The Health Foundation’s latest quick guide, What makes us healthy? An introduction to the social determinants of health highlights eight social and economic factors that influence people’s opportunities for good wellbeing and health and the wide range of sectors that need to take action to improve people’s health and reduce inequalities.
Yet, when health outcomes are still commonly regarded as the responsibility of health care services, how do we motivate the wider action and investment that is necessary to improve and maintain good health? Their new Social and Economic Value of Health research programme aims to build some of the evidence needed to engage and motivate cross-sector action.
The chicken and the egg
We know a lot about the impact of the social and economic determinants on people’s health (indicated by the outline arrow in the diagram below).
However, the relationships are complex and dynamic, and little is understood about the other direction: the impact of people’s health on the economy and society (the solid arrow). While there is ample focus on the burden of illness – what ill health costs us both as individuals and as a society – there is rarely acknowledgement of the converse: that good health is an asset, essential for a flourishing society and economy.
While this diagram is an extreme simplification, it illustrates the potential to establish virtuous cycles of improvement in health and in social and economic prosperity, as well as vicious cycles that can perpetuate health and socio-economic inequalities if we fail to invest in improving and maintaining good health through action on the social determinants.
For example, good wellbeing and health through childhood can support an individual’s attendance at school, and better educational attainment. This can then help them to get into good employment, which we know is a positive influence on health. Continued good health can support ongoing labour market participation and earnings, which in turn provides increased opportunity to maximise their health potential – for example by affording good housing in a safe area, that provides opportunities to be active and consume a healthy diet. And so the cycle continues…
The complexity of this relationship between health status and socio-economic factors is a reason for our lack of understanding of the impact people’s health has on society and the economy. When things influence each other in this way, it is difficult to establish what is causing what (a bit like the chicken and the egg), or where changes in both are simultaneous results of something else entirely.
As part of their work to help us understand the impact of people’s health on society and the economy their new Social and Economic Value of Health research programme will take a close look at the relationship between health status and socio-economic factors, and try to establish the causal impact of a person’s health. They have awarded six projects funding for up to three years to help build evidence and understanding about the contribution that individuals’ health status makes to their social and economic outcomes, as well as those of their close family members.
Their findings will help develop a clearer rationale for action on the social determinants of health, that is consistent with the maintenance of good health throughout people’s lives, and equitably across the population.
You can read the full article here https://www.health.org.uk/blog/building-evidence-around-social-and-economic-value-health