How charities help to keep the country well

Say ‘health’ in the UK and the average person thinks of the NHS: of doctors and nurses and beds and medicine. Elections are fought and won more on ‘NHS policy’ than they are on ‘health policy’ more broadly.

Yet research shows that well under half, and maybe as little as 10%, of what makes us healthy is related to health care services. As a recent publication by the Health Foundation explains, there are many factors outside of health care services that make us healthy. These include social factors like our family life, our living standards, the quality of our work and financial circumstances. Health is as much about staying well as it is about accessing treatment when you’re ill.

This means that charities of all kinds, across the country, make a key contribution to the nation’s health even when that is not their primary purpose. For example, a charity improving access to decent housing or green spaces will support people’s health by improving the quality of their surroundings. But their impact on health often goes unrecognised. Only 4% of UK voluntary sector organisations’ activities are defined as health-related.

As a think tank and consultancy working to improve the effectiveness of the charity sector, we at NPC have valued the chance to work with the Health Foundation and the Institute of Health Equity (IHE) to better understand the role charities play in keeping the nation well.

How do non-health charities influence public health?

Our experience of working across the charity sector suggests that non-health charities have a distinctive role to play in reducing health inequalities. They tend to support some of the most marginalised groups to tackle the root causes of poor health. In contrast to a highly specialised health system, charities often engage people through a range of activities and services – building trusted relationships and taking a more holistic view of our wellbeing.

We wanted to help charities navigate the evidence base on the social determinants of health – from housing to employment, relationships to green spaces – and use it to support their work to reduce health inequalities. Our final report, Keeping us well: How non-health charities address the social determinants of health, designed to complement IHE’s comprehensive evidence review, provides a summary of this agenda and the key evidence in these areas.

How can evidence help charities improve their services?

We hope that making the evidence more accessible to charities will enable them to understand and even increase the impact they’re having on health outcomes. For example, a small charity working to develop social networks can read about the evidence that such networks positively affect both physical and mental health. Delving into more detail, the charity can look at how this happens through various mechanisms such as reducing stress, promoting feelings of purpose and encouraging healthy behaviours. They could then adjust services to maximise their impact on health: for example, increasing people’s control over how community groups operate so they feel a greater sense of purpose.

By understanding the evidence that is already out there, charities can focus on delivering against what they already know works, rather than demonstrating their health impact from scratch, given that this is not their main mission. This frees them up to deliver more of the great work that they already know they do.

Charities are a gateway to communities

Beyond the individual services that they provide, charities have a vital role to play in the wider conversation about our health. Their reach into different communities and their particular understanding of health makes them well placed to raise awareness of issues with the public and policymakers.

We believe that the impact of the sector’s work on health needs to be recognised and supported more widely if we are to improve health outcomes. We hope this recognition will also come from organisations who exist to support charities, including funders and umbrella bodies.

During challenging times for the NHS and for care services, and in a country still reeling from the consequences of austerity and stagnant real wages, charities are stepping up to tackle social inequalities and mitigate their effects. We hope that this is the beginning of a journey that will bring many rewards to the health of our citizens and help us progress towards better, more equal health for the nation as a whole.

Dan Corry (@DanRCorry) is CEO of NPC (@NPCthinks)