Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the global burden of disease study 2015. It typically occurs in the context that the individual or group is believed to possess undesirable characteristics or characteristics deemed unworthy of attention. 2010;15(4):295–7. All authors read and approved the final manuscript. As primary healthcare is the point of initial contact the majority of people have with the health system and it includes such a wide variety of components, it can offer help for many health issues. The majority (15/21) of the tools were developed and used with patients attending mental health services of some kind. 2013;20(1):71–81. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Poverty risk, social exclusion, severe financial constraints in the Netherlands and other EU countries in 2017. This report and the subsequent 2010 WHO Europe report reinforced the significance of the role that health systems and primary healthcare have in addressing social exclusion and improving the health status of populations . Significantly, none of the 22 individual tools discovered were specifically developed or used in general primary healthcare settings. A brief measure of vocational activity and community participation: development and reliability of the activity and participation questionnaire. The steps include (i) identifying research questions, (ii) identifying all relevant studies, (iii) selecting significant studies, (iv) charting the relevant data, and then (v) summarising and reporting the results. Depressive symptoms were measured by a 15-item Chinese version Geriatric Depression Scale. Accessed 25 Apr 2017. I really appreciate your marketing scales database online. The Social Inclusion Scale (SIS) has three subscales measuring social isolation, relations and acceptance. Authors therefore argue that it is not enough to examine these issues individually, and that the links between them must be explored. The tools that are listed have been developed and utilised in a number of different countries, and by researchers from various backgrounds and disciplines. Labonté RN, Hadi A, Kauffmann XE. Mathieson J, Popay J, Enoch E, Escorel S, Hernandez M, Johnston H et al. This scoping review found that the concepts of social inclusion and social exclusion, while often described as abstract and lacking clarity, have both been discussed and measured at the individual level in relation to health. The authors summarised that “action to improve the health of disadvantaged populations should …. While limited access to social resources is often assumed to be of significance for educational success, it has rarely been measured explicitly. Development and preliminary validation of a measure of social inclusion for use in people with mental health problems: the SInQUE. Gruskin S, Ferguson L. Using indicators to determine the contribution of human rights to public health efforts. London: Routledge; 2009. Accessed 13 June 2017. This may have been because quantitative scores are easier to conduct and to repeat over time in busy clinical settings, and this is precisely where tools included were mainly intended for use. Additional file 1 summarises the background literature relating to each of the 22 tools selected for this scoping review. A scale generated by Bude and Lantermann was used to assess social exclusion. Copenhagen: World Health Organization Regional Office for Europe; 2003. 2001;25(4):121–3. It is unclear why social exclusion is a less frequently used term in this context: it may be related to variations in the language used around the concepts of social inclusion and social exclusion, or the perception that social exclusion is more difficult to measure when compared with social inclusion. In: Lymbery M, Butler S, editors. The domains these tools cover are also very similar to the domains covered by those tools explicitly stating that they are measures of social inclusion. Accessed 10 Dec 2016. (2018) 25:410–420 411 However, social exclusion can also occur in the online world as cyberostracism (Williams et al., 2000). 2009;72(12):520–30. Definitions of social exclusion can be broadly categorised: some address the problems associated with exclusion [59, 60], others detail what aspects of life people are excluded from , and others mention the various levels on which exclusion is seen to operate . A review of the definitions of both social inclusion and social exclusion also revealed the variations among the explanations of these complex concepts. Graduate Entry Medical School, University of Limerick, Limerick, Ireland, School of Medicine, Clinical Science Institute, National University of Ireland, Room 342, Galway, Ireland, You can also search for this author in Accessed 14 Jul 2016. 