Developing methods to Evidence 'Social enterprise as a public health intervention'

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.

In seeking to develop the methods required to evidence 'social enterprise as a public health intervention', three main stages of work are required. The first stage (years 1-3) focuses on building a conceptual model of the input-output relationship, characterising how we might get from engaging with social enterprise activity to enhanced health for individuals or communities and the implications for what should be measured. In this programme of work, we propose to do this through two means: a history project, combining oral histories with interrogation of the Social Enterprise (Scotland) Collection; and a more contemporary analysis, involving systematic review as well as survey research and in-depth interviews with entities in the social enterprise sector in Scotland. The programme will then move (in years 2-4) to investigate the input-output relationship in three case studies, involving overarching organisations encouraging social enterprise activities in rural and urban communities and across various age groups in Scotland. This will involve mixed methods, quantitative elements exploring the feasibility of using broader measures of health-related well-being covering aspects such as sense of coherence, social capital and capabilities as well as more-regular measures of health. The final stage of the proposed research (years 3-5) will involve the design and application of quasi-experimental comparative studies of the impact on health and well-being of engaging with two large social enterprises, one aimed at enhancing tenancy sustainability in young adults and social isolation in older people and the other aimed at improving health and educational opportunities of young adults.

The main beneficiaries of the research, of course, would be individual clients and communities engaging with social enterprise activity. More directly, the users of the research are likely to be both the social enterprise sector and government departments interested in upstream-based health improvement. The sector will gain from having a much richer description of the benefits it provides to society, backed by better-developed methods to evidence the degree of benefit and, ultimately the evidence itself. In the shorter term, this will arise by ensuring the inputs of the social enterprise sector and other key partners are embedded into the research and its dissemination. Other key partners in the research are Glasgow Centre for Population Health (GCPH) and the Scottish Social Enterprise Academy. The supervisory team for each project would have an additional member from one of these two bodies.
An advisory committee will also be established with representation from the Glasgow Social Enterprise Network, Greater Glasgow and Clyde Health Board, Glasgow Homelessness Network, Local Housing Associations, Social Enterprise Scotland and Assist Social Capital. These organisations would participate in a Knowledge Exchange Forum, also involving other overarching social enterprise support bodies (e.g. SENSCOT (Social Enterprise Networks in Scotland) and Social Firms Scotland), to meet twice per annum to allow for contributions from the sector to the developing research programme as well as enhancing the ability of the programme in real-time dissemination and creating future research partnerships.
Government will be well-placed to consider the results of the research, given the existence of the Social Enterprise and Health Roundtable, of which the principal investigator is a member. This membership invitation was extended to the principal investigator precisely because of the research agenda of the Yunus Centre to which this proposed research programme is core. Obviously, for government, benefits are likely to be in the reform of answering the question of whether investments in social enterprise, and enhancement of the supportive environment for social enterprise, are worthwhile relative to other ways of spending scarce societal resource t enhance health and well-being.
Internationally, impacts will be realised through involvement of practice-based networks, such as Euclid, the European network of civil society professionals, SIX (the Social Innovation Exchange) and the Foyer Federation, of which Aberdeen Foyer is a part. SIX is a global community promoting of social innovation as a way of finding better solutions to societal challenges. Glasgow Caledonian University is one of six inaugural members of SIX's newly-established Global Council.
With respect to timescales, we have stated above that dissemination will be in real time, or rather ongoing, through the Knowledge Exchange Forum. This is because lessons will emerge in the short term as to how the social enterprise sector might portray itself in health and well-being terms. In the more medium term results will emerge from the case studies as to the nature of such benefits, how they are brought about and what their extent might be. This last issue, of extent, will be firmed up in the final phase, leading up to year 5. Of course, as upstream public health interventions, such 'firming up, will be indicative only, with further benefits to arise beyond the programme (if potential is confirmed) not only from the interventions evaluated but the grand collaboration across academia and social enterprise practice created.