Can Corporate America Help Solve the Parenting Crisis?

BY Stephen Koepp | August 27, 2020

Parents of school-age children are sharing uncharacteristic feelings for this time of year: despair, anxiety and anger. In normal times, this would be a season of pleasant anticipation, with kids about to head off to a place of learning and supervision. This year, it’s a full-on social crisis. All the scenarios for going back to school during a pandemic–remote schooling, hybrid schedules, or a return to the classroom–feel risky or nearly impossible to manage.

“All the choices stink,” Kate Averett, a University of Albany sociologist who has been interviewing parents, told the New York Times. “Parents tell me about not being able to sleep because they’re so anxious, or tell me they’ve been crying a lot.” Times columnist Michelle Goldberg is one of those perplexed parents: “When I lie in bed struggling to figure out how to balance physical risk, economic sustainability and emotional well-being, I can’t make the equation work. And If I can’t do it, I’m not sure how parents with far fewer resources are doing it either.”

Parents say they feel abandoned by government. This presents an urgent question for employers: In the absence of a normal system, what can they do to help the parents who work for them? The issue is not just a humanitarian one, but a practical matter. In a nationwide poll by the Washington Post-Schar School, “50% of working parents said it would be ‘harder’ or ‘impossible’ to do their jobs if their children’s schools provide only online instruction this fall,” a number that rose to 66% among parents of younger children. In another poll of parents, four out of five said they would have no in-person help educating and caring for their children at home.

Those are ominous statistics. In fact, solving the parenting crisis looks like a prerequisite for jump-starting as the U.S. economy. To see how businesses are responding, From Day One consulted HR executives and other business leaders who have spoken at our conferences. The overview: Companies are assessing the programs they have and considering what they should add. Among the solutions in play: flex time, additional paid days off, increased back-up child care, tutoring discounts, nanny stipends, help with forming learning pods, and information-sharing forums on how to cope with the situation.

Currently, only a tiny fraction of U.S. companies offer subsidized child-care centers or programs, but now many large employers are scrambling to explore their options. Megan Neumann, a consultant at Mercer who focuses on employer health and benefits choices, told the Washington Post she is getting four times as many inquiries from client companies about child-care and educational help as she did before the pandemic began. “Employers really haven’t ever been focused on [the needs of school-aged kids]” she said. “People have depended on the school year to provide for watching children and fostering a learning environment.”

In June, the Cincinnati-based Fifth Third Bank began offering employees 30 days of subsidized child support this year, either in-home or at a care center, the Chicago Tribune reported. RELX, a global information-analytics company, has increased its offering of backup-care days provided to employees through Bright Horizons, the largest provider employer-sponsored child care, according to Amy Noelle, RELX’s global benefits leader. Working with Bright Horizons, the company also offers “the ability for parents to engage with the Sittercity website to find an instructor to lead a learning pod,” Noelle told From Day One.

The reality is that most of the burden of solving this crisis will likely fall on women, which will cause them both immediate stress and potentially a long-term setback. “I have concerns looking at data that showcases how women are more impacted by child-care and elder-care constraints and what it may mean for retaining and attracting female talent long-term if we do not all take a more progressive stance in this space,” Annalisa Esposito Bluhm, head of executive and strategic corporate communications at General Motors, told From Day One.

“Here at GM, empathy is everything. It's difficult for so many and we have to provide flexibility for those juggling work with family-care issues,” she added. Bluhm offered a snapshot of the situation in the Detroit metro area and her own coping challenges: “Our district started the school year virtually and will assess at the end of October. We cannot find child care for our kids–all centers are at capacity. Nannies and tutors are in high demand and difficult to come by. Those who are available are commanding a weekly cash price north of $700 per week. There is no reality where I can find support and the only option I will have is to modify my work day to help my kids from 8:30 am to noon and then work from 1 pm to 6 pm and after they go to bed to make up the difference.”

What Are the New Boundaries?

One of the biggest ways for managers to help their employees, including parents, is to set forth work-from-home guidelines for managers and employees. Adi Ignatius, editor in chief of Harvard Business Review, praised the “work from home pledges” formulated by IBM and said his organization would be adopting them too. The guidelines include pledges to “be family sensitive,” “support ‘not camera ready’ times,” and “to set boundaries and prevent video fatigue.”

