US Health care services

We have developed a differentiated view on material environmental, social and governance (ESG) issues in the US health care sector.

Grounded in decades of experience

Our health care services investment framework is a tool to guide our investment analysis, track key ESG issues, and engage with management teams. It was created by our fixed income and equity analysts who have an average of 14 years' experience in the industry.*

Cheryl Frank, Capital Group portfolio manager and analyst, shares her perspective on the key issues that create and destroy value in the US health care sector.

Zeroing in on what matters

Our health care services analysts created this US-focused framework using their considerable global-sector experience, our proprietary research, issues identified by the Sustainability Accounting Standards Board (SASB), and engagement with companies and issuers.

From a comprehensive set of inputs, they prioritised the social and governance categories of consumer wellbeing and corporate governance as material to the long-term sustainability and success of health care companies.


  • Climate change risk

  • Natural resource management

  • Pollution & waste management

  • Environmental opportunities


  • Human capital management

  • Consumer wellbeing

  • Social opportunities


  • Corporate governance

  • Corporate behaviour

Consumer wellbeing

Our analysts concluded there are three critical factors when considering consumer wellbeing: safety, access and privacy.

Corporate governance

Our analysts prioritised governance issues they believe may affect the company's dedication to ESG broadly: ethics, integrity and accountability.

Management quality, ethics and accountability



Identifying management teams with steadfast integrity is essential to long-term success. Management ethics are a key lens through which to understand all other ESG issues.


Best practices:

  • Management incentives linked to patient outcomes

  • Culture of regulatory compliance in law and spirit

  • Culture anchored in community service and social well-being

Our evolving approach

As one component of our three-part approach to ESG, our investment frameworks are continually evolving. Through our monitoring process as well as engagement and proxy, our analysts continuously gather and incorporate new information.

*Average years of experience for the seven equity and fixed income analysts who worked to create the health care services research framework. Calculated as at 30 June 2020.