Which company has the biggest impact on Americans’ health? Pharmaceutical companies? Hospital system? What about restaurant chains like McDonald’s and Chick-fil-A? Or how about Netflix? Or Facebook? The prevalence of chronic diseases such as diabetes, heart disease, obesity, and depression is linked to health behaviors such as our diet, physical activity, sleep patterns, and even social behavior. And these behaviors are influenced by the products and services in our lives. But which products have positive effects, which have negative effects, and where is there room for improvement? Building H, a project of the nonprofit Public Health Research Institute, has identified four We explore all of these questions in the 2024 Building H Index, a rating and ranking of more than 75 popular products and services across industries, and offer some thoughts on how below. National policy makers can use this information.
Everyday products and services in industries such as food, entertainment, and transportation shape how we eat, sleep, move, and socialize. Fast food, which is high in calories, sodium, fat, and sugar, can lead to diet-related illnesses. Intensive TV viewing can lead to lack of exercise, lack of sleep, and even unhealthy snacking. The new wave of online ordering and delivery services can lead to feelings of social isolation and loneliness. All of these industries impact the health of their customers, which over time can lead to chronic diseases that cost hundreds of billions of dollars annually to treat.
Currently, companies do not have a strong incentive to design products that have a positive impact on health. Regulation of consumer products is based on a safety paradigm. That is, if a substance is too dangerous to use or too toxic to consume, its use will be prohibited or otherwise restricted. This paradigm does not help prevent chronic diseases that result not from the isolated use of individual products, but from the collective effects accumulated over time from the use of many similar products. No one will develop diabetes just by eating at a fast food restaurant. But eating 25% of your calories at fast food restaurants for 10 years can make you sick. To create stronger incentives for companies to deliver products that have a positive health impact, or at least reduce negative impacts, create accountability for companies’ contributions to collective impacts on public health. We need public policy.
building h index
The 2024 Building H Index evaluates products and services across the entertainment, food, housing, and transportation industries based on their impact on five health behaviors: diet, physical activity, sleep, social engagement, and spending time outdoors. Rate and rank. Products from companies like Apple, DoorDash, TikTok, GM, Uber, Burger King, and Nintendo are covered. We research each product and examine the scientific literature for studies linking use of a specific type of product to any of the five behaviors, including product use, health behaviors, and how they are related. We conducted our own consumer research study.
We analyzed how each product affected each of five behaviors and scored the impact with the help of nearly 200 volunteers from the public health, medical, and health policy communities. The overall score for each product is between 0 (strong negative impact on all five behaviors) and 100 (strong positive impact on all five behaviors), with 50 representing a neutral impact. The top scorer was Mr. Culdesac, 82, a real estate developer who created a car-free community in Arizona that emphasizes outdoor social spaces and recreation. At the bottom was Netflix (18), with negative scores for all five behaviors. Overall, we found the impact to be real and far-reaching. Most products affected most of the five behaviors. The effects were not all negative. Many companies received positive scores, and we found outliers within each industry that positively impacted some behaviors.
For example, the finding that many fast food chains and food delivery services have a number of negative impacts is not surprising, but nonetheless troubling. Entertainment services such as video streaming, social media and video game consoles were a major concern, with all but one of the 20 services receiving negative scores. The most pressing concern was our findings regarding the role of technology in general and AI in particular. Too often they are used to facilitate unhealthy behaviors and increase consumption. The world’s most cutting-edge technology is being applied to help people eat more fast food, watch more TV, and avoid interacting with other people. These new technologies deeply shape our daily lives and, if not harnessed to support healthy behaviors, could further entrench unhealthy lifestyles in our society.