“This is a time when organizations can truly demonstrate what it means to have an inclusive culture,” Reneé Konzelman, VP of HR at Honeywell UOP, told From Day One. “Employees have to be agile and adapt to the challenges that these stay-at-home orders bring, and managers need to be flexible and understanding that the workday is no longer 9-to-5  given remote schooling obligations during the school day.”

Several experts emphasized to From Day One that corporations will need to develop a host of solutions to fit different needs. “This is new territory and there will be no ‘perfect’ answer,” according to Mikeisha Anderson Jones, VP of inclusion & diversity in the Colleague Experience Group at American Express. “Teaching (and remembering) about flexibility, creativity, resiliency, and agility will become even more important.”

“There is no magic bullet, rather a range of steps to help employers manage the stressors for employees,” according to Rich Maiore, president of Rocket Social Impact. “This includes flex-time and collective child-care, to mental-health apps and wellness coaching.” His firm has provided each employee with a $250 stipend to create a more functional home office or play space at home. He added: “I myself have turned my office into a panic room designed to keep pesky children out. It won’t win me Father of the Year, but may preserve my sanity.”

Appcast, a talent-recruiting platform, established a set of principles focused on fairness,  flexibility and clarity about goals and expectations, Leah Daniels, SVP of strategy, told From Day One. Among the most important: “Clear communication between managers and employees about each employee’s unique situation and how the employee plans to manage through it.”

Promod Vohra, chief talent strategy officer at the IT firm ACS, agreed that managers need to listen carefully to employees as they decide on new procedures. “I feel that in addition to developing broad policies, most of the employees may need individual attention, as everyone’s needs are different. We must have patience and time to hear them out. That will solve half of the problem. These are unprecedented and unpredictable times and no standard policy can cover all bases. I hope this will result in better relationships and loyalty,” he told From Day One.

Where Do Parents Need Help?

When it came to discovering employee needs, Robin Schroyer, health and well-being manager for CommScope, conducted a virtual listening tour. “We have a global employee population, and to understand more of what our employees are facing with their children (focused on 10 and younger), I held a series of focus groups, connecting with people around the world. I am still working to complete my qualitative analysis, but there are a few themes I have identified: vacation time, network connectivity issues in the home, quality of child learning, impact on youth psychological and social growth, health, money (childcare vs private schools), productivity, communication strategies and mental health.” Schroyer is working on solutions to many of the issues.

Managers need to make sure that in adjusting schedules and workloads to respond to the needs of some, they don’t let bias creep in. Appcast’s guidelines warn of this kind of thinking: “Don’t assume that primary parents or parents of young children are working less hard or that our employees with older children or no children are picking up the slack.” Daniels mentioned a few other current necessities: “A sense of humor, empathy and recognition that the best-laid plans can go south when there are small children involved.”

At a time when uncertainty and ambiguity are rampant, some companies have tried to bridge the information gap by creating a forum for sharing tips, resources and other information. At Zillow Group, where the company has been offering flexible hours to their staff, managers have also “set up parents groups and have brought in speakers to provide guidance on home schooling,” according to Scott Moore, the company’s senior manager of early-talent recruiting. Fortive, an industrial and tech giant, asked parents to share their own tips with each other, curated the information, and circulated a flyer across the organization, according to Shinder Dhillon, the company’s VP of inclusive and diversity.

Since the parenting crisis overlaps with a pandemic health crisis, companies have been considering both simultaneously. At Hewlett Packard Enterprise, “We’ve been focused on building our internal communities–parents, caregivers, those living alone,” according to Samanntha DuBridge, the company’s VP of global benefits and culture/engagement. “We are also providing additional days if needed for COVID and in the U.S. expanding our backup childcare. We’ve continued to add to our mental-health offerings and added Headspace,” the meditation app. At Southern California Edison, the company has offered 10 additional paid days off, on top of already existing vacation and sick time, for COVID-related care of the employee or any member of the family. The utility is also offering a stipend of $500 for home-office gear including ergonomic support, according to Liji Thomas, the company’s head of diversity and inclusion.

