News, Student Voice

The Social Determinants of Well-being: A holistic approach to supporting students capacity to flourish in Higher Education.

The story of health and wellbeing inequity swiftly entered the conversation with the COVID-19 outbreak and the Black Lives Matter movement. Whilst recent government reports have shown that the BME COVID-19 infection and morbidity rates are much higher than their white counterparts, and the infection rates are also higher in more deprived parts of the city, country (and the world), it follows that there is also more experiences of grief, health-related anxieties, and other forms of acute virus-related psychological distress. The outcome of young people’s immediate contact with the stark reality of disproportionate viral risk in less affluent areas and BME communities opens up a wider discussion about the disparities in the levels of wellbeing among the young people in Higher Education.

University services rightly talk about widening participation prior to university. But it is less often that we hear about the uneven gradients of health, wellbeing, and academic engagement among different social groups of students once their studies commence – the playing field still remains unlevel after access.

Financial stress a major burden on student success – On The Record
UniSa – On The Record.

The efforts of the University and Bristol SU to integrate under-represented students cannot go unnoticed. There has been more reluctance, however, to publicise more critical, albeit still serious, conversations about the connection between racism, classism, and mental illness in our University. In any case, the disparate health and wellbeing outcomes of BME and low-income students are not just facts to take note of for future reference, but conditions to be challenged immediately and not merely performatively. Although conversations about personal finance and economic privilege often feel quite taboo in public settings and workplaces. These are awkward conversations at best or emotionally-charged at worse. But, in the current political moment, the conversations must happen so as to avoid downplaying the unequal access to financial resources between students at UK Higher Education institutions.

Holistic approaches to wellbeing acknowledge how social background, day-to-day financial insecurities, and experiences of microagressions threaten wellbeing. To effectively grapple with questions about student wellbeing, we must also factor in concerns about student finances, stressful and precarious part-time work, and the time affluence of students from particularly privileged social backgrounds.

Financial setbacks, disproportionate numbers of COVID-related deaths (and grief) in poorer areas, compromised free time to study, and perceptions of wider inequities that creep into university life can hinder motivation, academic attainment, and a students’ sense of belonging within the university community.

Of course, there is no clear-cut correlation between access to essential funds and wellbeing or the lack of financial support and low levels of wellbeing. But as with any human situation, the added financial concerns, pressures, and insecurity pose a greater detriment to wellbeing for students without access to financial resources than those with access.

Public health researchers and wellbeing educators have recently reconsidered how we talk about wellness and illness. One paper noted that by emphasising lifestyles modifications, medication, and ‘taking personal responsibility’ for our own wellbeing, we neglect considerations concerning the structural determinants influencing a person’s behaviours. Such an approach runs the risk of creating a kind of ‘victim-blaming’ narrative in our wellbeing services. (Sharma et al. 2018) Relying on services which promote an individuals’ initiative to take wellbeing practice into their own hands and change a few habits in their lifestyle without any wider psychosocial work or specific support services for the marginalised social groups seems inadequate.

The Story So Far

The University has been working to eliminate barriers to participation in Higher Education for students from low to middle-income backgrounds with their ‘Access to Bristol schemes’. Widening access, though fruitful, does not mark the endpoint of addressing barriers to social mobility and student’s capacity to excel. A sizeable proportion of students in the UOB community report that their parents are not in a position to help them financially or because their parents’ own financial situation was difficult.

Studying in an affluent city like Bristol is costly. A 2016 UPP report on student experiences finds that 73% of 558 respondents listed financial difficulties as a factor that makes university life hard to cope with, coming second only to the stress of studying by a single per cent. The troubling fact is that maintenance loans remain the same regardless of city, other than London, which is understandably seen by many fellow students as frustrating. Interviews conducted in 2016, for instance, frequently reported the relatively high cost of rent in Bristol compared with other UK cities. The severe shortage of affordable housing in Bristol is an issue that affects all Bristol residents, but for students who negotiate their housing situation with peers from different financial backgrounds, finance-related distress and hostile feelings of “us and them” can disrupt the University’s new aim of creating a sense of belonging.

“My stepdad said ‘Bristol is so much more expensive than Sheffield’ and I was weighing up the two for Uni’s and I didn’t really get it: ‘what do you mean, more expensive, what like a fiver more a week or something?’ and in reality, it’s probably more like £40 a week or something and I just didn’t understand that this kind of money is like a whole day’s work on minimum wage” (Year 3, A2B bursary in Davies & Harris 2016)  

Not all the under-represented students find it easy to fit comfortably into the existing culture of what is regarded by many students both inside and outside Bristol as a “posh university”. The conversations between students about ski trips, intercontinental holidays, and research trips have also been noted as affecting student’s perception of their “belonging” within a wider University community that shows signs of wealth and privilege.

