Search results

Individuals living in areas of higher deprivation are more likely to have requested mental health treatment but are less likely to have received treatment or benefitted from it. Less is known about the extent of access equality and treatment outcomes for individuals with a long-term health condition who experience mental health difficulties. The purpose of this paper is to evaluate the extent to which the neighbourhood Index of Multiple Deprivation predicted access to treatment, appointment attendance, treatment completion and clinical outcomes in a British health psychology clinic.

Retrospective data were used from 479 individuals referred to a health psychology clinic over 12 months. Clinical outcomes were measured using the Clinical Outcomes in Routine Evaluation – Outcome Measure. Patient data were linked with their neighbourhood Index of Multiple Deprivation decile. Data were analysed using correlation, linear regression and Fisher’s exact test.

There were no significant associations between deprivation and whether an individual attended assessment, attended treatment or completed treatment or between deprivation and patients’ clinical outcomes. Exploratory evidence indicated that individuals from higher deprivation neighbourhoods may be over-represented in clinic referrals, and individuals from lower deprivation neighbourhoods may be under-represented, compared with local population distribution estimates.

This evaluation provides insights into treatment outcomes and deprivation in those with physical health difficulties. Further evaluation using a larger sample and comparing referrals with local prevalence estimates of comorbid mental and physical health problems would enable greater confidence in the conclusion that no evidence of inequality on the basis of neighbourhood deprivation was found.

The Strathclyde experience makes it clear that local government should be precise about the objectives it wishes to pursue, the likelihood of achieving these, the methods it must adopt, and the best way of monitoring progress and effectiveness. Strathclyde Region has laid the base for a much more efficient delivery of services and resources relating to its particular needs, this information being derived from local data collection and analysis and providing essential underpinning to policy initiatives on issues (e.g. services to the unemployed, one‐parent families). Regional deprivation strategy has increased political awareness of Regional employees, and the 1983 strategy emphasises community development. Through a greater commitment by Regional staff to act positively in reducing the impact of urban deprivation, the effect of Regional policy on the lives of individuals has been significant.

The cardinal point to note here is that the development (and unfortunately the likely potential) of area policy is intimately related to the actual character of British social policy. Whilst area policy has been strongly influenced by Pigou's welfare economics, by the rise of scientific management in the delivery of social services (cf Jaques 1976; Whittington and Bellamy 1979), by the accompanying development of operational analyses and by the creation of social economics (see Pigou 1938; Sandford 1977), social policy continues to be enmeshed with the flavours of Benthamite utilitatianism and Social Darwinism (see, above all, the Beveridge Report 1942; Booth 1889; Rowntree 1922, 1946; Webb 1926). Consequently, for their entire history area policies have been coloured by the principles of a national minimum for the many and giving poorer areas a hand up, rather than a hand out. The preceived need to save money (C.S.E. State Apparatus and Expenditure Group 1979; Klein 1974) and the (supposed) ennobling effects of self help have been the twin marching orders for area policy for decades. Private industry is inadvertently called upon to plug the resulting gaps in public provision. The conjunction of a reluctant state and a meandering private sector has fashioned the decaying urban areas of today. Whilst a large degree of party politics and commitment has characterised the general debate over the removal of poverty (Holman 1973; MacGregor 1981), this has for the most part bypassed the ‘marginal’ poorer areas (cf Green forthcoming). Their inhabitants are not usually numerically significant enough to sway general, party policies (cf Boulding 1967) and the problems of most notably the inner cities has been underplayed.

The purpose of this paper is to investigate to what extent urban regeneration programmes were targeted at the most deprived geographical areas and populations within the boundaries of nine local authorities (LAs) in the North West of England.

For each of the nine LAs, area‐level and individual survey data were used in estimating the proportions of the more deprived neighbourhoods and individuals included in (or excluded from) regeneration target populations after 1995.

The area‐level approach found that, in general, the more deprived neighbourhoods within local authority districts had been included in a main regeneration programme target area. However there was evidence of inconsistent coverage between LA areas, as well as some cases of very deprived local areas having no involvement at all in major regeneration programmes since 1995. Additional analysis of available survey data found that substantial numbers of residents with one or more individual indicators of deprivation (not in full‐time employment, not owning home, in difficult financial situation) had not been included in a regeneration target population.

The basic nature of the measures of regeneration and deprivation used in the study reflect its status as the first stage of a wider project investigating the association between regeneration activity, social exclusion and health.

The findings of the study highlight the requirement for evaluators of a regeneration programme to consider how successful the intervention has been in targeting those residents for whom it was initially designed. This should precede any measurement of the programme outputs and their impact upon the “well‐being” of the targeted community.

The study is original in its use of both aggregated and individual level data in its consideration of how regeneration targets “need”.

The purpose of this paper is to examine the reasons and risk factors that explain the threefold increase in drug-related deaths from 267 in 1996 to 934 in 2017 in Scotland. The authors explore the known links between deprivation and problem drug use (PDU) and discuss the impact of drug policy and service provision on PDU and drug-related deaths.