A new corporate charitable program that has been growing in popularity in recent years, the employee relief fund, could be a helpful source of funding to mitigate the child-care crisis. Such funds were inspired mainly by the need to help victims of natural disasters, but they can be used for other kinds of personal emergencies as well. Since March 15, E4E Relief, a nonprofit that administers these programs on behalf of employers, has awarded nearly $70 million in 100,000 grant awards to employees at its partner companies. In a time of COVID, such financial grants have helped families avoid personal crises like missing a rent payment or losing their child care, according to Holly Welch Stubbing, CEO of E4E Relief.

While many employers are rushing to address this crisis, only big and prosperous companies are likely to be able to pay for substantial solutions. A more sweeping response would require a philosophical sea change in how the U.S. deals with child care, which is exactly the demand of a new cohort of political activists: the “rage moms” who are sick of being expected to do it all. Senator Elizabeth Warren, who made child care a priority issue in her Presidential campaign, told the New York Times she has experienced a new surge in support for her position. “Right now, I think women have just had it up to their eyeballs. They no longer feel isolated and one-off in how they couldn’t figure out how to make the system work, and recognize the system is broken, and nobody’s making it work,” she said. “They’re fired up. And I love it.”

Steve Koepp is a co-founder of From Day One. Previously, he was editorial director of Time Inc. Books, executive editor of Fortune and deputy managing editor of Time


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ADHD in the Workplace: What You Should Know–and What Can Help

