SOCIAL EXCLUSION AND SUPPORT

What we know
What information do we have about the Eastern Board area?
What is the result of this on our health locally?
Policies
What is happening in the Eastern Board area?
References

 

Statistics
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Links
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Documents
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What we know

Poverty, relative deprivation and social exclusion have a major impact on health and premature death and the chances of living in poverty are loaded heavily against some social groups. Absolute poverty – a lack of the basic necessities of life – continues to exist, even in the richest countries and areas. The unemployed, many ethnic minority groups, guests workers, disabled people, refugees and homeless people are at particular risk. Those on the streets suffer the highest rates of premature death.

Relative poverty means being much poorer than most people in society and is often defined as living on less than 60% of the national median income. It denies people access to decent housing, education, transport and other factors vital to full participation in life. Being excluded from the life of society and treated as less than equal leads to worse health and greater risks of premature death. The stresses of living in poverty are particularly harmful during pregnancy, to babies, children and old people.

Social exclusion also results from racism, discrimination, stigmatisation, hostility and unemployment. These processes prevent people from participating in education or training, and gaining access to services and citizenship activities. People who live in, or have left, institutions such as children’s homes and psychiatric hospitals are particularly vulnerable.

The greater the length of time that people live in disadvantaged circumstances, the more likely they are to suffer from a range of health problems, particularly cardiovascular disease. People move in and out of poverty during their lives, so the number of people who experience poverty and social exclusion during their lifetime is far higher than the current number of socially excluded people.

Poverty and social exclusion increase the risks of divorce and separation, disability, illness, addiction and social isolation and vice versa, forming vicious circles that deepen the predicament people face.

Social support and good social relations make an important contribution to health. Social support gives people the emotional and practical resources they need. Belonging to a social network of communication and mutual obligation makes people feel cared for, loved, esteemed and valued. This has a powerful protective effect on health. Social isolation and exclusion are associated with increased rates of premature death, poorer chances of recovery after illness and people who get less social and emotional support from others are more likely to experience les well-being, more depression, a greater risk of pregnancy complications and higher levels of disability from chronic diseases. In addition, bad close relationships can lead to poor mental and physical health.

Social cohesion helps to protect people and their health. Societies with high levels of income inequality tend to have less social cohesion and more violent crime. High levels of mutual support protect health while the breakdown of social relations reduces trust and increases levels of violence.

(WHO, 2003)

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What information do we have about the Eastern Board area?

Being excluded from society has a particular impact on those living alone and in single parent families. In the Eastern Board area, 30.51% of the population live alone. Over 37,000 pensioners live on their own with the Eastern Board area, 14.17% of the population, which is higher than the Northern Ireland figure of 12.84%.

Lone parent families may experience social exclusion and low social support. 13.1% of the Eastern Board households are single parent families, a total of over 34,000 households. This again is above the Northern Ireland figure of 12.71%.

The Northern Ireland Housing Executive reports that in 2003/04 8594 households in Northern Ireland were accepted as homeless, over half of which presented at a Housing Executive office in the Eastern Board area.

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What is the result of this on our health locally?

The Institute of Public Health in Ireland was set up to promote co-operation for public health between Northern Ireland and the Republic of Ireland. It produced a report entitled Inequalities in Perceived Public Health (A Report on the All-Ireland Social Capital and Health Survey). One of the aspects the report studies was social exclusion and support and its findings are relevant to the Eastern Board area.

The report found that males are slightly more likely than females to have infrequent social contacts particularly with relatives) and to have limited practical, financial and emotional support networks. Older people are more likely to have infrequent contact with friends and less likely to have infrequent contact with relatives and neighbours. The study found that the likelihood of having limited support networks does not vary significantly with age. Limited practical, financial and emotional support networks are more common in Northern Ireland than they are in the Republic.

People who have lived in the local area for a longer time are less likely to have infrequent contact with neighbours and relatives and less likely to have limited practical and financial social support networks. The results highlight the limited social support networks of those who are divorced, separated or widowed.

The Institute of Public Health in Ireland study also indicates that people in higher education categories are more likely to have infrequent contact with neighbours and relatives. On the other hand, limited practical support networks are more likely among respondents in the lower education categories.

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Policies

A Social Exclusion Unit was established within the Cabinet Office in 1997. It published a report,
Bringing Britain Together, which was both a diagnosis of the problem and a description of what needed to be done. The Social Exclusion Unit was given the task of formulating policies aimed at tackling multiple deprivation in England and other parts of the UK were expected to draw on its work to formulate their own strategies.

Scotland – Working Together for a Healthier Scotland
Wales – Better Health – Better Wales
England – Saving Lives: Our Healthier Nation

Local and regional health strategies include the New Targeting Social Need (TSN) initiative. New TSN specifies that: 'Some groups have additional needs which, if not catered for, could place their most vulnerable members at risk due to social exclusion'.

Promoting Social Inclusion is a specific initiative within the Government's policy of New TSN that aims to bring different Government departments, agencies and voluntary organisations together to examine the problems facing particular groups and to make recommendations as to how these problems can most effectively be addressed.

In April 2004 an extensive consultation commenced on a strategy to tackle poverty and social exclusion in Northern Ireland. In the consultation document, entitled "New TSN - The Way Forward Towards an Anti - Poverty Strategy," a range of proposals is described for the future direction of New Targeting Social Need (New TSN), the high level policy for tackling poverty and social exclusion in Northern Ireland. Copies of the public consultation document "New TSN - The Way Forward - Towards an Anti-Poverty Strategy" can be obtained from the New TSN Unit, Room E3.19, Castle Buildings, Stormont, Belfast BT4 3SR or by e-mailing newtsn@ofmdfmni.gov.uk or from the website www.newtsnni.gov.uk

One of the key principles of the DHSSPS's public health strategy Investing for Health is to tackle social exclusion. It also aims to encourage community involvement in improving health, especially in disadvantaged neighbourhoods and to engage individuals in their social context.

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References
Baggott, R (2000); Public Health: Policy and Politics; Hampshire: Palgrave

Balanda, K & Wilde, J (2003); Inequalities in Perceived Health, A Report on the All-Ireland Social Capital and Health Survey; Dublin: Institute of Public Health in Ireland

World Health Organisation (2003); Social Determinants of Health: The Solid Facts (second edition); Denmark: WHO

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For further information on this topic please contact us at publichealth@ehssb.n-i.nhs.uk

Eastern Health and Social Services Board Champion House, 12-22 Linenhall Street, Belfast BT2 8BS Telephone: (028) 9032 1313 Fax: (028) 9055 3681 Text Phone:(028) 9032 4980 Website: www.ehssb.org E-mail: pr@ehssb.n-i.nhs.uk
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