Exclusão social em ambientes de atenção primária: chegou a hora da medição

  • Patrick O’Donnell University of Limerick
  • Khalifa Elmusharaf University of Limerick
Palavras-chave: exclusão social, inclusão social, marginalização, cuidados de saúde primários, instrumentos de medição, desigualdades na saúde

Resumo

A exclusão social é um conceito que tem sido discutido e debatido em muitas disciplinas nas últimas décadas. Em 2006, a Rede de Conhecimento de Exclusão Social da OMS publicou um relatório detalhando seu trabalho explicando a relevância da exclusão social para o domínio da saúde. Como parte desse trabalho, os autores formularam uma definição complexa de exclusão social que se mostrou difícil de adaptar ou operacionalizar nos contextos de saúde. Analisamos esse trabalho da OMS e outras evidências publicadas, e decidimos que a exclusão social é um conceito que vale a pena medir no nível individual nos contextos de saúde. Sugerimos que o espaço da atenção primária à saúde, em particular, seja um cenário ideal para fazer essa medição. Examinamos as ferramentas de medição de exclusão social existentes e examinamos as abordagens adotadas por seus autores e os vários domínios que mediram. Propomos agora desenvolver e validar essa ferramenta para uso em ambientes de atenção primária.

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Biografia do Autor

Patrick O’Donnell, University of Limerick

Clinical Fellow in Social Inclusion, Graduate Entry Medical School

 

Khalifa Elmusharaf, University of Limerick

Senior Lecturer in Public Health, Graduate Entry Medical School

 

Referências

1. Peace R. Social exclusion: A concept in need of definition? Social Policy J New Zealand. 2001;(16):17-36.

2. Piachaud D, Bennett F, Nazroo J, Popay J. Social inclusion and social mobility. 2009. [cited 2016 Dec 10] Available from: http://www.instituteofhealthequity.org/resources-reports/social-inclusion-and-social-mobility-task-group-report/task-group-9-social-inclusion-and-social-mobility-full.pdf

3. Popay J, Escorel S, Hernández M, Johnston H, Mathieson J, Rispel L. Understanding and tackling social exclusion. Final report to the WHO Commission on Social Determinants of Health from the Social Exclusion Knowledge Network. World Health Organization, 2008.

4. Department of Health. Inclusion Health: Improving Primary Care for Socially Excluded People. [cited 2016 May 12] Available from: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/ documents/digitalasset/dh_114365.pdf.

5. van Bergen APL, Wolf JRLM, Badou M, Wilde-Schutten K, Ijzelenberg W, Schreurs H, et al. The association between social exclusion or inclusion and health in EU and OECD countries: a systematic review. Eur J Public Health. 2018;cky143. DOI: https://doi.org/10.1093/eurpub/cky143

6. Aldridge RW, Story A, Hwang SW, Nordentoft M, Luchenski SA, Hartwell G, et al. Morbidity and mortality in homeless individuals, prisoners, sex workers, and individuals with substance use disorders in high-income countries: a systematic review and meta-analysis. Lancet. 2018;391(10117):241-50. DOI: https://doi.org/10.1016/S0140-6736(17)31869-X

7. Luchenski S, Maguire N, Aldridge RW, Hayward A, Story A, Perri P, et al. What works in inclusion health: overview of effective interventions for marginalised and excluded populations. Lancet. 2018;391(10117):266-80. DOI: https://doi.org/10.1016/S0140-6736(17)31959-1

8. Cabinet Office Social Exclusion Task Force & Department of Health. Inclusion Health Evidence Pack. 2010. [cited 2016 Sep 15] Available from: http:/www.cabinetoffice.gov.uk/media/346574/inclusion-health-evidencepack.pdf.

9. Marmot M. Inclusion health: addressing the causes of the causes. Lancet. 2018;391(10117):186-8. DOI: https://doi.org/10.1016/S0140-6736(17)32848-9

10. Department of Health. Inclusion Health: Improving the way we meet the primary health care needs of the socially excluded. [cited 2016 May 15] Available from: http:/www.cabinetoffice.gov.uk/media/346571/inclusion-health.pdf.

11. O’Donnell P, O’Donovan D, Elmusharaf K. Measuring social exclusion in healthcare settings: a scoping review. Int J Equity Health. 2018;17(1):15. DOI: https://doi.org/10.1186/s12939-018-0732-1

12. Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. Milbank Q. 2005;83(3):457-502. DOI: https://doi.org/10.1111/j.1468-0009.2005.00409.x

13. World Health Organization (WHO). The World Health Report 2008: Primary health care now more than ever. Geneva: WHO, 2009.

14. Elmusharaf K, Daboin BEG, Crocetta TB. Do we really know who are left behind and who are at risk of being left behind? J Hum Growth Dev. 2018; 28(3):218-22. DOI: http://dx.doi.org/10.7322/jhgd.152135
Publicado
2019-05-06
Seção
Artigos Originais