Pete came to our weekly psychotherapy session frustrated with work. He had just returned to his office, post pandemic, and found the new, open plan noisy and overwhelming. Pete, which is not his real name, has attention-deficit/hyperactivity disorder (ADHD) and is easily distractible and sensitive to noise. He had trouble concentrating, was irritated by the constant chatter of colleagues, and, as a result, was feeling less productive.“Could you talk to your manager about getting some accommodations?” I asked.“No way!” he said. “That would be a career killer.”Pete’s wariness is not uncommon. A few of my psychotherapy patients with ADHD have confided in their managers, but most feel it’s unwise to do so. They fear they will be stigmatized and sidelined.Edward Hallowell, M.D., agrees with their concern. The founder of the Hallowell ADHD Centers and one of the leading authorities on the disorder, explained to From Day One: “We’re not there yet. Most corporate professionals think of ADHD as some kind of mental illness.”Given that ADHD is not well-understood in the workplace, how can employees speak up about their needs in a way that feels safe? And how can managers and HR leaders better understand how to respond to those needs–whether employees want to name their ADHD, or not? A well-accommodated employee is, after all, a happier and more productive one. “It’s in everyone’s best interest to remove obstacles to someone’s performance,” said Hallowell. Here’s what experts recommend:Know What It IsADHD is a neuro-developmental disorder characterized by symptoms of restlessness, impulsivity and difficulty sustaining attention to boring tasks. It tends to run in families and is often inherited from a parent. There are three types: inattentive (dreamy and distractible), hyperactive-impulsive (restless and talkative), and a combination of the two. Most adults with ADHD have the inattentive type. Though it was long considered to be a childhood disorder affecting mostly boys, research has shown that it persists into adulthood—about 30% to 70% of children with ADHD continue to have symptoms later in life.Ned Hallowell, M.D., a pre-eminent expert on ADHD (Photo courtesy of the Hallowell ADHD Centers)An undiagnosed adult may think of themselves as spacey, messy, or undisciplined—and they often suffer from low self-esteem. A recent study found that only 10% to 25% of adults with ADHD receive an accurate diagnosis and adequate treatment. “They are often inaccurately diagnosed with anxiety or depression, which are really just the fallout of untreated ADHD,” said Ari Tuckman, a psychologist in West Chester, Penn., who specializes in the treatment of ADHD. As Hallowell puts it: “It’s like driving on square wheels.” In dealing with tasks, you will make progress, but it may take longer.And That the Diagnosis Is On the RiseWhile children are still the most likely group to be identified with the disorder, the number of adult diagnoses has been rising for decades. The pandemic accelerated the trend: the overall incidence in adults (30 to 49 years old) nearly doubled from 2020 to 2022, fueled mainly by an increase in diagnoses among women, according to Epic Research, a medical-record software company. While it’s not clear exactly why women are being diagnosed more often, experts theorize that it may be due to increasing smartphone and technology use, which can amplify distractibility and stress, as well as a greater awareness that ADHD can be also be a women’s issue. As more adults are diagnosed, they—like Pete—often face workplaces that are not ADHD-literate.How It Affects Work Performance–But Not Always in a Bad WayPeople with the disorder may have difficulty with organization, time management and procrastination—all of which can make it hard to meet deadlines and work within teams. They find tedious tasks, such as scheduling and filling out expense reports, unusually challenging and have a different sense of time than others. “People with ADHD have more difficulty seeing time and feeling the future,” notes Tuckman,More than half (56%) of adults with ADHD said they believe the disorder “strongly impacts their ability to succeed at work,” according to a 2008 survey by McNeil Pediatrics. A more recent survey by Akili, a therapeutic-technology company, interviewed 500 adults with ADHD and found that employees with ADHD felt the disorder had a negative impact on their career.     