Action on the social determinants of health through social enterprise

Roy, Michael J.; Lysaght, Rosemary; Krupa, Terry

doi:10.1503/cmaj.160864

Cited by 20 publications

(24 citation statements)

References 6 publications

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“…The provision of employment is a focus for many social enterprises. The health effects of social enterprise as an alternative to mainstream employment, particularly for people with mental illnesses or intellectual or physical disabilities, and/or as a gateway to either mainstream or supported employment for other vulnerable people most at risk of poor health outcomes, are starting to be better understood ( Ferguson, 2013 , Lysaght and Krupa, 2011 , Roy et al, 2017a , Roy et al, 2017b ). In this study we found that the meaning of work assumes different connotations depending on the type of organisation.…”

Section: Discussionmentioning

confidence: 99%

“…Previous research ranges from grey literature written by practitioners ( Boswell et al, 2009 , McDermid et al, 2008 , Westwater, 2009 ), to a growing body of (mainly conceptual) work by academics ( Donaldson et al, 2011 , Farmer et al, 2016 , Macaulay et al, 2017 , Roy et al, 2014 , Roy and Hackett, 2017 ). Recently developed conceptual models ( Macaulay et al, 2017 , Roy et al, 2014 , Roy et al, 2017a , Roy et al, 2017b ) employ tools and methods common in the development and evaluation of complex public health interventions (viz. Craig et al, 2008 ) to identify processes and causal pathways between certain social enterprise-led activities and potential impacts on different dimensions of health and wellbeing.…”

Section: Introductionmentioning

confidence: 99%

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Differentiating the effect of social enterprise activities on health

Macaulay

Mazzei

Roy

et al. 2018

Social Science & Medicine

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An emerging stream of literature has focused on the ways in which social enterprises might act on the social determinants of health. However, this previous work has not taken a sufficiently broad account of the wide range of stakeholders involved in social enterprises and has also tended to reduce and simplify a complex and heterogeneous set of organisations to a relatively homogenous social enterprise concept. In an attempt to address these gaps, we conducted an empirical investigation between August 2014 and October 2015 consisting of qualitative case studies involving in-depth semi-structured interviews and a focus group with a wide variety of stakeholders from three social enterprises in different regions of Scotland. We found that different forms of social enterprise impact on different dimensions of health in different ways, including through: engendering a feeling of ownership and control; improving environmental conditions (both physical and social); and providing or facilitating meaningful employment. In conclusion, we highlight areas for future research.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Differentiating the effect of social enterprise activities on health

Macaulay

Mazzei

Roy

et al. 2018

Social Science & Medicine

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“…Such complexity is a result of (i) the magnitude and the range of interacting components; (ii) the flexibility of the intervention and its fit with the local environment; (iii) behaviours, groups or levels and (iv) their outcomes ( Craig et al , 2008 ; Fletcher et al , 2016 ; Grant and Hood, 2017 ). It has been suggested that social enterprises have the potential to be a ‘non-obvious actor’ in the delivery of such complex public health interventions ( Roy et al , 2017 ; Calò et al , 2019 ), even where health is not part of the stated social mission of the organization ( Macaulay et al , 2017 ), however, more empirical evidence is needed to determine this ( Calò et al , 2018 ).…”

Section: Introductionmentioning

confidence: 99%

Social enterprises’ impact on older people’s health and wellbeing: exploring Scottish experiences

Henderson¹,

Steiner

Mazzei

et al. 2019

Health Promotion International

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The global aging demographic is putting pressure on state-delivered health and social care services. As the austerity agenda in the UK cuts state-funded service provision for older people despite increasing demand, social enterprise has become a politically and economically attractive model for the sustainable delivery of some public services. Yet little is known about the impact of social enterprise on the health and wellbeing of older people. In this paper we address this gap in understanding and consider social enterprise activities as complex public health-promoting interventions. Our study aimed to understand what impact social enterprise activities had on the health and wellbeing of participants aged over 50, and also how that impact was created. To achieve this, we conducted qualitative semi-structured interviews with a sample (n = 43) of staff, volunteers, clients and carers aged over 50 who were involved in activities delivered by three social enterprises. Using a thematic analysis to explore manifest and latent themes, two antecedents of subjective younger age emerged explaining how benefit was created, namely downward social comparison and identity. The social enterprise activities we studied benefited participants' health and wellbeing, impacting positively on participants' sense of purpose, social support, connectedness and inclusion. These health and wellbeing benefits can be considered as outcomes of complex public health interventions for older people, and we relate these outcomes to beneficial conditions within the intermediary social determinants of health. We conclude by discussing the future impact of social enterprise activities and current UK policy on the structural determinants of health.

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“…Notwithstanding the potential tensions and challenges in achieving this dual mission, many social enterprises are unable to remain profitable in the long term (Kay et al, 2016;Khieng and Dahles, 2015;Smith et al, 2013). Emerging research explores whether the provision of health services within SEs is also possible (Roy et al, 2017(Roy et al, , 2014(Roy et al, , 2013. Debates focus on whether SEs can be an alternative provider of healthcare (Hazenberg and Hall, 2016;Roy et al, 2013), to understanding how SEs affect health outcomes (Farmer et al, 2016;Gordon et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Should social enterprises complement or supplement public health provision?

Poveda

Gill²,

Junio

et al. 2019

SEJ

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Purpose This paper aims to explore how stable employment, company culture and tailored health, digital and core skills training provided by a social enterprise (SE) in the Philippines affect survivors of exploitation. Research shows survivors experience adverse social conditions and physical and mental health outcomes caused by their exploitative experience. Stable, decent employment has been identified as critical to their recovery and reintegration. This paper discusses the SE’s impact on the employees’ physical, mental and social health and behaviour. Based on our findings, the authors discuss the contribution of SE in improving health outcomes and providing health services and conclude that SEs should not replace but complement public health government programmes. Design/methodology/approach This paper uses mixed methods, presenting data from a longitudinal survey (household income, mental health and social well-being) and a follow-up qualitative study, which uses in-depth interviews and participatory videos to explore survey findings. Findings The quantitative analysis demonstrates positive, but gradual, changes in sexual and reproductive health behaviour; personal empowerment; and trauma, anxiety and depressive symptoms. The qualitative findings show how improvements in executive functioning, self-regulation and self-esteem occur incrementally over time. As their self-efficacy improves, employees need to avoid being overly dependent on the SE, to support their autonomy; therefore, access to complementary public health services is fundamental. Originality/value This paper focusses, to the authors’ knowledge, on a unique SE, which hires survivors of exploitation, without losing their competitiveness in the market.

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Action on the social determinants of health through social enterprise

Cited by 20 publications

References 6 publications

Differentiating the effect of social enterprise activities on health

Differentiating the effect of social enterprise activities on health

Social enterprises’ impact on older people’s health and wellbeing: exploring Scottish experiences

Should social enterprises complement or supplement public health provision?

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