Should social programs target finances, health, or well-being

High-income countries have made enormous health gains over the past century and a half. In the Netherlands, life expectancy increased with three years per decade. And more of those years are spent in good health. However, not everyone has benefited from these gains. People from lower socio-economic backgrounds are falling behind, and the gap between them and the rest of society has been widening over the years.

Many of these countries have a vibrant civil society and an abundance of social programs designed to aid those fallen behind. Although a sign of social solidarity, many of these programs demonstrate mixed impacts upon evaluation. One important reason is that they often lack the resources to address problems cohesively, focusing instead on one aspect of the problem they find manageable without paying due regard to connected aspects. Some programs for example offer job application training, but when finding that their clients struggle to pay attention due to lingering financial worries and feelings of depression, they may not know what to do. Should they focus on taking away these worries instead? This begs the question: What should social programs focus on to help those fallen behind?

In recent years, both scientists and the general population gained awareness of the deep entanglement between finances, health, and well-being. People cannot be reduced to a set of problems to be tackled independently, thinking that somehow these solutions add up to solve the problem as a whole. Researchers pay increasing attention to how problems are related, and many lessons have been learned over time. Policy-makers and practitioners who understand the complex relationship between financial, physical, and mental well-being find themselves in the unique position to use these insights in how they design their programs.

This paper provides an overview of academic and grey literature and the lessons we can learn from these studies.