The association between social exclusion or inclusion and health in EU and OECD countries: a systematic review

Abstract Background Social exclusion (SE), or the inability to participate fully in society, is considered one of the driving forces of health inequalities. Systematic evidence on this subject is pertinent but scarce. This review aims to systematically summarise peer reviewed studies examining the a...

Full description

Saved in:

Bibliographic Details
Published in:	European journal of public health Vol. 29; no. 3; pp. 575 - 582
Main Authors:	van Bergen, Addi P L, Wolf, Judith R L M, Badou, Mariam, de Wilde-Schutten, Kimriek, IJzelenberg, Wilhelmina, Schreurs, Hanneke, Carlier, Bouwine, Hoff, Stella J M, van Hemert, Albert M
Format:	Journal Article
Language:	English
Published:	England Oxford University Press 01-06-2019 Oxford Publishing Limited (England)
Subjects:	Adults Cross-sectional studies Health disparities Inclusion Inequality Mental health Observational studies Public health Reviews Social exclusion Socioeconomic Determinants Systematic review
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Abstract Background Social exclusion (SE), or the inability to participate fully in society, is considered one of the driving forces of health inequalities. Systematic evidence on this subject is pertinent but scarce. This review aims to systematically summarise peer reviewed studies examining the association between the multidimensional concepts of SE and social inclusion (SI) and health among adults in EU and OECD countries. Methods The protocol was registered on Prospero (CRD42017052718). Three major medical databases were searched to identify studies published before January 2018, supplemented by reference and citation tracking. Articles were included if they investigated SE or SI as a multidimensional concept with at least two out of the four dimensions of SE/SI, i.e. economic, social, political and cultural. A qualitative synthesis was conducted. Results Twenty-two observational studies were included. In the general population, high SE/low SI was associated with adverse mental and general health. For physical health, the evidence was inconclusive. In groups at high risk of SE, support was found for the association between high SE/low SI and adverse mental health but no conclusions could be drawn for physical and general health. Conclusions This review found evidence for the association between high SE/low SI and adverse health outcomes, particularly mental health outcomes. The evidence is mainly based on cross-sectional studies using simple and often ad hoc indicators of SE/SI. The development and use of validated measures of SE/SI and more longitudinal research is needed to further substantiate the evidence base and gain better understanding of the causal pathways.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23
ISSN:	1101-1262 1464-360X
DOI:	10.1093/eurpub/cky143