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

Abstract

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.

Social Enterprise, Population Health and Sustainable Development Goal 3: A Public Health Viewpoint

“…This can occur by acting on and modifying the economic, social and environmental challenges communities’ face, which in turn can help promote health and wellbeing and improve quality of life among children, adolescents, working adults and the elderly across countries, societies and generations. Although social enterprises have been studied as upstream intervention on population health and wellbeing (e.g., women, and elderly), these studies have not been linked to sustainable development frameworks and SDG 3 in particular [ 29 30 31 32 33 ]. Therefore, social enterprises present an opportunity to engage businesses as partners in health promotion and achievement of sustainable population health and sustainable and inclusive societies and for all segments of the population (specifically the most disadvantaged).…”

“…Various scholars have argued that SEs can help address the social determinants of health towards the achievement of health equity [ 29 30 31 32 33 ], which in turn will contribute to attainment of the SDGs and, specifically, SDG 3. This may occur as an upstream intervention through a “set of actions with a coherent objective to bring about change or produce identifiable outcomes [ 34 ].”…”

“…It is argued that no matter how good the local health system, access to that system and the lifestyles of individuals are dependent to a very large extent upon factors in the social environment. Rather than acting on individual risk factors such as smoking, alcohol, diet, and exercise (a pathogenic approach to health), SEs address inequities more broadly by acting on the social, economic and environmental circumstances of the most vulnerable members of society [ 29 30 31 32 ].…”

“…women and elderly) using the upstream approach (intervening on the social determinants of health) have been carried out in high income countries (e.g. UK, Australia and United States) [ 30 31 32 33 ].…”

A systematic scoping review of community‐based interventions for the prevention of mental ill‐health and the promotion of mental health in older adults in the UK

“…Table 3 details these study designs, outcomes measured and evidence of effectiveness reported. The vast majority of studies had adopted mixed methods (n = 21: Beech et al, 2017;Camic et al, 2013;Camic et al, 2014;Clift et al, 2012;Dayson & Bashir, 2014;Devine et al, 2020;Gandy et al, 2017;Greaves & Farbus, 2006;Haighton et al, 2019;Hallam & Creech, 2016;Hemingway & Jack, 2013;Hind et al, 2014;Houston et al, 2000;Middling et al, 2011;Moore et al, 2015;Mountain & Craig, 2011;Orellana et al, 2020;Sextou & Smith, 2017;Todd et al, 2017;Vogelpoel & Jarrold, 2014;Wilkinson et al, 2020) or qualitative methods (n = 19: Andrews et al, 2003, Callan, 2013Cattan et al, 2011;Cotterill & Taylor, 2001;Gardiner & Barnes, 2016;Chatters et al, 2017;Goulding, 2013;Heenan, 2011;Henderson et al, 2020;Houston et al, 2000;Lang & Brooks, 2015;McGeechan et al, 2017;Moffatt et al, 2017;Mountain et al, 2008;Mountain et al, 2017;Preston & Moore, 2019;Skingley & Bungay, 2010;Wildman et al, 2019;Wilk...…”