We have known for a long time that the economic prosperity of a place is linked to the health of its population. Recently, attention has turned to the role that economic strategies (the ways in which the economy is developed) and businesses (as key organisations within the economy) can play to improve health. However, these strategies have yet to be deployed at scale. For example, a recent report found that 85% of economic development departments were not as engaged as they could be in tackling the determinants of health.
At a recent Salzburg Global Seminar programme, ‘Bridging worlds: how can we use business and economic development strategies to support better health’, policymakers, business representatives, academics and civil society representatives met to explore these topics. Here are some key themes that emerged:
A wellbeing economy
The discussions at Salzburg were incredibly rich. Some participants viewed inclusive growth as a key policy objective while others discussed a lack of clarity around what this term means in practice. We were particularly struck by the idea of a wellbeing economy – an economy that is high equity, health-promoting, and environmentally sustainable.
We talked about specific interventions including the role of anchor institutions and employee ownership models. Anchor institutions can be hospitals, universities or businesses – organisations grounded in a place, which impact wellbeing through their procurement or employment practices. These are promising areas but further work is needed to build the evidence base on how these approaches will impact health.
Future of work – the ‘fourth industrial revolution’
The rise in insecure work and a lack of skills in the context of broad technological changes around automation and digitisation was considered. To address this, participants highlighted a need to develop positive policy responses, including the promotion of universal basic assets such as libraries, reskilling and strengthened workers’ rights. The extent to which we can plan for the future remains unclear.
A new model for business
Some discussions centred around the role of businesses. Questions arose around how to align values and incentives so that businesses have a fundamental role in promoting the health of their customers and employees, and through their supply chains. An alternative to the ‘corporate responsibility model’ is certification as a ‘b-corporation'. This entails a business expanding their bottom line of net profit to a ‘triple bottom line’ – people, planet and profit – and could be explored further in the UK.
The wide variation across the business landscape was highlighted as a challenge to ensuring cross-sector effective action. Ways in which investment could be tied to health impacts of business were explored, along with new investment vehicles such as Social Impact Bonds, which were felt to have had some success in cases where return on investment can successfully be generated.
How do we measure the success of economies and the health impacts of businesses? We discussed the need for measures that go beyond GDP, and considered the importance of measuring human relationships among multidimensional frameworks. New Zealand’s living standards framework is a key example of good practice.
We talked about the challenges of multidisciplinary working, such as engaging with complexity, short-term thinking and language differences. New principles for multi sectoral engagement were seen as a potential framework for governing such engagements. Power, control and intergenerational fairness were also identified as key issues.
Conflicting narratives are an obstacle to taking forward whole-system change towards a wellbeing economy. There was enthusiasm and support for developing new narratives that empower people towards successfully tackling some of the issues and transitions that we face.
The role of citizen engagement in envisioning economic futures was explored. This approach has the potential to ensure economic development decisions keep the best interests of citizens at their heart. Programmes in Ohio, USA were cited as successful examples. Challenges around successful scaling of grassroots and co-production values were also highlighted.
Additionally, the implications of diversity and inclusion, and the specific role of gender, were discussed. There is an opportunity for businesses to take an intersectional approach (one that recognises the multiple ways that a person might experience discrimination) to create inclusive economies.
How do we create change?
We were most struck by how broad and complex the challenges are. There are so many details and different perspectives, and the real challenge will be in implementing this work at scale. There is a need for more engagement and dialogue across existing key players and new partners to generate momentum for change, towards a high equity, health promoting and sustainable economy. Businesses have an important part to play in this.
We have commissioned the RSA and DEMOS Helsinki to explore case studies of alignment between economic strategies and health and will share our work later this year.
Please do get in touch – what do you think about these topics? Are you doing anything that you’d like to share? Or have you had similar challenges?
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This blog originally featured in our email newsletter, which explores perspectives and expert opinion on a different health or health care topic each month.