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Social health: the forgotten pillar of health and wellbeing… until now

I suspect most of you reading this will be familiar with the four pillars of health wellbeing: physical, mental, financial and social. I’ve lost count of the number of Robertson Cooper clients who have used them to guide the design and implementation of a health and wellbeing strategy. And yet in the execution, it was always that last one, social health, which felt like the runt of the litter – less well defined than the others, harder to measure and elusive in terms of creating meaningful outcomes. This, in stark contrast to clearly defined and measurable efforts to support and develop the other three pillars.

But now, of course, that has all changed. Our social fabric has been challenged in a way that most of us can’t remember ever happening before, with infrastructure and institutions upon which we rely (schools, nursery, transport, shops, gyms, pubs, coffee shops, restaurants and more) quite simply not there anymore. We’re all dislocated from many people we’re used to seeing on a daily and weekly basis and thrust into the bosom of our own families (which, it goes without saying, has a potential upside).

As a result of all this, the idea of social health is now fully centre stage but – much like an under-funded public service – when its time comes do we really understand it well enough and know the right levers to pull to protect and enhance it?

As early as 1947, the WHO included ‘Social Health’ in its definition of overall health. Back then they saw it in terms of social adjustment (the efforts we each make to align with society’s standards so that we’re accepted), social support and our capacity to perform ‘normal’ roles in society. This take on social health sounds a bit dated now – but it does have relevance to our current situation.

Social adjustment has just been turned on its head – what are the norms and ‘standards’ to which we’re now aligning in order to be accepted by society?! As we all know, it’s very much shifting sands and ‘day-to-day’ out there in society right now – and to an extent inside businesses, but there is a clear implication for employers here. That is, the clearer you can be about your new standards and expectations the easier it will be for your employees to align and feel (relatively) comfortable with them while we work through this crisis.

Equally, social support is more relevant than ever – we can’t ‘put an arm around’ a family member, friend or work colleague the way we once could, but that doesn’t mean we don’t still need social support. In a work context, a lot has been said (and sold!) about the role of tech and virtual meetings in this crisis but I would suggest that, while these are obviously useful tools, they are not an answer in and of themselves. Think about what social support really gives you in normal times, think about how much of that is covered by your daily team catch up on Zoom – what’s missing? From my perspective it’s something about the difference between interactions that are transactional (‘in and out’) Vs ones that ‘surround you’ during your whole working day. Sure, on Zoom you can get the work done and have the conversations required, but something is lost for each of us.

Finally, is the idea of ‘performing our normal roles in society’. Self-evidently this has changed for most of us beyond recognition – thousands of teachers who can’t teach, millions of parents turning their hand to home schooling, furloughed employees switching to work in 999 call centres, electricians driving Tesco delivery vans and nurses denied the ability to provide the levels of care upon which they pride themselves. Changes like these are profoundly unsettling for any society (albeit often shot through with genuine community spirit) and they ask each of us difficult questions about our own identity. For some, the questions, when answered, will lead to enlightenment; but for others they will lead to confusion, loss of direction and perhaps worse.

I’m not offering any sort of social health prescription here, but I do think now is the moment for both employees and their employers to re-consider the importance, relevance and definition of this oft overlooked (in the good times) idea. And I’m struck by the fact that the power of this old WHO definition of Social Health only really seems to be clear when its object is so much harder to achieve.


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