(Davies & Harris, 2016)

“The majority of students here are quite obviously privileged …with Anthropology obviously travelling is quite a big thing …a girl the other day was saying that her parents bought her trip to Poland and a trip to Thailand for her birthday and I’m sat there going, well I went to Wales yesterday. Wales is brilliant but you know, there’s like a bit of competitiveness…” (Year 2, UoB bursary in Davies & Harris 2016)

It is important to remember the economic disparity between students is not the only threat here, as the competitive attitudes brought into the University environment also shape students’ response to the inequities between them and their peers.

In 2016 Bristol students experiencing financial insecurity were found to be twice as likely to report mental illness/ (Davies, 2016) Many of these cases involved mature students, whose finance-related worries tied up with supporting partners and/or family, organising part-time degrees around jobs. Also, first-generation working-class students navigate a radically different culture of leisurely (often costly) pursuits on top of the increased financial uncertainty after entering University: alcohol, live music events, and sporting activities.

With regards to the increased cost of living in a city like Bristol, the University marketing team has a duty towards honesty in their production of promotional materials to prospective students. Especially those students joining universities which ‘down-the-line’ may make studying difficult to financially manage. Where help is not received from parents, widening-participation students often encounter additional sources of worry and instability. This experience feels all the more devastating when students’ expectation of University was shaped by glossy marketing.

The added stress of dealing with financial setbacks alone can prove excruciatingly isolating. Particularly when we accept affluent peers into our social circles who are able to rely on parents to support their sense of comfort. According to the 2015 HEFCE, the differential sense of belonging emerged as a key cause of radically different student outcomes. If universities wish to maintain their aims of cultivating a greater “sense of belonging” across our diverse student population, then staff and fellow students will have to become more open to hearing low-income students out, most notably, we must start hearing low-income students out, as detriments to wellbeing often emerge outside the University campus. Listening to students as well as advising students is required for a sufficient institutional comprehension of interrelated struggles concerning financial predicaments and wellbeing. 

Does the ease of student access to financial support from parents really set them on a more privileged trajectory for academic success? Surely, the problem of poor wellbeing emanates from a confluence of factors and the academic outcomes of students are based on merit? Yes, the interactions between aspiration, wellbeing, and attainment are complex. Although some people may remain sceptical of whether financial safety-net inequities actually represent pressing issues for the personal and academic development of students, I have some replies to those maintaining incredulous scepticism. Let us turn to the empirical research.

Unequal social, cultural, and economic capital across Higher Education

The adult wellbeing measurement comprises five questionnaire items with four response levels each and is designed to capture people’s capability to live a life that they value (Al-Janabi et al. 2012). These ‘capabilities’ are stability (feeling settled and secure), attachment (able to achieve love, friendship and support), autonomy (able to be independent), achievement (able to progress in life) and enjoyment (able to experience enjoyment and pleasure) (Al-Janabi et al. 2012). Financial insecurity, barriers to interpersonal connection with fellow students in the University community, and struggles to maintain financial independence and

The notion of cultural/social capital refers to the transmission of attitudes and esteem that enforces ways of behaving (Modood, 2011). It goes without saying that students enter the university with different access to resources and social and economic capabilities. In Higher Education, this is exemplified by how different students’ network, how they draw on external support, and their financial security, all of which affect how much students engage with learning. Also, the financial responsibilities low-income students must endure take away from their study time and often leave students feeling tired, more-stressed, and overworked. 

Recent institutional fieldwork (2015) reports wide disparities between informal academic support that is offered to students possessing numerous socioeconomic resources. These examples range from middle-class students who email essays to university-educated parents and wider family networks to proof-read and regularly Skype to share work, through to first-generation working-class students unable to draw on the same pool of resources.

Underrepresented students could benefit from the wider expansion of the peer-mentoring initiative, so as to incorporate more first-generation student role models both inside the student and scholarly community. I hope to see peer-review events and widening-participation initiatives brought forth into academic settings throughout the University experience, not just prior. The University does have a role in acknowledging the unequal access to essay-enhancement and mentoring resources from larger social networks and we must be finding ways of mitigating against that risk.

Work Life Balance

A significant number of Bristol undergraduates have paid jobs in term time, with others taking on paid work during the summer break or both. Undoubtedly, the money earned from paid work supplements income from loans, grants, and bursaries. Still, even with support from this income, financial maintenance in the city of Bristol can prove challenging for many low to middle-income students. 

