Macassa G. Responsible leadership styles and promotion of stakeholders’ health (Short report). SEEJPH 2019, posted: 07 March 2019. DOI 10.4119/UNIBI/SEEJPH-2019-207 Page 1 of 5 S H O R T R E PO R T Responsible leadership styles and promotion of stakeholders’ health Gloria Macassa1 1Department of Public Health and Sports Science, University of Gävle, Sweden. Corresponding author: Gloria Macassa, MD, Professor of Public Health and Epidemiology, Department of Public Health and Sports Science, University of Gävle, Sweden; Address: SE-801 76, Gävle, Sweden; Telephone: +4626648228; Email: Gloria.macassa@hig.se. Macassa G. Responsible leadership styles and promotion of stakeholders’ health (Short report). SEEJPH 2019, posted: 07 March 2019. DOI 10.4119/UNIBI/SEEJPH-2019-207 Page 2 of 5 Abstract The aim of this short report is to stimulate a conversation on the potential role to be played by responsible leadership in promoting the health and well-being of stakeholders (employees and society at large). The report first describes responsible leadership styles and then briefly discusses the potential connection with health promotion within the lens of the wider determinants of health and intersectorial collaboration. Integrative responsible leadership and health promotion share a common vision: to alter the economic, environmental, and social contexts in which decisions relating to health and well- being are made, thus affecting health equity. Keywords: health promotion; responsible leadership, stakeholders, sustainable development goals. Conflicts of interest: None. Macassa G. Responsible leadership styles and promotion of stakeholders’ health (Short report). SEEJPH 2019, posted: 07 March 2019. DOI 10.4119/UNIBI/SEEJPH-2019-207 Page 3 of 5 Responsible leadership Responsible leadership (RL) is a relational process between leaders and stakeholders aimed at establishing accountability in matters pertaining to organizational value creation (1). Pless et al. define leadership style as an observable behaviour that reflects different degrees of such accountability in executive actions and discussions (2), and argue that this behaviour could be evaluated by other people like subordinates (who are classical followers, peers, and external constituencies) (2). This short report looks at RL styles and examines how they can influence health promotion through Corporate Social Responsibility (CSR) strategies and processes in the organization. This approach to RL is supported by Doh and Quigley’s understanding of RL behaviour, which they see as going beyond “doing no harm” to contributing to value creation in relation to multiple bottom lines (3). According to Maak et al. (1) there are two RL behaviours with two distinct leadership styles: instrumental and integrative. Instrumental RL is centred on driving business, with a strategic focus on business performance (1) and less attention paid to non-core business issues (2). This style entails a personalized vision based on the achievement of organizational goals such as maximization of profits, growth, and dominance over the competition (1). Instrumental RL is also associated with weaker interactions with stakeholders, mostly based on key business stakeholders, employees, governments, and investors. Regarding relations with internal stakeholders (employees), instrumental RL is suggested to lead by objectives, setting high performance goals as well as focusing on managing employees’ performance and excellence to meet the defined goals (2). Relations with external stakeholders are suggested to come through economic means-end relationships (4) or beneficial in terms of power, or through relations with governments, legislation or media (for urgency issues). Instrumental leaders are rational, as they search for information about selected societal issues that they see as providing business benefits (2,4). In contrast to this, an integrative RL style is characterised by a balanced approach towards value creation, leading the business towards societal as well as business objectives (the so-called “double-bottom- line”) (1). Integrative responsible leaders use communication and vision statements as an active leadership tool to convey positive messages regarding societal impact, taking boundary-spanning roles and connecting with a large range of stakeholders (1,4).These leaders are connected to external constituencies, governments, and investors as well as being facilitators of collaboration between stakeholders from different sectors and industries. They can also facilitate inclusive processes in decision making, use moral reasoning and often make pro-social choices (1). The two leadership styles are summarised in Table 1. Can responsible leaders contribute to public health promotion? According to the World Health Organization (WHO), health promotion is the process of enabling people to increase control over and improve their health (5). Health promotion moves beyond the focus on individual behaviours towards a wide range of social, economic, and environmental interventions. It is strictly linked to the determinants of health and well-being which are known to be the conditions in which people are born, grow, live, work, and age. These conditions determine people’s chances for good health, and are sometimes called “the causes of the causes” (6). There is now a broader consensus that health is linked not only to behaviour or risk exposure, but also to how social and economic structures shape the health