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Popular products and services impact personal behaviors and thus the public’s health. But that impact can be hard to understand. Building H, a nonprofit working to build health into everyday life, gives H-Scores to 37 companies like Netflix (20 out of 100, not great), DoorDash (28 out of 100), and Niantic, maker of Pokémon Go (68, one of the highest scores). Stephen J. Downs, cofounder of Building H, and his collaborator Sara Singer, a professor of health policy and medicine at the Stanford School of Medicine, spoke with Harvard Public Health about their system.

Why study this topic?

Singer: Businesses have this footprint on health, even if they don’t realize they do. They impact the environment, employees through insurance benefits, and consumers through products and services. This last part, which we call the “product environment,” has gotten less attention, and we felt it was important to characterize it and measure it.

Downs: We needed something to make the “product environment” and its impact on health tangible and real and visceral. [We found] it’s perfectly reasonable and feasible to do.

What did you find?

Singer: We can show, based on information that’s publicly available, differences among companies and their impact on consumer [behavior]. And we can create a process that engages consumers in rating companies based on that impact.

What would you like to see happen based on the study’s results?

Downs: We want to see accountability for the impact of products and services. We just got a small grant from National Academy of Medicine to pursue a quantitative analysis of this idea.

Singer: If we could get people to recognize the product environment is a thing, and products and services actually shape their behaviors, I think people would start asking, “Could [the product] be better for me?” You want companies to care about the impact of their products on consumers, and the framework could easily be adapted by companies.

—Michael Fitzgerald

(Study in the American Journal of Health Promotion, August 2023)

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