And yet, people with ADHD often display qualities that work in their favor, notes Hallowell, who himself has ADHD. He sees the condition as a trait, not a disorder, that has positive benefits like creativity, humor, and spontaneity. “There’s more to it than most people realize,” he said. “ADHD is terrible term. We have an abundance of attention. Our challenge is where to put our focus.” People with ADHD can spend hours on topics that interest them and see details that others might miss, a trait sometimes called hyperfocus. Many successful people have talked openly about their ADHD, including Michael Phelps, Simone Biles, James Carville, astronaut Scott Kelly and JetBlue founder David Neeleman.How to Get DiagnosedIf you persistently miss deadlines, are chronically late, and feel like staying organized is a big effort, first ask a trusted friend or colleague if they find you more scattered than others. Then, make an appointment to see a psychologist or psychiatrist who specializes in treating the condition. There is no one standardized test—instead a professional will take a thorough history and may ask family members and friends to complete questionnaires about your behavior. You may be asked questions like, How often do you misplace items, feel bored and restless, or lose track of what needs to be done? If you meet the criteria, your doctor may talk to you about medication, therapy or coaching and, if needed, provide a diagnosis so you can receive accommodations at school or at work.Understand What HelpsMost people diagnosed with ADHD rely on medication to control their symptoms. Typical medications include stimulants such as Ritalin and Adderall, which increase the levels of the neurotransmitters dopamine and norepinephrine in the brain. There are also non-stimulant drugs such as Strattera. Stimulant medications that treat ADHD are the “most effective of medications in psychiatry,” said Tuckman, and help tame distractibility and impulsivity. About two thirds of people with ADHD diagnoses are prescribed stimulant medications, and that percentage has remained fairly consistent since 2013, according to Epic Research. Some people can help manage their symptoms by exercising regularly, getting proper sleep, and implementing strict organization and reminder systems. Or they hire very competent assistants.Once you are diagnosed and have figured out the best treatment, it’s like “getting fitted for the right eyeglasses,” said Dr. Hallowell. “Things come into sharper focus.”How to Make the Workplace More ADHD-FriendlySmall modifications can go a long way to helping people with ADHD perform better on the job. Tuckman suggests considering adjustments in the three domains described below. As an employee, you can make tweaks on your own or ask your manager for help. As for managers, if you have a worker who is struggling with organization and meeting deadlines, you could take the lead at putting these practices into place.Make distractions softer. Quiet spaces, headphones, and working on off-hours (say, early or late), can help mitigate the clatter of a bustling office. Often working from home is a good solution.Make important information stand out from the chatter. Putting assignments in writing, recording meetings, and highlighting deadlines can help workers whose focus is not great to stay on task.Bring the future closer to the present. Those who struggle with adhering to deadlines will benefit when big projects are broken into smaller chunks, and check-ins are on the calendar with frequent reminders of when tasks are due.So, Should You Tell Your Boss?If you have ADHD, you may be covered under the Americans with Disability Act (ADA). However, you might not want to play that card unless you absolutely must, says Belynda Gauthier, a retired HR director and past president of Children and Adults with ADHD (CHADD). “The first time I did a presentation on ADHD in the workplace, I launched into detail about how the employee should approach his supervisor or manager and suggested that he might want to go directly to HR first. An audience participant interrupted to tell me that her HR office actually is the problem for her. Oops! I took this to heart, did some serious thinking, and revamped my presentation. I no longer recommend revealing one’s diagnosis until and unless it’s necessary.” Indeed, 92% of surveyed adults with ADHD believe that their colleagues hold misconceptions, the most common of which is “people with ADHD just need to try harder.” A better strategy might be to simply approach your manager with a positive attitude and a few solutions. “Be sure to tell them what you are good at,” advised Hallowell.Gauthier suggests something like: “I am really enjoying processing these widgets, and I think I’m doing a good job. I believe I could do an even better job if I could move to that cubicle that’s farther from the copy machine. So many co-workers use it all day and everyone stops to say hello.” Avoid the use of the word “but” to qualify your suggestions and don’t be whiney, she says.      Accommodations can help, but sometimes the best solution is finding the right job in the right environment with the right supports. “When I finally figured out I had it, it was a relief,” David Neeleman said in a recent interview with Forbes. “I was just really careful to surround myself with people that could complement my ADHD. I have people around me that help implement a lot of the ideas I have.” When you can turn your intense focus on something that truly fascinates you, ADHD can be a bonus rather a deficit.Lesley Alderman, LCSW, is a psychotherapist and journalist based in Brooklyn, NY. In her therapy practice, she works with individuals and couples. She writes about mental health topics for the Washington Post and has been an editor at Money and Real Simple magazines and a health columnist for the New York Times.(Featured photo by Valentin Russanov/iStock by Getty Images) 