1 . Politics, sociology, health and economics are just a few fields that have explored this complex idea and adapted it. PubMed Google Scholar. For this review, final inclusion and exclusion criteria were developed as the searching and exploration of the resulting papers took place . Council of the European Union. This resulting review also contains publications across a number of disciplines, and work from a variety of countries is included. Social exclusion and anti-poverty policy: a debate. Article Chan K, Evans S, Ng Y-L, Chiu MY-L, Huxley PJ. The lead author was responsible for screening the titles and abstracts of all document using the agreed inclusion and exclusion criteria. Brennan A, Rhodes J, Tyler P. New findings on the nature of economic and social exclusion in England and the implications for new policy initiatives: discussion paper 101. Disabil Rehabil. A scoping review of the peer-reviewed and grey literature was conducted to examine tools developed since 2000 that measure social exclusion or social inclusion. 2004. http://www.who.int/mental_health/evidence/MH_Promotion_Book.pdf. Accessed 15 Sep 2016. Scoping reviews do not typically involve detailed critical appraisal of the included work, thereby allowing a variety of both peer-reviewed and grey literature to be included. Huxley P, Evans S, Munroe M, Webber M, Burchardt T, Knapp M et al. Levac D, Colquhoun H, O’Brien KK. Accessed 24 Jul 2017. Yanicki SM, Kushner KE, Reutter L. Social inclusion/exclusion as matters of social (in)justice: a call for nursing action. The impact of psychosis on social inclusion and associated factors. Researchers agree that social exclusion serves a specific function for those who employ it, an… Sayce L. Social inclusion and mental health. s.n.. These tools vary in the number of items they include, how scores are allocated and in how they are administered. Pinfold V. ‘Building up safe havens…all around the world’: users’ experiences of living in the community with mental health problems. Social Exclusion How much a person has experienced the feeling of being isolated and ostracized is measured with three, seven-point items. Income inequality, Gini coefficient. Manual searches of the reference lists of included publications were carried out, and we attempted to contact all relevant tool authors. Search Now. **Before using this scale, researchers are asked to fill out this permission form. Popay J, Escorel S, Hernández M, Johnston H, Mathieson J, Rispel L. Understanding and tackling social exclusion. 2012;59(5):501–7. 2001;5(2):18–23. Qual Life Res. Three (3/21) of the tools had both a long and short version of the tool developed; the SCOPE, the Australian Community Participation Questionnaire (ACPQ) and the Participation Scale (PS). London: Palgrave MacMillan; 2000. Other sources mention numerous additional groups at risk of social exclusion: people who are unemployed, people who are migrants and refugees, people with mental health problems, women and children, older people, rural dwellers, people leaving institutions and single parent families [3, 29]. Shaw M, Dorling D, Smith GD. Cabinet Office Social Exclusion Task Force & Department of Health. Accessed 14 Feb 2017. 2008;17(1):123–35. The conclusion that she and other authors have reached is that primary healthcare professionals, who work in such proximity to many socially excluded groups, have an onus to advocate and act on behalf of these patients [34,35,36]. It is notable that none of the tools stated that its aim was to measure only social exclusion. Many aspects of social exclusion are deeply entrenched, and eliminating them is a long-term project. Department of Health and Children. The outputs of the tools varied substantially: 13/21 reported some form of a score of social exclusion or social inclusion. Eur J Homelessness. We have listed the measurement tools developed for use with individual patients in healthcare settings. This highlights the point that the concepts of social inclusion and social exclusion are felt to be relevant to researchers and practitioners across many disciplines, but this may have led to duplication when it came to the development of measurement tools. Promoting Mental Health: Concepts, Emerging Pvidence, Practice: World Health Organization. Google Scholar. Wilkinson R, Marmot MG, editors. Furthermore and in contrast to the subjective outcome measures, the more objective number of important people in regular contact was also used as outcome variable. Others felt that this ‘new’ concept could also be seen as more acceptable politically and less stigmatising for those people who are actually affected by it [10, 14]. It is also well documented that discrimination can lead to social exclusion. A total of 170 documents were included in the final scoping review. Dickens G, Weleminsky J, Onifade Y, Sugarman P. Recovery star: validating user recovery. There were no scales or tools found that were developed for the measurement of social exclusion alone. Int J Epidemiol. Measuring the degree of social exclusion of a person attending a healthcare service could allow their status to be monitored over time, and potentially show that certain healthcare interventions reduce social exclusion. The majority of the tools included were constructed for engaging with patients in mental health settings. Br J Gen Pract. The Guardian. 