The challenges of balancing part-time work alongside academic study, extracurricular engagement, and social interaction matched with student perceptions of stark disparities between access to financial support establish a troubling concern for lower-income students wishing “to belong” in the wider University culture.

The message coming from stakeholders consulted for a study done by King’s College in 2015 reported that students’ experiences within HE are definitely affected by financial issues: ‘a student who is in university has more things on their plate. When there are financial issues, they are obviously in a different position from someone who does not have to deal with such concerns’. (p, 36) Also, in our current volatile political climate, students are easily at risk of losing their jobs and have few of the necessary finances to continue’. (SH 8) ‘Being in paid employment for long hours during term time and devoting fewer hours to independent study both have significant effects on students’ self-reported learning gain.

What are the lived experiences of low-income students reliant on part-time jobs to survive University?

On a purely anecdotal level, the start of the second year of University marked a period where I desperately searched for part-time jobs to acquire an income that could sustain basic financial maintenance through Teaching Block One. This was necessary since the majority of my (sizeable) maintenance loan was set aside for the rising rental prices across Bristol, particularly neighbourhoods close to the Clifton Campus.

Looking back, I learnt a lot from the challenging experiences of part-time night shifts in a hectic nightclub. I now know the type of work that does not suit me in terms of personal wellbeing. I need sleep to survive and thrive in academia. But how did I end up in part time work that was so detrimental to my wellbeing? The simple answer: financial desperation.

More importantly, I learnt about the experience of alienation from peers, a growing sense of hostility, and ill-will towards the immense privilege of frivolous spending among fellow students. The sleep deprivation correlated with huge disruptions to my concentration levels and the quality of my studies. I was unable to think clearly because I rarely slept well. This loss of enthusiasm for learning was matched with lost opportunities to socialise after studying with course friends because “I had to work” which more and more troubling as time went on. The breaking point was when all of this disturbance was met with disappointing grades and little else to show for my time at University other than a zero-hour contract. I had to leave the job for the sake of my degree. I left myself in a worrying financial situation and was on the brink of dropping out of my studies, as I was so desperate to escape and find solace in my friendships back home.

How do we address these socioeconomic contributors to low-level wellbeing? As a supplement to the current guides to wellbeing services, explicit route planners or maps to bursaries, financial assistance schemes, and scholarships, would have helped students in similar situations comprehend where the “safety net” options for financial support were located.  First-generation/low-income students also need more indirect and explicit “know-how” information concerning how to ‘package’ the opportunities, services, and support available at University into a valuable ‘personal capital’. Such a package will need to suit schedules which are often overrun with precarious part-time work and financial strains. Knowing where the opportunities were and how to access them would have proven invaluable.

Also, it seems sensible to caution against any temptation to overplay the importance of instilling “student initiative” and “individual responsibility” in students who are embedded in highly-complex psychosociological situations. This is because financially stretched students with low levels of wellbeing and histories of lapsing into mental illnesses, such as Generalized Anxiety Disorder, report a lack of motivation, immense confusion, inability to focus on daily tasks, and fundamental needs for greater support bases when stable levels of mental health are deteriorating.  

Of course, the sheer scale of unequal access to financial income goes beyond the interiority of the University. But financial pressures and alienation from affluent peers must be taken into consideration when assessing the wellbeing of students from widening participation/BME backgrounds.

To become the empathetic and informed members of a university looking to increase students’ sense of belonging, we must acknowledge the interplay between financial concerns, poor levels of wellbeing, and disappointing academic outcomes. To do any justice to the wellbeing agenda, the socioeconomic concerns of staff and student communities must be addressed without stigma, without hostility.


Blackman, T. What affects how much students learn? HEPI Policy Note 5, 2018 https://www.

Davies, S & Harris, R. 2016. Widening Participation? Exploring the effect of financial support and outreach on the experiences of students in Bristol. Report. Bristol Policy Research Repository.

Stallman, H. M. (2010). Psychological distress in university students: A comparison with general population data. Australian Psychologist, 45, 249–257. doi:10.1080/00050067.2010.482109

Eisenberg D, Golberstein E, Gollust SE. (2007). Help-seeking and access to mental health care in a university student population. Med Care. 2007;45(7):594–601

UPP, Annual Student Experience Study (2016)

Reid and Solomon. (2019) Financial concern predicts deteriorations in mental and physical health among university students.

WHO Commission on Social Determinants of Health. Closing the gap in a generation: health equity through action on social determinants of health. Geneva, WHO, 2008.

Owen Barlow BILT Student Fellow 19/20 – working on the project ‘Wellbeing and the Curriculum’.

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