Why health really does equal wealth

Now fully back in the swing of work, I find myself wondering whether Scrooge’s reforms lasted beyond #BlueMonday and whether Bob Cratchit’s improved ts and cs were long-lasting – and if so, if Scrooge’s profit margins suffered as a result.

I highly doubt it because while, for employees, being in ‘good work’ has a huge impact on health and wellbeing, it also has significant knock-on benefits for workplace productivity, the community and the economy as a whole.

Historically, conversations about economic progress and productivity have focused on skills shortages, but at last, the nation’s focus has turned to the important role of workers’ health – something those of us working in public health have long since known.

In 2022, the cost to the economy of working age ill-health and disability was between £240-330 billion. This figure has likely risen with last year’s Keep Britain Working report revealing that a staggering one in five adults are out of the labour force – with a rise of 800,000 since before the pandemic of those not working because of ill health.  Importantly, this number includes a large proportion of people aged 50-69 who are at greater risk of never returning to work.

The Government has also commissioned a report to explore the increase in the number of 16-24 year olds who are not in education, employment or training (NEET). To get a feel for the numbers, according to the Office for National Statistics, in the first quarter of last year, this number was well over 900,000, with around 60% of these classified as economically inactive. Worryingly, over half cited health as a key reason.

Meanwhile, given the well evidenced link between poor school attendance and educational attainment, and the fact that school attendance rates have not returned to pre-pandemic levels, there are also serious concerns about tomorrow’s workforce.

These statistics are not only alarming, but also likely to increase even more without an effective multi-layered strategy to address the whys and wherefores because not only does health matter to work, but work matters hugely to health. In other words, being in happy, healthy work is a determinant of our health in and of itself, which then impacts both time spent in work, and productivity while there.

And of course, with every person out of work due to ill health, there is not only a cost to the economy because of lost productivity, but also in benefits, health and social care.

It is therefore good news that the Government is looking at how to help businesses provide jobs in an environment that supports people to stay in work. However, the answer does not lie solely with employers. It isn’t just about providing training in mental health or onsite childcare, it isn’t just about offering flexible working or occupational health services. It is about all these things and more – making health a key part of the economic growth agenda, investing in health to build greater resilience, and promoting social and economic equity by improving health.

The difficulty is that there are lots of individual programmes being run by lots of different stakeholders. Directors of Public Health, who are responsible for the health and wellbeing of their local population, are ideally placed to make connections and facilitate effective partnerships between these stakeholders because they are already working with partners in local government, the NHS, voluntary organisations and a wide range of businesses.

By understanding what the various local barriers are to finding – and staying in – good work, they can then try to break down and remove those barriers. Ultimately, the aim is that everyone, regardless of their background, can have opportunities to access good work and – and this is really important – that employers, regardless of their size or skillset, have the tools they need to provide that environment.

That means improving and strengthening the links between skills, work and health by delivering joint schemes with local employers as well as programmes like Connect to Work to support people with complex barriers to employment. At the same time, we need to continue to improve the health of working aged adults to make us all more resilient and able to work, and protect our children and young people from future ill-health.

In some areas, public health teams are working directly with local employers to embed workforce wellbeing. In others, Work and Health Strategic Partnerships have been established to really embed key principles like early intervention and providing the right support for people to stay in work.

In my own patch of Sheffield, we have funded a work and health job retention service for over 20 years. Delivered by our colleagues in the voluntary sector, Sheffield Occupational Health Advisory Service provides advice and support to people struggling to stay in work or off sick. Through the ICB Health and Growth Accelerator, they also deliver training for line managers on understanding employer responsibilities and supporting staff.

What all these initiatives have in common is taking a long-term, collaborative approach across departments and organisations that can meet people’s needs in a sustainable way. By embedding support, embracing equality and diversity, and working together, we can both support people to stay in work now, and improve health and resilience so that the next generation can enjoy a healthy and happy working environment.

To that end, ADPH are embarking on a new stream of work to strengthen the links between work, health and economic development, influence ongoing national policy development and address gaps in understanding local responses.

Of course, this work comes at the same time as NHS and local government reform, a time that offers great opportunity as well as considerable challenge, and it won’t be easy. However, we are here, ready and willing to help the Government realise its ambition to support people into good, secure jobs.