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包容健康中的有效措施:边缘化和被排斥人群的有效干预措施概述。

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

机构信息

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.

Department of Psychology, University of Southampton, Southampton, UK.

出版信息

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

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.

摘要

包容健康是一项服务、研究和政策议程,旨在预防和纠正最脆弱和被排斥人群的健康和社会不平等。我们对包容健康目标人群的健康和社会干预措施进行了证据综合,包括无家可归者、吸毒者、囚犯和性工作者。这些人群通常有多种重叠的风险因素和极高的发病率和死亡率。我们确定了许多干预措施来改善身心健康和物质使用;然而,证据稀缺的是结构性干预措施,包括住房、就业和法律支持,这些措施可以防止排斥和促进康复。需要专门的资源和更好的与受影响人群的合作,以实现现有干预措施的效益。研究必须告知早期干预和实施政策的效益,以解决排斥的上游原因,如不良的童年经历和贫困。

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