The health and well-being impacts of a work integration social enterprise from a systems perspective

Abstract

Summary Recent research has drawn upon the social determinants of health (SDH) framework to attempt to systematize the relationship between social enterprise and health. In this article, we adopt a realist evaluation approach to conceptualize social enterprises, and work integration social enterprises in particular, as ‘complex interventions’ that necessarily produce differential health outcomes for their beneficiaries, communities and staff. Drawing upon the findings from four social enterprises involving a range of methods including 93 semi-structured interviews with employees, managers and enterprise partners, together with participant observation, we demonstrate that these health outcomes are influenced by a limitless mix of complex and dynamic interactions between systems, settings, spaces, relationships and organizational and personal factors that cannot be distilled by questions of causality and attribution found in controlled trial designs. Given the increased policy focus on the potential of social enterprises to affect the SDH, this article seeks to respond to evidence gaps about the mechanisms and contexts through which social enterprises promote or constrain health outcomes, and thereby provide greater clarity about how research evidence can be used to support the social enterprise sector and policy development more broadly.

Organisational structures and processes for health and well-being: insights from work integration social enterprise

“…Specifically, involvement in social enterprise improved people's mental health, self-reliance/esteem and health behaviours, reduced stigmatization and built social capital. Scholars are starting to explore the organisational features of social enterprise that enable them to achieve these health and wellbeing outcomes [10,29,30].…”

Perceptions of Health and Wellbeing Among Employees in a Work Integration Social Enterprise in Sweden

“…It is worth mentioning that they also pointed out that they learned their new work without much pressure and stress and that they were able to socialize and establish a social network with co-workers. Similarly, Joyce et al [28] found that employees they interviewed felt a strong sense of connection to other people employed in the organization. In a study carried out in Manchester, UK, employees working in an SE perceived that they had adequate control over their jobs, as well as flexibility and support, and that they were involved in decision making and had received appropriate training and development, all of which contributed to job satisfaction [52].…”

“…In relation to Work Integration Social Enterprises (WISEs), which are the target of this study, evidence shows that there is an association between their activities and improved wellbeing among users [23,28]. For instance, Barraket et al recently reported that, in Australia, WISEs can increase young people's access to employment and/or employability, improve their self-reported mental health and wellbeing, and positively influence healthier behaviours, including healthy eating, reduced smoking, and reduced drug use [23].…”

“…In addition, WISEs were reported to contribute to the improvement of young people's confidence and social skills in professional and personal contexts, as well as fostering positive new relationships and connections [23]. Also, WISE strategies and organizational processes in many cases influence health outcomes through having an impact on social determinants of health, such as employment and income, in turn offering a sense of purpose, structure, and opportunities for social cohesion and having a direct benefit on mental health (e.g., through improved self-esteem and social connection as well as reduced anxiety and depression) [28]. A recent study carried out in Spain found that different groups of employees created their own narrative of working in WISEs based on experiences of meaningful work; employees with no disadvantage experienced improvements in eudaemonic wellbeing (meaning and purpose) while those in disadvantage reported improvements in hedonic (happiness) wellbeing [29].…”

Best practices in evaluating work integration social enterprises for persons with intellectual disabilities: A scoping review

“…Given that there was no discussion of ‘best practice’ in evaluation of this field evident in the literature, these findings represent the first assessment of evaluative research related to SE and ID. It is possible that lessons could be learned from the broader SE field, particularly WISE related to other populations (e.g., Barraket, 2014; Hazenberg et al, 2014; Joyce et al, 2021). Nonetheless, this review yielded some useful guidance for evaluation planners in terms of the fit of methodology with research aims, and the strengths and weaknesses associated with evaluations conducted in an emerging field of study.…”