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Integrating ESG indicators into public health governance as a policy innovation for institutional accountability: a
Pierluigi Catalfo1, Daniele Virgillito1, Giuseppe Messina2
1Department of Economics and Business, University of Catania, Catania, Italy.
Objectives:
To examine how ESG indicators and related frameworks are being translated from corporate disclosure into public health governance.
Methods:
Following PRISMA-ScR and the PCC framework, we synthesized 25 studies and grey-literature documents to map definitions, implementation levels, governance uses, barriers, and research gaps. ESG integration was defined as the use of environmental, social, and governance indicators to support accountability, transparency, stakeholder engagement, sustainability alignment, and strategic control in health systems.
Results:
ESG-related frameworks may strengthen reporting practices, multisectoral coordination, and alignment with the Sustainable Development Goals when supported by leadership, technical capacity, harmonized indicators, and standardized reporting systems. However, the evidence remains heterogeneous and exploratory. Direct effects on governance performance, health outcomes, or equity are rarely demonstrated. Key gaps include unclear conceptual boundaries between ESG, CSR, SDG monitoring, and sustainability reporting, limited appraisal of reporting versus actual performance, measurement inconsistency, and under-representation of low-resource and Global South contexts.
Conclusion:
Future research should validate sector-specific ESG indicators and evaluate whether ESG integration improves accountability, equity, and sustainable public health governance.
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