Obesity has sometimes been called the silent epidemic, exposing millions of adults and children around the world to increased risks of non-communicable diseases such as hypertension, diabetes, and coronary heart disease. As countries continue to grapple with rising rates of obesity, a first-of-its-kind study of more than 500 social ventures has shed light on the methods used by social entrepreneurs to tackle this complex issue.
Titled “Social entrepreneurship in obesity prevention: A scoping review”, the study identified 512 social ventures engaged in obesity prevention across 32 countries and developed a taxonomy of their obesity interventions, contexts and business models. Social ventures have created a diverse range of solutions to balance the effectiveness and affordability of their programmes, often with the knowledge and support of local communities. Studying their characteristics provides unique insights that have far-reaching implications for public health. The study was published in Obesity Reviews, the most widely cited peer-reviewed medical journal on obesity.
The findings reveal important insights on the role of social ventures in obesity prevention and how they could complement the work of public health initiatives:
- Social ventures can relieve the burden on healthcare systems. The review found that most social ventures were initiated, supported, or sustained by local communities. Close to half (49%) aimed for financial self-sufficiency, that is, zero-reliance on donations, while 43% of social ventures were already self-funding. With public health resources already stretched thin by COVID-19, and many nations (including Singapore) reporting higher rates of obesity during the pandemic, there is an urgent need to consider alternative solutions.
- More can be done to address obesity in developing countries. Although the prevalence of obesity in the developing world hovers around 30%, the study found that 93% of social ventures tackling obesity originated and operated in high-income countries. This shortfall is made even more glaring by the fact that, of the 140 lower- and middle-income World Health Organisation (WHO) member countries, only 38% had national policies to reduce obesity.
- The rise of urban solutions. Five main categories of intervention were identified. Urban farming (43%) featured prominently among them, coming in second only to the number of interventions that target diet and nutrition (59%). The remaining categories were physical activity (31%), access to healthy food sources (22%), and population health education (16%). Urban farming offers a holistic solution providing greater community access to fresh and nutritious produce, while at the same time offering opportunities for community education and outdoor activity. We expect urban farming to continue growing in popularity, on the back of demand for healthier food and concerns over food safety and security.
- Positive social messaging can make obesity messages more attractive. Almost 50% of the social ventures chose to address obesity alongside other problems such as employment and poverty. For example, Table for Two – which originated in Japan and has since expanded to Korea, the United States, and Germany – sold balanced meals and donated the cost of calories saved to meals for undernourished students in Africa and the Philippines. Combining health messages with other positive social objectives is a promising communications strategy that can be adopted by public health organisations in their outreach efforts.
- Impact measurement remains elusive. The study found that only 25% of social ventures reported the impact of their efforts, with only 16% doing so in the past two years. Of the 16%, three quarters were non-profits suggesting slightly higher reporting demands from donors and sponsors. Social ventures may have difficulty devoting the resources required to effectively measure impact, and more studies on this subject could yield valuable information from a public health research perspective.
Associate Professor Audrey Chia, co-author of the study and Director of the Leadership Development Programme at National University of Singapore (NUS) Business School said, “In the last 30 years, no country has managed to reverse the rise in obesity. With multiple causes – such as genetics, individual behaviour, and physical and social environment — obesity seems intractable. Solutions require multipronged strategies that activate the whole of society. This study highlights social entrepreneurs’ range of efforts to address obesity across different contexts – work, school and community — while recognising interrelated factors like education; availability and affordability of fresh food; and health promoting spaces. The work of social entrepreneurs can complement other public- and private-sector efforts.”
A global scoping review was conducted encompassing a search of academic and non-academic databases, news databases, and web-based searches of Google and social media. To be included in the study, social ventures had to have at least one revenue or resource stream that partly or entirely sustained their work, and must not solely or mostly provide free products and services. These criteria help distinguish social ventures from charities and welfare organisations that rely mostly on donations.
The review was co-authored by Assoc Prof Audrey Chia, of NUS Business School and the NUS Yong Loo Lin School of Medicine, Dr Junyu Ong, House Officer, MOH Holdings, Ms Anjali Bundele, Research Assistant, Alexandra Hospital, Singapore, and Assoc Prof Yee Wei Lim, NUS Yong Loo Lin School of Medicine.