Social determinants of health : an interdisciplinary approach to social inequality and well-being

This book provides an applied, interdisciplinary approach to an understanding of the key social determinants of health, essential at a time of increasing inequalities and reductions in existing NHS services and local authority budgets. A person's health and wellbeing is influenced by a spectrum of socioeconomic, cultural, living and working conditions, social and community networks and lifestyle choices. Based on the 'rainbow model' of the social determinants of health, chapters from experts in a wide range of disciplines examine the key factors which can lead to poor quality of life, homelessness and reduced mortality. Featuring practitioner, academic and commentator experiences, and clear case studies, this book will enable researchers, front-line workers, managers, service commissioners and politicians to identify and employ the most appropriate health, social and economic interventions to support those at the edge of the community, and the promotion of their inclusion in society. SOCIAL DETERMINANTS OF HEALTH Contents List of tables and figures Tables Figures Notes on contributors Editor Contributors Acknowledgements Preface Part OneLife chances 1. The individual: growing into society Neuropsychological development Affection, fear and anxiety in early development Social anxiety Communication and socialisation The well-being of children Poverty, child abuse and neglect Social inclusion strategies Troubled families Deviant and anti-social behaviour Mental health and human distress 2. Addressing inequalities in education: parallels with health Introduction Patterns of inequality in educational outcomes Policy responses to educational inequalities Complex local responses to educational inequalities Concluding comments 3. Wholistic well-being and happiness: psychosocial-spiritual perspectives 21st-century living What is well-being? Wholistic living Spiritual and faith dimensions The Happiness Course Conclusion 4. Nutrition in marginalised groups Introduction Nutritional requirements Nutritional status of homeless individuals Dietary intake in homeless individuals Improving dietary intake in the community Conclusion Part TwoLifestyle challenges 5. Alcohol-related harm and health inequalities Introduction The relationship between alcohol and health inequalities Health inequalities: the UK policy context Interventions to address alcohol-related inequalities Conclusion and ways forward 6. Addiction, inequality and recovery Introduction Substance use and addiction Early life adversity and addiction Inequality and addiction How do unequal societies generate addiction? How can society support recovery from addiction? 7. Health and exercise in the community Introduction Physical activity Physical inactivity International policy Physical activity guidelines Examples of successful public health and community interventions to increase physical activity Summary 8. Health and well-being in the digital society Introduction The digital society and internet use Influence on sedentary behaviour Influence on mental health Interpersonal influence on health and well-being: the first alcohol case study The influence of commercial digital marketing: the second alcohol case study Conclusion Part ThreeSocial and community networks 10. Support for people with learning disabilities: promoting an inclusive community Introduction What is a learning disability? How does a learning disability present? A brief history Challenges The future Conclusion 11. Community well-being programmes: reviewing ‘what works’ Introduction What Works: Wellbeing Centre What is well-being? What is community? What is community well-being? What do we know about what works for community well-being? Implications of health and social inequalities for the evidence base Our inclusive approach Conclusion 12. Looking through a realist lens: services provided by faith-based and third sector organisations Introduction Context Looking through a realist lens Terminology The living history of realist evaluation and synthesis Experiencing a realist-inspired evaluation of a Salvation Army community programme The concept of added value Conclusion Part FourEmployment and housing 13. Social enterprise and the well-being of young people not in education, employment or training Introduction The prevalence and make-up of the NEET population Causes of NEET status Consequences of NEET status Context: budgets and costs NEETs and entrepreneurship NEETs and social enterprise Conclusion 14. Health and homelessness Introduction Health and homelessness Rafters – health is about housing; housing is about health Relationships Resources Restoration Resilience Summary 15. Local authority perspectives on community planning and localism: a case study Introduction Social housing policy: a brief history From Right to Buy to Pay to Stay What is needed in housing policy Part FiveSupporting people at the edge of the community 16. Towards an integrative theory of homelessness and rough sleeping Introduction A useful theory Factors at different levels A psychological approach to homelessness The psychology of environment–individual interaction Environmental factors Psychological factors Attachment and interpersonal issues Cognitive functioning Negative beliefs Summary Proposed model of repeat homelessness Psychological interventions Measuring outcomes and economic evaluation Conclusions 17. Mental health and multiple exclusions Introduction Defining multiple exclusions Research about people experiencing homelessness Prevalence of mental health disorders within the population Why is understanding multiple exclusions important? Implications for service delivery Concluding remarks 18. Brain injury and social exclusion Social disadvantage and brain injury Screening for brain injury Homelessness and brain injury Offending and brain injury The Linkworker system Discussion 19. What works to improve the health of the multiply excluded? Introduction Why special effort is needed Not simply a housing problem What works Models of service delivery What works – values Social determinants of health Conclusions Part SixThe socio-political environment 20. Geopolitical aspects of health: austerity and health inequalities Introduction Health and place Austerity, health and place Increasing the health gap Conclusion 21. Health and well-being of refugees and migrants within a politically contested environment Introduction Health and migration: general context Contexts of support Segregation of services Contexts of politics Health and the experience of (forced) migration Health and public/political discourses Conclusion 22. The Care Act 2014 From the Poor Law to well-being A monumental reform? Shifting the focus from deficits to assets Community-based approaches Well-being: a new organising principle The elephant in the room To integrate or not to integrate? Conclusions: two systems, one purpose? Time for dialogue without preconditions? 