Lesley Alderman, LCSW | May 15, 2024

Workers Want Weight-Loss Drugs, But How Can Employers Pay the Bills?

When consumers see splashy TV commercials for weight-loss drugs, they often find the the pitch irresistible. But for HR and benefits executives, they may trigger an uneasy feeling. That's because the revolutionary weight-loss drugs like Wegovy bring with them both magic and mystery–the magic is how well they can work; the mystery is how to pay for them.GLP-1, or glucagon-like peptide-1, drugs have historically been used to treat diabetes. But the development of stronger drugs like Novo Nordisk’s Ozempic in recent years, and now the approval of Wegovy and Eli Lilly’s Zepbound specifically for weight management, has led to a sharp increase in demand. That’s particularly true as more research emerges showing the drugs may also reduce the risk of cardiovascular disease, stroke, and potentially bring other long-term health benefits. Yet the medications can cost as much as $1,000 to $1,500 per month–a price that few Americans can afford unless they have generous health-insurance coverage.And unlike expensive drugs for rare conditions, the potential number of patients for GLP-1s is vast. More than 40% of Americans have obesity, according to the Centers for Disease Control and Prevention, and that is expected to reach 50% by 2030.Many doctors are thrilled about the potential for GLP-1s to change how obesity is treated, but that puts employers–where nearly half of Americans get their health insurance–in a tricky position. Here’s what employers need to know as they consider coverage for these drugs in the quickly changing landscape:High Costs, Low CoverageWhile employer health plans widely cover GLP-1s for the purpose of treating diabetes, coverage for weight-loss purposes is much more spotty right now. A survey last fall by the International Foundation of Employee Benefit Plans found that 27% of 205 employers covered GLP-1s for weight loss and another 13% did not yet cover them but were considering adding coverage. Meanwhile, Willis Towers Watson (WTW), a global insurance benefits-consulting company that serves many large employers, found about 38% of employers it surveyed cover the weight-loss drugs. Those that do cover them are seeing significant cost increases. The retail price for Wegovy comes out to $15,000 to $16,000 per year, and after rebates and discounts from manufacturers, health plans still pay about $9,000 per year, says Cody Midlam, a director at WTW’s pharmacy practice. The cost per member per month for GLP-1s has doubled each of the last three years, according to WTW’s analysis, amounting to an extra $11 per member per month last year, or about 9% of all pharmacy costs.Companies are aware of the research showing the drugs’ effectiveness at tackling obesity. Yet while doctors say that helping people lose weight could lead to less cardiovascular disease, fewer mental health issues, and savings from avoiding knee replacements or other surgeries related to obesity, long-term data on clinical outcomes remains limited. With high employee turnover in many industries, it’s tough for these employers to factor in potential future savings in healthcare costs over the life of the employee.“Those outcomes take a very long time to manifest,” says Midlam. “It’s not something that’s easily measurable on a short timescale when plan decisions are being made.” Andrew Witty, CEO of UnitedHealth Group, the largest U.S. insurer, said his corporate clients see the benefits, but first have to deal with the short-term costs. “We’re very positive about the potential for another tool in the toolbox to help folks manage their weight. We recognize that has potential benefits,” Witty said in the third-quarter earnings call last year. “But we’re struggling.”Employers Meet the DemandDespite the high costs and headlines about some insurance plans scrapping GLP-1 coverage, plenty of employers see the upside to covering the new obesity medications. Ninety-nine percent of companies already covering GLP-1s said they planned to continue doing so next year, according to a fall survey from Accolade, a healthcare navigation and advocacy company. Employers reported that after they added GLP-1 coverage, they saw higher employee satisfaction, increased engagement in other well-being programs, and improvements in other or comorbid health conditions. Midlam of WTW says his firm’s corporate clients want to “avoid member disruption” wherever possible.Doctors agree that should be a priority. Dan Azagury, M.D., medical director for the Stanford Lifestyle and Weight Management Center, says GLP-1s have been a “game changer” for many of his patients. “If you stop it overnight, whether it’s insurance, or financial, or shortages, the rebound is ferocious,” he said. “So it’s really very frustrating that they encounter that situation.” Some companies have expressed concerns about the idea of paying for a drug that employees essentially have to take forever to maintain its benefits. But while side effects, including vomiting and gastrointestinal issues, can be unpleasant for some people, doctors like Azagury say they know how to