Using quantitative data sets from the National Records of Scotland (NRS) for drug-related deaths registered in 2017 and data sets from the Scottish Index of Multiple Deprivation (SIMD), we produce statistical data on mortality rates relating to areas of deprivation, gender and age.

The data highlight the disproportionate number of deaths in the most deprived areas in comparison to the least deprived areas and the national average. Findings indicate that one quarter of male and female DRD in 2017 were under 35. When examining the least deprived vingtile, drug-related deaths account for 2.84 per 100,000 population. Based on this mortality rate calculation, the amount of drug-related deaths are 23 times higher in the most deprived area than the least deprived area.

The research design uses data obtained from the NRS and data from Scottish Multiple Index of Deprivation. Due to the limitations of available data, the research design focused on SIMD population vingtiles.

This research contributes to making unarguable links between entrenched structural inequality and increased drug-related death.

This paper contributes to knowledge on the need for drug policy advisors to recognise the importance of deprivation that plays a major part in risks of problematic drug use and harms.

While several national data sets have published information by SIMD vingtile, no published research has sought to investigate the disproportionate number of deaths by population in the most deprived areas.

There are significant inequalities in mental health, with mental health problems and poor mental health more common in areas of deprivation. Current policy in Scotland acknowledges the impact of social and environmental factors on community mental health and well‐being and the need for public mental health to engage with regeneration initiatives. This study, based in a low‐income community in east Glasgow, assesses what factors influence community mental health and well‐being and how to develop par tnerships to address these issues. It involved a workshop with community planning agencies and residents' groups in east Glasgow, an action research project with local residents and a validation event with local residents. The study found that social circumstances influenced mental health and well‐being, with people having concerns about their neighbourhood and environment, with antisocial behaviour emerging as a major factor contributing to residents feeling unsafe, isolated and unhappy living in the area. At the same time, residents talked a lot about how happy they felt about the community they were par t of and the impor tant role that social capital can play in low‐income areas in promoting well‐being. The study also highlights the need for par tnerships between health and other sectors and the impor tance of ensuring multi‐agency working that embeds public mental health within the agendas of housing and regeneration sectors. Finally, it demonstrates that action research between par tner agencies and communities will be more effective in identifying key issues and that within such a process, there is more likely to be ‘buy in’ from these agencies to bring about social change.

Background: Evidence from a range of major public health incidents shows that neighbour-based action can have a critical role in emergency response, assistance and recovery. However, there is little research to date on neighbour-based action during the 2020 coronavirus pandemic. This article reports on a survey of people engaged in supporting their neighbours in weeks three and four of the UK COVID-19 lockdown.

Methods: Members of area-based and community of interest COVID-19 support groups in the Bristol conurbation were invited to complete an online survey. Of 1,255 people who clicked on the survey link, 862 responded; of these, 539 responses were eligible for analysis.

Results: Respondents reported providing a wide range of support that went beyond health information, food and medical prescription assistance, to include raising morale through humour, creativity and acts of kindness and solidarity. A substantial proportion felt that they had become more involved in neighbourhood life following the lockdown and had an interest in becoming more involved in future. Neighbour support spanned all adult age groups, including older people categorised as being at-risk to the virus. With respect to most measures, there were no differences in the characteristics of support between respondents in areas of higher and lower deprivation. However, respondents from more deprived areas were more likely to state that they were involved in supporting certain vulnerable groups.

Conclusions: As with previous research on major social upheavals, our findings suggest that responses to the viral pandemic and associated social restrictions may increase existing social and health inequalities, and further research should explore this issue in more depth.

In the past two decades governments in Britain have launched a series of initiatives designed to reduce the disparities between areas of affluence and deprivation. These initiatives were funded by central government and were delivered through a series of partnership boards operating at the neighbourhood level in areas with high levels of deprivation. Drawing on similar approaches in the US War on Poverty, the engagement of residents in the planning and delivery of projects was a major priority. This chapter draws on the national evaluations of three of these programmes in England: the Single Regeneration Budget, the New Deal for Communities and the Neighbourhood Management Pathfinders.

The chapter begins by identifying the common characteristics of these programmes, known as area-based initiatives because they targeted areas of concentrated deprivation with a population of about 10,000 people each. It then goes on to discuss the three national programmes and summarises the main findings in relation to how far key indicators changed for the better. The final section sets out the ways in which policy objectives changed in 2010 after the election of a coalition government. This produced a shift to what was called the ‘Big Society’ where the rhetoric favoured a transfer of power away from central government towards the local, neighbourhood, level. This approach favoured self-help and a call to volunteering rather than channelling resources to the areas in greatest need. The chapter closes by reviewing the relatively modest achievements of this centralist, big-state approach to distressed neighbourhoods of 1990–2010.

“Food deserts” in British cities are partly the result of the expansion of multiple food retailing. New large stores force smaller stores to close down, thus depriving local residents of food shopping opportunities. Examines this proposition through an analysis of changes in consumer access to food shopping in Cardiff over the last 20 years. Shows that although accessibility scores have increased in Cardiff since 1980 they have increased at a faster rate in higher income areas. In a pocket of deprived areas accessibility has declined over the decade. Thus, there has been a polarisation effect with a widening gap in accessibility scores across the city.