What works in inclusion health: overview of effective interventions for marginalised and excluded populations

Serena Luchenski; Nick Maguire; Robert W Aldridge; Andrew Hayward; Alistair Story; Patrick Perri; James Withers; Sharon Clint; Suzanne Fitzpatrick; Nigel Hewett

doi:10.1016/S0140-6736(17)31959-1

What works in inclusion health: overview of effective interventions for marginalised and excluded populations

Lancet. 2018 Jan 20;391(10117):266-280. doi: 10.1016/S0140-6736(17)31959-1. Epub 2017 Nov 12.

Authors

Affiliations

¹ Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, UK; The Farr Institute of Health Informatics Research, University College London, London, UK. Electronic address: s.luchenski@ucl.ac.uk.
² Department of Psychology, University of Southampton, Southampton, UK.
³ Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, UK; The Farr Institute of Health Informatics Research, University College London, London, UK.
⁴ Centre for Public Health Data Science, Institute of Health Informatics, University College London, London, UK; The Farr Institute of Health Informatics Research, University College London, London, UK; Institute of Epidemiology and Health Care, University College London, London, UK.
⁵ Find and Treat Service, University College London Hospitals, London, UK.
⁶ Center for Inclusion Health, Allegheny Health Network, Pittsburgh, PA, USA; Street Medicine Institute, Ingomar, PA, USA.
⁷ Street Medicine Institute, Ingomar, PA, USA.
⁸ Groundswell UK, London, UK.
⁹ Institute for Social Policy, Housing and Equalities Research, Heriot-Watt University, Edinburgh, UK.
¹⁰ Pathway Charity, London, UK.

PMID: 29137868
DOI: 10.1016/S0140-6736(17)31959-1

Abstract

Inclusion health is a service, research, and policy agenda that aims to prevent and redress health and social inequities among the most vulnerable and excluded populations. We did an evidence synthesis of health and social interventions for inclusion health target populations, including people with experiences of homelessness, drug use, imprisonment, and sex work. These populations often have multiple overlapping risk factors and extreme levels of morbidity and mortality. We identified numerous interventions to improve physical and mental health, and substance use; however, evidence is scarce for structural interventions, including housing, employment, and legal support that can prevent exclusion and promote recovery. Dedicated resources and better collaboration with the affected populations are needed to realise the benefits of existing interventions. Research must inform the benefits of early intervention and implementation of policies to address the upstream causes of exclusion, such as adverse childhood experiences and poverty.

Publication types

Review

MeSH terms

Delivery of Health Care / organization & administration*
Health Services Accessibility / organization & administration
Health Status Disparities
Housing
Humans
Ill-Housed Persons
Preventive Health Services / organization & administration
Social Determinants of Health
Social Marginalization*
Women's Health