ESG performance, financing constraints, and workplace health investment: evidence from Chinese biopharmaceutical enterprises

Background Workplace health promotion (WHP) is critical for occupational health management, yet empirical evidence on determinants of corporate health investment remains limited. This study examines whether ESG performance promotes workplace health investment in Chinese biopharmaceutical enterprises and investigates the mediating role of financing constraints. Methods Using panel data from 55 A-share listed biopharmaceutical companies (2015–2023, 495 firm-year observations), we employed fixed effects models with manually collected health expenditure data. The three-step method tested financing constraints as a mediator. Heterogeneity analyses and multiple endogeneity treatments were conducted. Results ESG performance significantly promotes workplace health investment ( β = 0.0024, p > 0.01), with financing constraints mediating 20.8% of the total effect. The Social dimension shows the strongest association. Effects are stronger in non-state-owned enterprises, high R&D intensity firms, and vaccine/blood products companies. Health expenditure reduces R&D personnel turnover and enhances innovation output. Conclusion ESG performance effectively promotes workplace health investment by alleviating financing constraints, providing empirical support for integrating occupational health promotion into corporate sustainability strategies. Theoretically, this study bridges corporate finance and occupational health research by revealing the transmission mechanism of “ESG → financing constraint alleviation → workplace health expenditure.” Practically, the findings suggest that ESG improvement can serve as a market-based lever for promoting organizational investment in employee health programs.