2014;60(2):148–54. There are a number of concepts very closely aligned with social inclusion and exclusion that were measured by seven of the 22 tools described. This SDG mentions the effective management of conditions such as HIV and substance abuse and the introduction of universal health coverage among other targets. 2010. http://webarchive.nationalarchives.gov.uk/20130124054057/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_114365.pdf. For example, a GP may see and treat a person with community-acquired pneumonia using antibiotics and advise when to return if symptoms worsen. 2009;57(3):211–23. Social determinants of health: the solid facts. Some of the 22 tools included were previously validated and evaluated, others were not, and this was not taken into account for this publication. Existing measures of success in primary healthcare interventions with marginalised patients are generally limited to the traditional disease mortality and morbidity outcomes; but there is the possibility that these do not capture the essence of life and health as a socially-excluded person. Another reason the SEKN work may not feature is that the SEKN authors stated “inclusion in some measures of a variety of health indicators as a component of or risk factor for social exclusion, rather than an outcome of the experience, all make it difficult to ‘measure’ the impact of social exclusion in health outcomes”. (Ed. In: Taket A, Crisp BR, Nevill A, Lamaro G, Graham M, Barter-Godfrey S, editors. This review identified 22 relevant measurement tools across the peer-reviewed and grey literature. 2000;6(3):201–12. Van Brakel WH, Anderson AM, Mutatkar R, Bakirtzief Z, Nicholls PG, Raju M, et al. 2015;124(1):127–39. A 2010 World Health Organization (WHO) report on poverty and social exclusion stated that these two factors were the “driving forces of health inequities for millions of people across the 53 Member States of the European Region” . Preliminary development and validation of an Australian community participation questionnaire: types of participation and associations with distress in a coastal community. 2006;28(4):193–203. PubMed Accessed 01 Feb 2017. Med. Unless otherwise noted, copyrights of the scales themselves are uncertain. 2016;10(1):31–51. Social exclusion is a common part of life. 2016;3(2):171–8. Globalization and social exclusion in cities: framing the debate with lessons from Africa and Asia. Soc Inclusion. The human givens. Social exclusion influences health directly through its manifestations in the health system and indirectly by affecting economic and other social inequalities that influence health. O’Donnell, P., O’Donovan, D. & Elmusharaf, K. Measuring social exclusion in healthcare settings: a scoping review. 2008. http://www.who.int/social_determinants/knowledge_networks/final_reports/sekn_final%20report_042008.pdf. 3/21 resulted in the development of a visual map of the social inclusion status of the person in question (HOS, MHRS, Inclusion Web [IW]). Aust N Z J Psychiatry. Room described many of the recurring ideas seen across various definitions when he stated that social exclusion was ultimately a “multidimensional, dynamic and relational concept” [14, 62, 63]. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Room G. Social quality of Europe: perspectives on social exclusion. of interventions aimed at fighting poverty and social exclusion and promoting social inclusion. Ment Health Rev J. It is very helpful in the search for viable constructs on which to do sound scientific research. Primary healthcare services, such as general practice, work to alleviate many of the causes and ill effects of social exclusion on a daily basis – primary healthcare professionals understand that to cure or attempt to resolve the health problems of many of their vulnerable patients, they often need to find solutions to the exclusionary processes being experienced by those patients, as well as dealing with the actual medical issues. Geneva: International Labour Organization; 1997. Inclusion Matters: The Foundation for Shared Prosperity: The World Bank. Many international bodies, such as the World Bank and the International Labour Organization, have also adopted the concept of social exclusion for use in their spheres of influence [10,11,12]. Soc Indic Res. Results: Of the 415 subjects, 246(59.3%) were males and 169(40.8%) females. The Hague: Kluwer Law International; 1997. p. 255–62. 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