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Table 1 Domains and entry points for action and their definitions in the action-oriented public health framework on financial wellbeing and financial strain

From: An action-oriented public health framework to reduce financial strain and promote financial wellbeing in high-income countries

DOMAINS & ENTRY POINTS FOR ACTION

DEFINITIONS

Government (All Levels)

This domain targets structural actions that can be taken by governments through the governing systems of public and private sectors. It refers to macroeconomic, public, and social policies as well as underlying power structures

Improve Regulation, Oversight, and Funding of Macro-Economic Systems and Policies

Increase effectiveness and impact of government regulation and oversight of financial sector, housing market, and employment and labour market.

Ensure adequacy of funds for sustainable actions

Expand Provision, Regulation, and Funding to Care, Education, and Transportation Services

Ensure governments oversee, regulate, and provide guaranteed level of adequate funding to quality essential care (e.g., childcare, health care), education, and transportation services

Prioritize Redistribution-Based & Universal-Type Policies

Build and improve equity-based policies that redistribute wealth or span the socioeconomic spectrum. Such policies (e.g., progressive taxation, universal basic income, and raising minimum retirement pension) disproportionately benefit people who experience disadvantage

Provide Sustainable Funding to Programs and Services

Ensure continued and appropriate amount of public financial assistance to support operations and service delivery infrastructure of organizations and governments, targeting areas that directly or indirectly impact people’s financial circumstances

Organizational & Political Culture

This domain targets those processes that affect the delivery and sustainability of government, organizational, and community actions. It involves consideration of organizational culture and power dynamics

Simplify Access to Benefits & Services

Remove barriers and bureaucratic ‘red tape’ that limit people’s access to benefits, programs, and services, including communication barriers (e.g., low literacy levels), strict contingencies (e.g., work-for-welfare), restrictive eligibility criteria, and onerous assessments (e.g., to qualify for disability benefits)

Budget for Wellbeing

Create budgets that prioritize long-term human wellbeing over financial outcomes alone (e.g., balancing budgets through austerity measures that negatively impact health and overall wellbeing)

Assess and Measure Long-Term Impacts

Use measures of human wellbeing to understand the long-term impacts of policies, programs, and services (e.g., social impact)

Take a long-term approach to evaluation (e.g., cost–benefit analysis)

Socioeconomic & Political Context

This domain targets social and political actions. It encompasses changes to the political and community landscape that, together, shape the availability of resources, opportunities for poverty reduction, possibilities for growth of the middle-class, and improvements in the distribution of power at the societal level

Expand Access to Financial Services & Products

Increase access to mainstream and alternative financial services and products that are inclusive, culturally appropriate, affordable (e.g., low-fee or no-fee), flexible in terms of contracts and transactions, and responsive to people’s needs and circumstances

Facilitate access to information about mainstream and alternative financial services and products

Strengthen Employment Security (Income and Benefits)

Improve access to stable, well-paid, and regulated jobs with employee benefits programs for all workers

Enhance Quality Education

Facilitate access to education and training to improve people’s long-term income prospects

Improve Housing Security

Strengthen affordable housing policies, including high quality options for public housing

Increase access to diverse affordable and supportive housing options in order to provide people with dignified choices that fit their needs

Promote Neighbourhood-Level Advantage

Increase neighbourhood-level access and opportunities for education, employment, safety, and security (e.g., addressing high exposure to the criminal justice system or providing meaningful supports for poorly funded public amenities)

Target family, community, and neighbourhood through multi-level initiatives to improve local services and supports

Social & Cultural Circumstances

This domain is about political, community, organizational, and individual actions that shape or recognize social and cultural contexts, hierarchies of power, and people’s social backgrounds and identities (e.g., immigration status, gender, sexual orientation, race/ethnicity) that accumulate to impact their financial circumstances

Include Cultural Values of Financial Practices & Ways of Living

Recognize and respect the complexity and diversity of cultural values attributed to financial resources (e.g., money, goods) and financial transactions

Build initiatives that recognize the symbolic and economic values of different ways of being and doing (e.g., pay for informal caregiving)

Address Stigma & Discrimination (e.g., systemic racism and ableism)

Build initiatives to explicitly reduce stigma and discrimination of groups who experience cumulative disadvantage across the lifespan (e.g., racialized people) and intersecting challenges (e.g., Indigenous woman experiencing disability) in financial services, job markets, and school or workplaces

Address financial abuse and barriers to both financial independence and intergenerational wealth-building that disadvantaged groups have systematically experienced

Foster Connection & Belonging

Enhance community capacity, empowerment, and connections through community-led or participatory approaches promoting social capital and social cohesion

Life Circumstances

This domain targets political, community, organizational, and individual actions that impact people’s complex life circumstances, multiple roles, and power relationships (e.g., individual agency and power within a household) that come together – positively or negatively – to shape their financial situation

Develop around People’s Everyday Realities

Remove barriers to enrolment and participation in financial strain and financial wellbeing related initiatives (e.g., access to childcare, transportation costs)

Ensure the timing and content of the initiatives are tailored to the target populations. Consider people’s values, life stages, life demands, and daily roles and responsibilities

Consider Diverse Household Financial Circumstances

Create initiatives that are appropriate to people’s current financial circumstances, particularly for people experiencing poverty and facing unmet basic needs (e.g., food insecurity, energy insecurity, housing insecurity)

Set realistic, achievable goals (e.g., building savings only after basic needs are addressed)