical care. However, this is not the news story in other wealthy countries, where life expectancy continues to increase.
The downturn in the health status of Americans is not new. For much of the twentieth century, U.S. life expectancy had been among the highest in the world, and for many years exceeded the average life expectancy of people living in other wealthy countries (i.e., member nations of OECD). The U.S. health disadvantage emerged in the 1980s, when the increase in life expectancy in the United States slowed down, increasing more slowly than in other OECD countries (Figure 1.2). By 1998, the increase fell below the OECD average. By 2005, the 15-year survival rate of 45-year-old White women in the United States was lowest among 12 comparison countries. In 2015, U.S. life expectancy ranked last among industrialized nations (Table 1.1), and this trend continues. The recent decline in U.S. life expectancy stems from an increase in deaths among working-age adults (25–64 years of age); the risk of death among this population has generally increased since 2010 (Figure 1.3). U.S. workers are also less healthy and more likely to die earlier than workers in other wealthy countries. Children born in the United States are on course, on average, to die earlier than children born in other wealthy countries.
Figure 1.2
Life expectancy at birth in the United States and member countries of OECD, 1960–2017. Note:OECD = Organisation for Economic Co-operation and Development.
Table 1.1
Life expectancy at birth among males and females in 17 high-income countries, 2015.
Figure 1.3
Death rate among U.S. working-age adults (25–64 years of age), 1999–2018.
The U.S. health disadvantage extends beyond lower life expectancy. The prevalence of poor health conditions, from diabetes to alcohol-related car crashes, is higher in the United States than in other wealthy countries, which has clear implications for U.S. healthcare costs, labor productivity, and labor availability. Six of 10 Americans have at least one chronic condition and 4 of 10 have two or more chronic conditions, including 18% of Americans 18–44 years of age and 50% of Americans 45–64 years of age. Some studies have reported that Americans are feeling less healthy and are experiencing a decline in mental health and increasing rates of depression (primarily among adolescents and young adults). Meanwhile, participation by U.S. men in the labor force has plummeted from a high of 86.4% in 1950 to an estimated 68.2% in 2020. Although increased participation in the labor force over time by U.S. women has made up for some of the decline in men’s participation, women’s labor force participation has declined from a peak of 60.2% in 2000 to an estimated 57.4% in 20202Figure 1.4).
Figure 1.4
U.S. labor force participation, 1950–2010, and projected, 2020–2030.
The U.S. health disadvantage affects much of the population. The higher (worse) age-specific death rates in the United States drive the shorter (worse) life expectancy. These worse death rates affect young, middle-aged, and older people; males and females from infancy to 75 years of age; and all races and social classes. For example, the death rate among non-Hispanic White Americans is lower (better) than rates among most minority and low-income Americans. However, the death rate of non-Hispanic White Americans is higher (worse) than the death rate of non-Hispanic Whites in other wealthy nations. The death rate among U.S. White males and females in every age group younger than 55 ranks 16th or 17th (worst) out of 17 peer countries. High-income Americans, people with health insurance, college graduates, and those with healthier behaviors also fare worse than their counterparts in other wealthy countries: These Americans also have higher infant mortality, more chronic diseases, and lower life expectancy.
The U.S. health disadvantages are diverse. Compared with populations in other wealthy countries, Americans across income levels and racial/ethnic groups suffer and die at higher rates from a broad range of diseases and injuries—including heart, lung, and kidney disease; obesity; diabetes; car crashes; drug overdoses; and shootings—and from adverse birth outcomes (e.g., infant mortality), adolescent pregnancy, and HIV and AIDS.
These outcomes persist despite America’s large investments in healthcare, which vastly exceed the levels in which other countries invest in their own healthcare systems. Unless circ*mstances change, estimates suggest that the U.S. health disadvantage will continue to worsen, as it did during the coronavirus pandemic of 2020. The coronavirus was especially dangerous to people with existing chronic conditions and subjected Americans to the health complications from the economic downturn brought on by the pandemic.
Explaining the U.S. Health Disadvantage
The question of why Americans live shorter lives and have poorer health than people in other wealthy nations can be explained by how the United States differs from other wealthy countries in five areas:
Public policies and spending: Public policies and spending set the context for the other four differences. Health and quality of life are linked to many U.S. public policies and personal ideologies that influence those policies, including (a) America’s approach to governance and the decentralized influence of the states and (b) Americans’ unique concerns about the size of government, the amount of regulation, levels of taxation, gun rights, and other issues that affect public policies—specifically, the generosity of social welfare programs and investments in education, housing, and public health and other social needs.
