Social systems across Europe are under immense strain. This includes the health system, facing – amongst other challenges –chronic staff shortages, insufficient and inefficient funding, and rising service demands, all of which have been worsened by recent syndemics. There is much discussion about health system resilience, but a truly resilient health system will only come from a more resilient, healthier, and more equitable society. But could social innovation help us to draft a ‘new social contract' to strengthen our health and primary care systems?
Reacting to social trends
Social innovation has the potential to be effectively applied across different sectors, including the public sector. Yet, established institutional conventions, structures and procedures may no longer provide adequate solutions to the health and social challenges we face. Therefore, social innovation frameworks or initiatives provide a social platform where social learning and experimentation can reshape public policy. This provides the opportunity to improve welfare and wellbeing, as well as the opportunity to put health equity higher on the political agenda.
Public policy has long been an area affected by change. However, public policy often reacts to social trends or upheavals, rather than prompting change from within. In recent times, an unprecedented ‘polycrisis’ has sparked calls for a more visionary and proactive public sector – including a more visionary public health sector – enabling these sectors to pre-empt and mitigate crises.
New, visionary paradigms and models such as the ‘Economy of Wellbeing’ invert established conventions and structures to address the root challenges which drive social and health inequalities more effectively. Applying social innovation, including social movements, social service innovations, social business model innovations, or digital social innovations, can identify and promote practical ways to implement new social models which contribute to the desired outcomes of improved welfare and wellbeing for all.
A change for the better?
The acronym VUCA - standing for volatility, uncertainty, complexity, and ambiguity - has most frequently been used in military education to reflect on challenging states of affairs. However, its use in strategic leadership discussions to address problems across diverse sectors is on the rise. Recognising and accepting the challenges of a ‘VUCA world’ - a world that faces systemic challenges - can help public health and civil society leaders to be prepared to design and adapt to new ways to deliver health and wellbeing. It can also support the adoption of an agile organisational culture and agile collective mindset, which could be considered an important social innovation in the public sector.
In times of crises, we are provided with the prime opportunity to re-evaluate our existing systems and redevelop and invent structures and processes that can respond to highly dynamic and uncertain environments. Without constant innovation, the complex challenges facing Europe and the world will certainly increase inequality gaps.
Under conditions of extreme social uncertainty, adopting an agile culture and mindset can help find solutions for pushing health promotion forward.
Bridging the inequality gap
Using social innovation models, enables us to learn and implement the design, and testing of transformative processes faster. Such processes can help to develop urgent solutions to improve health equity. Conventional approaches that address health equity via health promotion may not keep pace with growing inequalities. Similarly, these approaches may cause greater social inequalities by driving social instability and unrest as they may not achieve impact on the appropriate timeline to curb this. Social innovation is a promising driver towards finding better solutions faster. It creates solid health values in terms of quality of life, wellbeing, and health equity, and supports upward convergence and social cohesion.
Reaching communities
Established institutional structures and routines that handle environmental, societal, and economic challenges do not lead to sustainable solutions. Social innovation has the potential to weave societal wellbeing into rising entrepreneurial activity within our communities.
Both social innovation and social entrepreneurship are emerging as vital tools by which interventions designed with a socially useful impact can reach the most vulnerable in our societies - reducing inequalities through social cohesion and employment. This rising effort to solve problems such as living conditions on a more local basis, along with added political awareness, provides strong framework conditions for social entrepreneurs to promote social innovation.
The European Commission sets out various funds to grow this innovation as was adopted by the Social Business Initiative (SBI) in 2011. Through grants such as the EU Programme for Employment and Social Innovation (EaSI) and European Fund for Strategic Investments (EFSI) Equity Instrument, social enterprises have access to investments at both the national and regional level. Last year, a report released by the Commission explored the impact of the SBI and its outcomes on the development of social enterprises, touching upon the effect of social innovation in the fight against inequalities.
Applying social innovation tools
One instrument employed in social innovation is strengthening social support and social influence. This mechanism can build bonding and bridging social capital which is positively related to health and health equity.
Community-based social innovation focuses on functioning structures and processes that recombine and align community resources. Such community innovation mechanisms can support those most vulnerable and those living in the most deprived areas of our societies. In this instance, community-based social innovation can empower individuals to improve their self-efficacy and help bridge the inequality gap.
Community-based solutions
There are some leading examples of community-based social innovation enterprises across Europe that promise to shed light on encouraging practices centred on social innovation, using bottom-up approaches and partnerships that have a social core.
Social innovation practices are encouraging approaches for addressing health promotion, utilising new knowledge that can drive institutional and behavioural change. Being categorised into several different types, from social movements, social service innovations, social business model innovations to digital social innovations, grants them the ability to link practice and society, improving social and health promotion, whilst simultaneously impacting health inequalities.
Professor Martin Dietrich
In 2016, Dietrich took over the position of Deputy Director of the BZgA. In 2017 and 2018, he also headed the BZgA department “Support for Health Promotion and Prevention by the Statutory Health Insurance Funds in Various Settings”. In 2018, Martin Dietrich also took over the management of the BZgA unit “Overall Planning, Coordination and Control, Central Project and Quality Management, Task Force”, which he initiated, and since mid-2020 has also been Deputy Head of the BZgA unit for communication methods and new media in health education.
In 2010 Dietrich was offered a W3 professorship in Business Administration, with a specialisation in Health Services Management Research, at Saarland University, which he took up in 2011. There, his thematic focus was on innovation and health services development. After moving to BZgA, he was appointed honorary professor at Saarland University in 2017. As an academic, Dietrich has worked in particular with methods of quantitative and qualitative empirical social research on behavioural and social science approaches in health services management.