Social enterprises—businesses that reinvest profits into a social mission rather than paying shareholders—are being tested as a way to narrow the UK’s widening health gap between rich and poor communities. The problem is stark: despite decades of policy, health inequalities linked to deprivation, unemployment, and financial exclusion continue to grow. Social enterprises already operate in many deprived areas, tackling issues like joblessness and debt that are known “upstream” drivers of poor health. But no one has rigorously measured whether they actually improve long-term health and well-being. This research aims to build the tools to find out. If successful, the project will produce a framework for evaluating social enterprises as public health interventions—not just as alternative health-service providers, but as organisations that address the root social causes of illness. The researchers will test these methods in long-term, mixed-method studies across Scotland and the rest of the UK, and create a Knowledge Exchange Forum to ensure findings are usable by policymakers and practitioners. The result could be a new, evidence-based way to invest in community-level health improvement, shifting public health strategy beyond clinics and into the fabric of local economies.
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This application is driven by recent thinking about the potential for social enterprise to operate between, and in partnership with, traditional private and state sectors in addressing the societal challenge of persistent and widening health inequalities. Such inequalities are compounded by, and related to, continuing high rates of deprivation, unemployment, worklessness and financial exclusion in the poorest communities. Many parts of the UK suffer disproportionately from such challenges. Despite acknowledgement of such relationships, gaps between best and worst off continue to grow. The research proposed here seeks to develop methods aimed at discovering the extent to which social enterprise can remedy this growing disparity. Social enterprises are trading organisations with a social mission, no share ownership, and whose surpluses are directed back towards the mission. Despite a long history in many economies, little is known globally about longer-term impacts of social enterprise on health and well-being. In addressing this knowledge gap, this proposed research would be distinctive through building an original programme around the notion of 'social enterprise as a public health and well-being intervention'. Of note, this programme would go beyond the recent focus on social enterprise simply as an alternative provider of health services; the cutting-edge thinking, here, being that, in addressing many aspects of social vulnerability, almost any social enterprise might claim to act on 'upstream' social determinants of health. The programme proposed would build on three main pillars: theory building and creating conceptual frameworks for evaluating social enterprise in health and well-being terms; applying such frameworks in empirical studies, particularly those of a longitudinal mixed-method nature, embodying quantitative and qualitative methods, permitting as rigorous an attribution of outcomes to interventions as possible; and addressing issues of generalisability through collaboration with a wide range of the social enterprise sector and creation of a Knowledge Exchange Forum to address relevance across throughout Scotland the rest of the UK.
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