Social and economic factors: Income and education are among the most important social and economic factors related to health. Compared with other wealthy nations, the United States has higher levels of income inequality, poverty, child poverty, single-parent households, divorce, and incarceration. The United States has lost its leadership position in education, ranking 24th in science and reading and 38th in math, behind such countries as Vietnam, Estonia, and Slovenia.
Social and physical environments: The built environment in U.S. cities, suburbs, and rural and tribal areas is designed for automobiles rather than pedestrians, cyclists, and public transit; and Americans are exposed to greater instances of violence and residential segregation than their peers in other wealthy nations.
Individual behaviors: Compared with their peers in other wealthy countries, Americans have lower rates of smoking3 and problem drinking, but they consume more calories per person, are less likely to fasten seat belts in vehicles, have more motor vehicle crashes involving alcohol, are more likely to own firearms, and are more likely to use and misuse drugs.
Healthcare: Unlike other wealthy nations, the United States does not offer universal access to healthcare. The U.S. healthcare system struggles with deficiencies in quality, fragmentation, and poor coordination of care; and it ranks poorly when compared with healthcare systems in other wealthy nations. Finally, health insurance in the United States is often tied to employment. When employment is disrupted, such as that caused by the coronavirus pandemic, many workers lose their health insurance coverage, often at a time of high need.
Lower spending on social services may also contribute to the U.S. health disadvantage. Major investments in social, economic, and environmental development in the 1930s and 1960s have not been replicated in recent decades. Between 1962 and 2017, the share of federal spending on social and economic investments (e.g., in education) decreased by 59%. During the same period, spending on programs that provide direct cash transfer and healthcare-related costs (e.g., Medicare and Medicaid) increased by 162%. Spending more on healthcare does not necessarily lead to better health. In fact, populations in countries that prioritize spending on social services over spending on healthcare have higher life expectancy. The same is true across the United States, where populations in states that dedicate a large proportion of their budgets to social services have higher life expectancy.
More recently, research attention has focused on another component of the explanation. Racism and bias is increasingly identified as an important contributing cause of poor health outcomes for such population groups as people of color in the United States. Structural, cultural, and interpersonal racism and bias have been shown to affect health, wealth, and well-being through socioeconomic, psychosocial, policy, and opportunity pathways, which are often intertwined. For example, residential housing segregation, unequal treatment within the criminal justice system, and lack of access to credit and capital have the effect, individually and together, of concentrating poverty, limiting access to quality education, and limiting employment and economic opportunities. Each of these contributes to poorer health outcomes. Racism and bias in the diagnosis and treatment of disease also contributes to poorer health outcomes.
The relationships among these areas are complex. Although healthcare is important when people are ill, research shows that unhealthy behaviors (e.g., smoking, lack of physical activity) contribute significantly to disease and death. Some studies attribute 40% of U.S. deaths to unhealthy behaviors, which, in turn, are influenced by the physical and social environments. People can make choices from only the options that are available to them; they cannot eat well if healthy foods are not available or walk to the store or park if the neighborhood is not safe. The physical environment—or the built environment—includes parks, housing, and transportation resources. The social environment includes the connections, networks, people, and institutions through which people interact (e.g., schools, employers, banks, libraries, and community centers). These interactions can either promote or damage health. Health-promoting conditions include social support, safety, and social connection. Health-damaging conditions include social isolation, discrimination, segregation, and trauma.
Social and economic factors—such as education, income, and poverty—rank among the most influential drivers of health, because socioeconomic resources enable people to pursue healthy behaviors, live in neighborhoods with desirable physical and social environments, and access healthcare. In an economy that depends on a skilled and knowledgeable workforce, like the United States economy, quality education may be the most important driver of health and economic opportunity.
Decisions on public policies and spending greatly influence the other four areas. Policies (or lack of policies) can determine a person’s opportunities and whether gaps in opportunities shrink or grow. Decisions that are made by government and the private sector at the national, state, and local levels determine whether
The environment is healthy and safe, including clean air and water; a built environment that promotes physical activity; access to healthy foods, quality and affordable housing, reliable transportation to jobs, education, and services; and a social environment that is free of violence, trauma, and discrimination;
Policies are instituted to encourage healthy behaviors, including avoiding smoking and misuse of alcohol and other drugs;
People have access to affordable, high-quality healthcare; and
The social and economic status of American families—such as children’s education, access to jobs with a livable wage, and income and savings—allows them to afford the conditions that shape good health.