of the populations globally. Macassa G. Responsible leadership styles and promotion of stakeholders’ health (Short report). SEEJPH 2019, posted: 07 March 2019. DOI 10.4119/UNIBI/SEEJPH-2019-207 Page 4 of 5 Table 1. Responsible leadership styles Behavioural characteristics Instrumental leader Integrative leader Vision Personalized Socialized Focus of business leadership/Value creation Leading business with a focus on the financial bottom-line Leading business with a focus on dual-bottom-line Approach to leading Leading by objective setting Leading by mobilizing stakeholders Stakeholders relations/Scope of interaction Low degree of interconnectedness Boundary setting Reactive Narrow focus on powerful and urgent stakeholders High degree of interconnectedness Boundary spanning Proactive Broader focus on all legitimate stakeholders Decision making process/ Applied logic/Justification of choices Exclusive Economic cost – benefit logic Business case justification Inclusive Pro-social cost logic Logic of appropriateness Source: Adapted from Maak et al 2016 (1). I argue that responsible leaders, especially those with an integrative behaviour style, will be more likely to advance CSR strategies and processes that are inclusive and that involve collaboration with other stakeholders, in order to improve people’s health beyond the workplace. This inclusiveness and collaboration, which is a common feature of integrative responsible leaders, is very important in health promotion and is referred to as “intersectorial collaboration” (7). Since its conception, health promotion was always thought to advance intersectorial collaboration beyond the health sector in pursuit of improving human health (5). This view was that by creating partnerships with sectors beyond the health sector, countries could better address the underlying causes of the conditions that create ill health, and especially health inequalities (7). Business organizations, through their integrative responsible leaders, can help improve population health by collaborating in addressing the social determinants of health (e.g., tackling environmental, economic, social and health challenges) between and within countries in the era of sustainable development goals (SDGs). For instance, Macassa and colleagues viewed responsible leaders as posited to achieve mutually shared objectives (for internal and external stakeholders) based on a vision of business as a force of good for the many, and not only for shareholders and managers (8). It is argued that health promotion offers a great opportunity and means to achieve the SDGs by equipping and empowering individuals and communities and by promoting inclusive models of governance via advocating health policies and environments (9,10). The SDGs are the foundation for supporting global health and international development work in the years to come. CSR strategies promoted throughout integrative RL and health promotion share a common vision; that is, to alter the economic, environmental, and social contexts in which decisions relating to health and well-being are made, thus affecting health equity. Macassa G. Responsible leadership styles and promotion of stakeholders’ health (Short report). SEEJPH 2019, posted: 07 March 2019. DOI 10.4119/UNIBI/SEEJPH-2019-207 Page 5 of 5 References 1. Maak T, Pless NM, Voegtlin C. Business statesman or shareholder advocate? CEO responsible leadership styles and the micro-foundations of political CSR. J Manag Stud 2016;53:463-93. 2. Pless N, Maak T, WaldmanD, Wang D. Development of a measure of responsible leadership. Acad Manag Proceed 2014;1:12973. 3. Doh JP, Quigley NR. Responsible leadership and stakeholder management: influence pathways and organizational outcomes. Acad Manag Perspect 2014;28:255-74. 4. Hahn T, Pless L, Pinkse J, Figge, F. Cognitive frames in corporate sustainability: managerial sensemaking with paradoxical and business cases frames. Acad Manag Rev 2014;39:463- 78. 5. World Health Organization.The Ottawa Charter for Health Promotion. Geneva: World Health Organization; 1986. http://www.who.int/healthpromotion/co nferences/previous/ottawa/en/ (accessed: 12 February 2019). 6. World Health Organization Commission on the Social Determinants of Health (WHO CSDH). Closing the gap in a generation. Health equity through action on the social determinants of health. Geneva: World Health Organization; 2008. https://www.who.int/social_determinant s/thecommission/finalreport/en/ (accessed:14 February 2019) 7. Corbin JH. Health promotion, partnership and intersectorial collaboration. Health Promot Int 2017;32:923-9. 8. Macassa G, Francisco JC, McGrath C. Corporate Social Responsibility and Population Health. Health SJ. 2017;11:5:528. 9. Spencer G, Corbin JH, Miedema E. Sustainable development goals for health promotion. Health Promot Int 2018. DOI: 10.1093/heapro/day036. 10. Fortune K, Becerra-Posada F, Buss P, Galvao LAC, Contreras A, Murphy M, et al. Health promotion and the agenda for sustainable development, WHO Region of the Americas. Bull World Health Organ 2018;96:621-6. _____________________________________________________________________________________ © 2019 Macassa; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://www.who.int/healthpromotion/conferences/previous/ottawa/en/ http://www.who.int/healthpromotion/conferences/previous/ottawa/en/ https://www.who.int/social_determinants/thecommission/finalreport/en/ https://www.who.int/social_determinants/thecommission/finalreport/en/