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Guidance, Please: My Profits or Your Health?

Many of my pre-packaged retirement portfolio options include holdings in tobacco companies. It seems the majority include investments in oil. What’s a self-proclaimed advocate of public health to do?

I must be a grown-up. It's 12:30 A.M. and I'm reviewing my 401(K) retirement options, contemplating what life will be like when I'm 60. In addition to providing me with an unpleasant reminder of my mortality, this process has highlighted the tension between private interests and the public's health.

Many of my pre-packaged portfolio options include holdings in tobacco companies. It seems the majority include investments in oil. What's a self-proclaimed advocate of public health to do? Go with the blue chips stocks, which would in effect mean hoping that more people smoke and drive instead of bike or walk, or stay true to my values and take my chances on soy bean futures? I'm betting on the bean, but some other, much larger, self-proclaimed advocates of health and well-being have taken the other route.

Such corporate behavior seems contradictory. If health and life insurance companies ostensibly promote themselves as stewards of health and well being, how can they legitimately invest in industries that have proven so harmful to public health?

Well, as the authors of these studies point out, we shouldn't be that surprised. By nature of their existence, corporate entities are driven by one thing and one thing alone: profit. This is not amoral; it is just the nature of the beast. Furthermore, the ability of health insurers to selectively deny policies to people who smoke and are overweight enables them to avoid paying for the downstream health consequences of their billion-dollar investments. (Health insurers will no longer be able to do this when key provisions of the Affordable Care Act are scheduled to take effect in 2014).

What do you think? Are you a doctor, nurse, or other type of health care worker who has a professional, and personal, interest in public health? Do your retirement investments include stock in tobacco, fast food, or other such industries? Do you consider this to be a conflict? What can be done about it?

Read more about The Public's Health.

What the authors of these studies do not discuss, however, is how such competing interests play out at the individual level, in effect giving people who work in health and wellness a choice:  their own long-term financial security vs. the health of the larger community.

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