Many Americans, including those in middle- and low-income households, and especially racial/ethnic minorities, have faced prolonged periods of economic stress, wage stagnation, and decreased social mobility (the inability to climb the economic ladder). These mounting stresses, which can be mitigated by better policies, contribute to poor health. The coronavirus pandemic of 2020 exacerbated and accelerated these economic and social stressors.
Why Does the U.S. Health Disadvantage Matter to Businesses and the Economy?
The U.S. health disadvantage has major implications for businesses and employers due to the adverse effects on the health of workers and their dependents. Employers share the burden as chronic diseases, such as obesity and diabetes, grow in prevalence in the workforce and among dependents. This poor health generates costs for employers, such as greater healthcare expenses; while higher rates of disability (as defined by the Social Security Administration), absences for illness and medical appointments (for themselves and dependent family members), and presenteeism (i.e., working while sick) generate indirect costs that reduce workforce productivity and contribute to declines in labor force participation. For example, the average full-time worker with diabetes misses an estimated 5.5 workdays per year; unplanned absences for this disease cost U.S. employers $20 billion annually in lost productivity. The indirect costs of diabetes to employers may approach $90 billion per year (Table 1.2).
Table 1.2
Indirect costs to U.S. employers due to diabetes.
Many American companies are discovering that there are economic benefits in the choice to address the vital conditions required for health (Boxes 1.1a and 1.1b). Poor education, unstable housing, and food insecurity affect the health status of workers and their productivity on the job. In a knowledge-based economy, businesses already understand the value of an educated and skilled workforce, but the larger health benefits of education may not be fully appreciated—nor is the price tag for gaps in education. Workers with less education or income are more likely to have chronic illnesses and complications, higher healthcare costs and more absenteeism and presenteeism. Even the ability to conduct manual labor, such as lifting packages or climbing stairs, varies by level of education (Figure 1.5). Lower income adds to psychological distress, an important consideration in an era of increasing deaths from drug use, problem alcohol use, and suicide. The opioid epidemic, a phenomenon with far less impact on businesses in other countries,4 costs U.S. employers billions of dollars per year in healthcare costs and lost productivity.
Figure 1.5
Age-adjusted prevalence (%) of difficulties with physical functioning among U.S. adults, 18 years of age and older, by level of education, 2017. Note:GED = General Education Diploma.
BOX 1.1AWHAT ARE VITAL CONDITIONS FOR HEALTH, WEALTH, AND WELL-BEING?
Our ability to survive and thrive—as individuals, institutions, industries, and even as a nation—depends on having a consistent set of vital conditions, such as clean air, fair pay, humane housing, early education, routine healthcare, and other pragmatic necessities (see graphic below). The status and quality of the vital conditions shape each person’s ability to attain his or her best possible health, wealth, and well-being. Everyone—including the public, private, and nonprofit sectors and individuals, families, and communities—has a role to play in assuring the vital conditions, equitably, for all Americans.
When any of the vital conditions is not met, a variety of threats predictably arise. Those threats drive demand for urgent services that people facing adversity might need temporarily to regain their best possible health, wealth, and well-being (Box 1.1b). If services are unavailable or inadequate, the consequences of unmet vital conditions may be devastating to individuals, families and communities, and the costs, which are considerable, are borne by society. Everyone pays.
The Seven Vital Conditions
The changing states of these vital conditions and urgent services shape the prospects for people and places across the United States, now and for generations to come.
People have no say in the vital conditions that they inherit from their predecessors. At the same time, people today can transform current and future vital conditions, for better or for worse.
Note: Belonging and Civic Muscle forms the core of the other elements because it is both a vital condition unto itself and a practical capacity expressed through every other kind of work. Graphic of the seven vital conditions is adapted with permission from WE in the World, on behalf of the WIN Network, Rippel Foundation, and Well Being Trust.
BOX 1.1BA DEEPER LOOK AT THE VITAL CONDITIONS
The vital conditions that shape each person’s ability to attain his or her best possible health, wealth, and well-being are defined in greater detail (in teal). When one or more vital condition is unmet, the demand for urgent services increases (in orange). Unmet vital conditions can be devastating to individuals, families, and communities and generate costs that are borne by all of society. Although the lack of a specific vital condition does not result in a specific urgent need, the adversity that results from one or more vital conditions being unmet can create any number of urgent needs, some of which are illustrated here. Belonging and civic muscle (in blue) is both a vital condition and component of each vital condition. When belonging and civic muscle are strong, assuring the vital conditions becomes easier.
