The last couple of weeks have seen my research move very much into the final phase as I completed my data collection for one stream of my research, and am working on drafts of a paper for the other. As I have the tentative results of each swimming around my head, things are starting to fit together and the language I have used in each has become particularly interesting.
The paper I am writing is on my analysis of social impact reports (Social Accounts and Social Return on Investment) to establish the ways in which organisations conceive of their impacts upon individuals and communities. It considers whether social enterprise can be deemed a ‘non-obvious’ health intervention- impacting upon people’s health without necessarily intending to, or recognising it. A number of recent public health experts have indicated that the harnessing of such interventions (and the institutions that deliver them) could be a solution for the future of public health provision. It does appear that social enterprises can and do impact on a number of factors within the lives of individuals and communities which have been strongly linked to improved health, although they may not have considered that their overt goal.
What struck me about the term ‘non-obvious’ was its subjectivity. To whom is it non-obvious? And what about the people who intuitively recognise the health impacts (and therefore consider it ‘obvious’)? The reports I looked at were informed by research conducted with a variety of different stakeholders, and ‘audited’ or ‘assured’ by an external observer, but fundamentally written by, at most, only a handful of staff at the organisation. If those particular members of staff did not recognise those impacts as health-related, or simply held a different perception of what constitutes health, does that make those impacts non-obvious, or simply not considered?
The second stream of my research consisted of interviews with numerous stakeholders around three social enterprise case studies. Comparing similar stakeholders across the case study organisations it can be seen that those working in the council or local NHS often do recognise the health impacts of organisations, and indeed commission services directly from them. Social enterprise leaders often see a holistic view of individual and community health, recognising the wellbeing impacts of the work they do. Indeed that is often why they do it. Staff and service users with a personal view of the work of social enterprises can recognise the impacts on people’s lives and can conceive of impacts upon health, tending to consider these in terms of noticeable changes in physical or mental health outcomes.
So when all of those with a knowledge of the work and impacts of social enterprises can recognise their impact on health, and when academic theory recognises that the impacts upon numerous ‘intermediate outcomes’ can have a direct impact on health, to whom is it non-obvious? Hopefully one of the outcomes of the CommonHealth project will be to fire the starting gun on shifting the perception of social enterprise from that of a ‘non-obvious’ to an ‘obvious’ public health intervention, reflecting the thoughts of the individuals and organisations that have contributed to my research.