help patients manage them, and that they are seeing more patients have a positive response to GLP-1s than to previous generations of weight loss medications. Holistic Care, Not Just PrescriptionsEven when employers decide they want to help their employees lose weight, there are still lots of details to consider. As companies approach designing their insurance plans for 2025 and beyond, they are trying to figure out how many employees are likely to use GLP-1 drugs if coverage is offered, whether there should be limits on who can get the drugs, and what kind of requirements they should use to prove the drugs are medically necessary. Most companies that cover GLP-1s use some cost-control strategies, according to the International Foundation of Employee Benefit Plans survey. Many use prior authorization, step therapy during which patients must try lower-cost drugs first, or specific eligibility requirements.Typically, eligibility requirements have been tied to the standards on the FDA labels for these medications. But some employers are considering restrictions such as only covering the drugs for people with obesity but not those who are overweight, says Tracy Spencer, a pharmacy practice leader for benefits consultant Aon. If they add those limits, she warns that employers should be aware that could change or jeopardize the rebates they get from the drug manufacturers, so they need to predict whether the savings they get from limiting the drugs’ use will offset the loss of the rebates.Benefits consultants like Aon and WTW are also seeing employers shift the way they look at GLP-1 drugs to view them as one piece in a broader strategy to address cardio-metabolic issues.That might mean employers choose to cover the drugs for targeted indications, such as covering Wegovy not for weight loss on its own, but for people with increased risk of cardiovascular disease, which Medicare recently announced it would do. It can also mean pairing GLP-1 coverage with required lifestyle modifications or participation in a virtual weight-loss or coaching program. Employers often have access to virtual health programs through their pharmacy benefit managers, and many have tried these to target diabetes in recent years. The biopharmaceutical company Moderna, which offers coverage of GLP-1s for diabetes and weight management, is one company that has tried this strategy. “In 2023 we saw a spike related to weight-loss management: We looked at claims data, and after mental health, obesity and weight management were the second drivers,” Jeffrey Stohlberg, Moderna’s director of corporate benefits, said at a From Day One conference earlier this year. So the company started using the virtual weight-loss management program Wondr Health, where an employee can work with a physician specializing in weight loss. “It’s not a path to GLP-1s, but [the physicians] can provide medication for that person,” Stohlberg said. Labcorp also announced in February that it would provide U.S. employees on GLP-1s with virtual care and medication management through WeightWatchers for Business. Other companies such as Omada Health and telehealth providers like Teladoc and Ro have launched similar offerings over the last year. Medical providers agree that a holistic approach is needed, but Angela Fitch, M.D., president of the Obesity Medicine Association and co-founder and chief medical officer of the obesity-focused primary care startup knownwell, worries that requiring a standard weight-management program for every person is another barrier and potentially a waste of money if the program doesn’t have solid evidence behind it.“You can offer lifestyle [strategies] in addition to medication,” she said, “but it should be driven by that shared decision making discussion with the clinician.” If insurers want to make sure patients are getting holistic care, she would rather have them require patients to get their prescriptions from a qualified physician who does a true evaluation so that solutions can be personalized. In her role with the Obesity Medicine Association, Fitch often advises employers on their health plan designs, so she understands that costs are a major concern for companies. But in her primary-care practice and others like it, she says her staff are “burning out” as they spend hours each day trying to navigate all the new and often strict and confusing insurance requirements for these medications. “We have got to deal with costs,” Fitch said. “But it should be transparent and flexible.” She worries that overly rigid restrictions are “adding to the bias and stigma of obesity” by signaling to patients that their weight is their responsibility to treat on their own. Her major advice is to view obesity with the nuance that people view other chronic conditions. “You do not need a GLP-1 management solution. You need a comprehensive obesity-care solution.”Abigail Abrams is a health writer and editor. Currently she is the senior manager of content operations for Atria. Previously, she was a staff writer on health and politics for TIME magazine. Her freelance work has appeared in the Washington Post, the Guardian, and other publications.