Like economic and social status, geography also plays a role in health. Today’s business leaders must consider the disparate living and health conditions to which their workers return at the end of their workday. The vital conditions in employees’ neighborhoods—from the quality of housing and drinking water to the amount of green space to instances of racial segregation—affect health at the worksite and the cost of healthcare. Different conditions in different neighborhoods mean that two workers at the same company will have different educational and economic opportunities, community supports, health statuses, disease risks, and life expectancies—for themselves and their children.
The bottom line is clear: Businesses have an economic interest in improving the vital conditions in workers’ neighborhoods and in working with community partners to maintain or create an environment that is healthy and safe. The same conditions that shape health are also the features that enable employers to attract and retain talented workers. Such conditions include good schools, resources for sports and physical activities (e.g., parks, playgrounds), modern, efficient infrastructure (quality affordable housing, broadband Internet access, transportation), and healthy social environments (e.g., lack of segregation and violence). Businesses have powerful incentives to act to improve the vital conditions that shape health (Box 1.2).
The bottom line is clear: Businesses have an economic interest in improving the vital conditions in workers’ neighborhoods and in working with community partners to maintain or create an environment that is healthy and safe.
BOX 1.2INCENTIVES FOR BUSINESSES TO IMPROVE THE VITAL CONDITIONS THAT SHAPE HEALTH
The National Business Coalition on Health described the incentives for businesses to invest in building healthy communities:
“Improve the health status, and therefore the productivity, of an employer’s current and future workforce;
Control direct (healthcare) and indirect (absenteeism, disability, presenteeism) costs to the employer;
Create both the image and the reality of a healthy community that may help recruitment and retention of workforce talent in tight labor markets;
Increase the buying power and consumption level for business products, in particular nonmedical goods and services, by improving the health and wealth of a community;
Strengthen an employer’s brand and recognition in the community;
Generate, for individual business leaders, positive feelings of civic pride and responsibility and of being a constructive member of the community;
Channel corporate philanthropy in a direction that will improve community relations, goodwill, or branding with the potential for a positive return for the business enterprise;
Help create public and private partnerships and a multistakeholder community leadership team that can become the foundation for collaboration, cooperation, and community-based problem-solving for many other issues affecting the business community, such as economic development and education.”
The decline in U.S. health transcends the business environment and affects the nation’s economy. For example, state and local economies suffer when poor health and living conditions make it difficult to attract new industries or force companies to relocate, taking jobs with them. The same adverse conditions that affect the health of a community also stifle upward mobility and the well-being of communities, creating conditions for social discord, crime, and violence. Lack of upward mobility and associated income inequality are costly to the economy. The U.S. health disadvantage puts the nation at a competitive disadvantage in the global marketplace, as U.S. companies compete with overseas companies that enjoy a healthier, more productive workforce and lower healthcare costs per capita. The rise in U.S. healthcare costs places unsustainable economic pressures on public payers (e.g., Medicare, Medicaid), employers, and patients who struggle with out-of-pocket expenses, while reductions in the health of the working-age population and reductions in participation in the labor force place economic pressures on businesses themselves. The U.S. health disadvantage has even raised national security concerns, as military leaders encounter a high prevalence of obesity and other health problems in active-duty personnel and future recruits.
Conclusion
The U.S. health disadvantage began to emerge in the 1980s. Although this chapter focuses on the decline in life expectancy as a signal of that disadvantage, the contributors to that decline are powerfully important. Increases in disease (e.g., obesity and diabetes) and substance misuse, which exceed that of peer nations, and substantial disparities in the vital conditions of health (meaningful work, safe environment, quality education, and humane housing) constitute pathways to reduced participation in the labor force, poorer health, and early death. To improve the nation’s health, wealth, and well-being, Americans must transform the disadvantaged communities in which too many live, grow, learn, work, and raise families. As demonstrated in the next chapter, health happens in communities and is largely driven by conditions outside the healthcare system that compromise health, limit opportunity, and shorten life. Children pay a particularly high price for these poor conditions, and today’s children are tomorrow’s workers and national leaders. They are the next generation of teachers, doctors, business leaders, and military personnel. If the U.S. health disadvantage of today is not fixed, by strengthening communities and expanding opportunities, then the future population—and workforce—will almost certainly be burdened with greater sickness, lower productivity, higher costs, and shorter lives. The U.S. health disadvantage is a threat to the business community and the national economy.