23. Health and social care in an age of austerity Introduction The economic case for spending on health and social care Getting better value from the money spent Social care Summary Conclusion Index Introduction -- Physical activity -- Physical inactivity -- International policy -- Physical activity guidelines -- Examples of successful public health and community interventions to increase physical activity -- Summary -- 8. Health and well-being in the digital society -- Introduction -- The digital society and internet use -- Influence on sedentary behaviour -- Influence on mental health -- Interpersonal influence on health and well-being: the first alcohol case study -- The influence of commercial digital marketing: the second alcohol case study -- Conclusion -- Part Three Social and community networks -- 10. Support for people with learning disabilities: promoting an inclusive community -- Introduction -- What is a learning disability? -- How does a learning disability present? -- A brief history -- Challenges -- The future -- Conclusion -- 11. Community well-being programmes: reviewing 'what works' -- Introduction -- What Works: Wellbeing Centre -- What is well-being? -- What is community? -- What is community well-being? -- What do we know about what works for community well-being? -- Implications of health and social inequalities for the evidence base -- Our inclusive approach -- Conclusion -- 12. Looking through a realist lens: services provided by faith-based and third sector organisations -- Introduction -- Context -- Looking through a realist lens -- Terminology -- The living history of realist evaluation and synthesis -- Experiencing a realist-inspired evaluation of a Salvation Army community programme -- The concept of added value -- Conclusion -- Part Four Employment and housing -- 13. Social enterprise and the well-being of young people not in education, employment or training -- Introduction -- The prevalence and make-up of the NEET population -- Causes of NEET status -- Consequences of NEET status -- Context: budgets and costs Intro -- SOCIAL DETERMINANTS OF HEALTH -- Contents -- List of tables and figures -- Tables -- Figures -- Notes on contributors -- Editor -- Contributors -- Acknowledgements -- Preface -- Part One Life chances -- 1. The individual: growing into society -- Neuropsychological development -- Affection, fear and anxiety in early development -- Social anxiety -- Communication and socialisation -- The well-being of children -- Poverty, child abuse and neglect -- Social inclusion strategies -- Troubled families -- Deviant and anti-social behaviour -- Mental health and human distress -- 2. Addressing inequalities in education: parallels with health -- Introduction -- Patterns of inequality in educational outcomes -- Policy responses to educational inequalities -- Complex local responses to educational inequalities -- Concluding comments -- 3. Wholistic well-being and happiness: psychosocial-spiritual perspectives -- 21st-century living -- What is well-being? -- Wholistic living -- Spiritual and faith dimensions -- The Happiness Course -- Conclusion -- 4. Nutrition in marginalised groups -- Introduction -- Nutritional requirements -- Nutritional status of homeless individuals -- Dietary intake in homeless individuals -- Improving dietary intake in the community -- Conclusion -- Part Two Lifestyle challenges -- 5. Alcohol-related harm and health inequalities -- Introduction -- The relationship between alcohol and health inequalities -- Health inequalities: the UK policy context -- Interventions to address alcohol-related inequalities -- Conclusion and ways forward -- 6. Addiction, inequality and recovery -- Introduction -- Substance use and addiction -- Early life adversity and addiction -- Inequality and addiction -- How do unequal societies generate addiction? -- How can society support recovery from addiction? -- 7. Health and exercise in the community NEETs and entrepreneurship -- NEETs and social enterprise -- Conclusion -- 14. Health and homelessness -- Introduction -- Health and homelessness -- Rafters - health is about housing -- housing is about health -- Relationships -- Resources -- Restoration -- Resilience -- Summary -- 15. Local authority perspectives on community planning and localism: a case study -- Introduction -- Social housing policy: a brief history -- From Right to Buy to Pay to Stay -- What is needed in housing policy -- Part Five Supporting people at the edge of the community -- 16. Towards an integrative theory of homelessness and rough sleeping -- Introduction -- A useful theory -- Factors at different levels -- A psychological approach to homelessness -- The psychology of environment-individual interaction -- Environmental factors -- Psychological factors -- Attachment and interpersonal issues -- Cognitive functioning -- Negative beliefs -- Summary -- Proposed model of repeat homelessness -- Psychological interventions -- Measuring outcomes and economic evaluation -- Conclusions -- 17. Mental health and multiple exclusions -- Introduction -- Defining multiple exclusions -- Research about people experiencing homelessness -- Prevalence of mental health disorders within the population -- Why is understanding multiple exclusions important? -- Implications for service delivery -- Concluding remarks -- 18. Brain injury and social exclusion -- Social disadvantage and brain injury -- Screening for brain injury -- Homelessness and brain injury -- Offending and brain injury -- The Linkworker system -- Discussion -- 19. What works to improve the health of the multiply excluded? -- Introduction -- Why special effort is needed -- Not simply a housing problem -- What works -- Models of service delivery -- What works - values -- Social determinants of health -- Conclusions