Abigail Abrams | April 15, 2024

What Transparency Can Expose: an Obvious Need for Organizational Change

In the realm of corporate values, few terms have been more universally embraced in recent years than the notion of transparency. Among its many applications, organizations have deployed it to contend with sticky social matters and public scrutiny of corporate ethics.  At the World Economic Forum’s annual conference in Davos this year, speakers repeated the term like a mantra, reflecting a movement that has been building for a while. Fast Company reported that at the summit in 2021, more than 60 businesses announced a “commitment to transparency” about their effects on society and the environment. In response to pressure from stakeholders on all sides, executives from TikTok, Glassdoor, Google, YouTube, Zoom, Boeing, Twitter, and the White House have all made public commitments to transparency in recent years.Yet lately it has been dawning on leaders that this magic, window-cleaning solution can make things worse, especially if what has been exposed seems to be hypocritical, poorly thought-out, or further obfuscation rather than moral clarity. The most notorious recent example came last December, when the presidents of Harvard, MIT, and the University of Pennsylvania gave hedged, lawyerly responses when asked in a congressional hearing whether calls for the genocide of Jewish people would violate their school’s conduct rules. Their answers frustrated stakeholders on many sides of the issue.Seeing the havoc that failed transparency can wreak, Harvard is second-guessing the value of transparency, and is considering keeping mum on divisive matters altogether. The Harvard Crimson reported in February that the school’s interim president is expected to announce that the school is considering a policy of “institutional neutrality,” in which it will make no statements on politicized matters. Leaders at other universities are in favor, it appears. During a recent panel discussion on the matter, Yale Law School professor Robert C. Post remarked that “when we speak outside of our lane, we invite reprisals, we invite regulations, which we cannot defend in terms of our mission,” he said. “There may be reasons to do it. But they have to be pretty good reasons because we’re vulnerable, we're especially vulnerable right now.” The public is not ready to retire the notion of transparency, however, so organizations need to take a more considered approach to it and the policies that it exposes. “Corporate values aren’t optional, and they’re more controversial and contested than ever,” writes Alison Taylor in her new book Higher Ground: How Business Can Do the Right Thing in a Turbulent World. “[Yet] aiming to base your values on commitments on the full range of stakeholder pressures and demands is a recipe for incoherence and fragmentation.”This has become the principal dilemma for leaders who want to run an ethical business, argues Taylor, a clinical associate professor at the NYU Stern School of Business. “It shows up in HR teams doing employee engagement surveys and trying to make themselves look good. It shows up in these glossy sustainability reports about all the wonderful things [the company] is doing,” Taylor told From Day One. “The thing that has changed is that those defenses don’t work anymore.”The Age of Clarity and CandorThe theory is that if you bare it all, the company will be rewarded for its candor. “If a single concept drives today’s businesses, regulators, journalists, and NGO activists, it’s that transparency is the route to accountability,” Taylor writes in her book. Yet all this new data-dumping, press-releasing, and report-publishing hasn’t necessarily reconciled what companies say vs. what they do, though trust in business has generally grown over the years, especially when compared with trust in government. Yet company after company, ranging from Boeing to Wells Fargo, have taken a shellacking for saying that they’ve fixed problems when they haven’t actually changed the culture or system that caused harm in the first place.In fact, disclosure is easily weaponized, Taylor argues. The companies that release details of their ethical transgressions or corporate misconduct can put the target on their own backs. In her book, Taylor tells of the story of a clothing company, operating in an industry known for its negative environmental effects and human-rights violations, that published a list of its suppliers in the spirit of transparency. They were among the first picked off as the target of a class-action lawsuit alleging forced labor. “The retailer making a good faith effort to be responsible and accountable was first in line for denunciation and punishment,” Taylor writes.Contending with a Public Wary of Good IntentionsAs companies see that their attempt at transparency can get them in trouble, many flatten their reporting into glossy packets and palatable stories. Some disclosures are required by law, yet by and large, these reports are voluntary. To steel themselves against criticism, especially involved tricky issues, many organizations appoint leaders charged with improving company culture and creating a more equitable workplace: chief culture officers, heads of compliance and integrity, and leaders of diversity, equity, and inclusion (DEI). To be sure, many who sit in these offices are formidable forces. Figures like Yelp’s chief diversity officer, Miriam Warren, and Bumble’s founder Whitney Wolfe Herd set high bars for the influence executives can have on equity and integrity inside and outside an organization.But some of the leaders installed in these roles are faced with the uncomfortable truth that their position is corporate PR. Taylor sees this often: People take jobs and think of themselves as organizational change agents, only to find that senior leaders think of them as defense mechanisms to protect corporate reputation and, in the case of compliance teams, to deflect regulators.For instance, the chief diversity officer is typically charged with making the business more demographically diverse and equitable for people across every department at every level of the business, yet many of them work with very limited resources. It's no wonder that turnover for the job is high.From Token Hire to Meaningful InfluenceOnce a company decides that it won’t favor transparency more than change, good things start to happen. This is when those leaders originally appointed as tokens can use their positions. If Taylor were to find herself in a role and learn that her presence was manipulative PR, she said, “I would make an argument about transparency needing to adapt the organization to a new generation. You can’t control the narrative, so hiring a load of people to do window dressing has become a waste of money. We can’t rely on confidentiality agreements, and we can’t rely on telling a good story.”Companies have to assume that young workers in particular are ready to undercut nice, neat stories and pounce on corporate misdirection, she says. Where a glossy report no longer suffices, those once-impotent appointees can play a valuable role, holding the company accountable from the inside before an angry public holds them accountable in the open air.Now that the public is suspicious of public declarations of corporate goodness, “no one believes it. There’s a total ‘gotcha’ mindset. Everyone rolls their eyes, and now there’s all this greenwashing and woke-washing litigation,” Taylor said. “It’s a pointless investment. You need to stop treating these as messaging challenges and treat them as organizational strategy challenges.”‘A Less Varnished Assessment of Activities’Taylor’s Higher Ground is loaded with case studies, action outlines, and advice. Not only for avoiding corporate blunders, but also correcting the bad habits and outright crookedness that cause them. Be a “first mover,” setting the example for peers, she writes. Companies often wait until a public scandal to start talking, but this tends to create chaos. She cites the example of Google releasing its transparency report on how it works with law enforcement in 2010. “This was not the result of a specific scandal but an effort to correct widespread misunderstanding.” Its success was due in part to the company being clear about what it can and cannot influence.Sure, there will be companies that invite scrutiny with their reporting, but that’s why Taylor warns against bending too deeply to public opinion and impatience that lures firms into dangerous waters. Don’t succumb to the pressures of social media, which turn companies into reaction engines, she advises. Wait long enough, and sensationalized social-media storms pass. Similarly, transparency often generates “impatient calls for an issue to be addressed instantly,” when real change takes time.Finally, forget about having 100% control over the stories told about your company and control over the behavior of your employees, which some companies increasingly see as liabilities, as evidenced by the new popularity of surveillance tools.Taylor believes that many corporate leaders sincerely want to avoid superficial reporting and put-on commitments to transparency. In five years of speaking to investors about sustainability reports, Taylor writes, “they told me again and again how much they–and their companies–would benefit from a less-varnished assessment of activities.”Emily McCrary-Ruiz-Esparza is a freelance journalist and From Day One contributing editor who writes about work, the job market, and women’s experiences in the workplace. Her work has appeared in the BBC, the Washington Post, Quartz, and Fast Company.(Featured illustration by Fermate/iStock by Getty Images)

Emily McCrary-Ruiz-Esparza | March 24, 2024