APPENDIX ATOOLS AND RESOURCES
Appendix A identifies tools and resources addressing topics explored in Chapter 1. The tools and resources were created by such businesses and organizations as John Hanco*ck Insurance Company, Organisation of Economic Cooperation and Development, The Kresge Foundation, and others.
BELDEN INC.: Pathways to Employment
| Community Challenge | The staggering levels of drug addiction in local communities across the United States has caused more than a health crisis. The economic impact of treating drug addiction is a burden on families and businesses. For those addicted, the ability to keep a job is difficult and gets harder over time, and those who manage to hold a job are less productive. For Belden, Inc. (Belden) something had to change. |
| Scenario | Belden has been a member of the Richmond, Indiana, community since 1928. As the second largest employer in Wayne County and a global leader in specialty networking solutions, Belden is a respected American company and proud of its safety record and strong workforce. Belden requires all job applicants have a drug-free background and pass drug screening. If hired, employees must continue to be drug-free. Belden employed more than 500 people at its Richmond plant. Nearly one-third of these employees were set to retire within 5 years. At the same time, the labor pool for manufacturing workers was declining, just as customer demand was increasing. Where would the new hires come from? |
| Action Taken | Despite an influx of applications, many potential employees were turned away. “We found the pre-employment drug screen failure rate was steadily increasing—between 10 to 15%,” said Paul Mottershead, vice president Corporate Communications. According to Mottershead, when the data were presented to Belden’s Board of Directors, one member asked Chief Executive Officer John Stroup: “If you’re not going to do something about this, who is?” With support from top leadership, Belden convened a team to work with community partners to address the drug use problem among its applicant pool. “We are not a healthcare expert and needed to rely on the expertise of [others] to develop, implement, and evolve [a] program,” Mottershead said. Partners included Centerstone Indiana, Meridian Health Services, Ivy Tech Community College, Manpower Richmond, and addiction specialist Dr. Mitch Rosenthal. Together, they built the Pathways to Employment Program, which launched as a pilot in February 2018 and provides 18 months of support to applicants who are hired by Belden. Through the program, Belden offers rehabilitation and a job to applicants who fail the pre-employment drug test but agree to enter the program. In the program, a healthcare provider assesses employees and places them into one of two groups—low risk or high risk for substance use disorder. From there, employees receive personalized, evidence-based rehabilitation treatment, during which they work in such positions as cleaning, inventory, and other roles that do not pose a risk to their safety or the safety of others. Drug tests are conducted almost weekly for the first 8–16 weeks. Employees must remain drug-free to work in higher risk positions, like a machine operator. Employees who fail a drug test are released and provided with community resources to help them with substance misuse. However, if employees are forthright about a relapse before failing a test, they get a second chance. By 2019, 34 employees had entered the program—12 were in machine operating roles, 12 left the program, and 10 were in lower risk roles. The program costs an average of $6,000 per low-risk employee and as much as $26,000 per high-risk employee. The program is also available to current employees who are seeking help with addiction problems. Based on the positive response, Belden developed a blueprint for other organizations to develop similar programs and began offering the program in 2020 at two other U.S. facilities. |
| Key Takeaway | Belden needed to hire people to produce products to meet business demands and the expectations of shareholders. All groups—business, government, and the healthcare system—worked together to address the need. Having a job is a critical part of maintaining a drug-free lifestyle; filling a job is critical to business success. Belden helped with both and is sharing its learnings with other companies, organizations, and communities. |
- 1
A decrease in life expectancy of this duration has not occurred since the worldwide influenza pandemic of 1917–1918.
- 2
An estimated 62.5% of men and women combined participated in the labor force in 2020 (Figure 1.4). Actual monthly labor force participation reached a low of 60.2% in April 2020, due to the impact of the coronavirus pandemic, before rebounding slightly to 61.5% in June 2020.
- 3
Higher rates of smoking decades ago may also be contributing to currently high U.S. death rates from tobacco-related illnesses.
- 4
An increase in opioid prescribing has been observed in other countries (e.g., Australia, Canada, Denmark, Finland, Germany, Sweden, United Kingdom), but no country has experienced an increase in drug overdose deaths comparable to the United States.
