A Cross-cohort Description of Young People’s Housing Experience in Britain over 30 Years: An Application of Sequence Analysis

Methods. Sequence Analysis supported by Event History Analysis. Key Findings. Despite only 12 years separating both cohorts, the younger 1970 cohort exhibited very different patterns of housing including a slower progression out of the parental home and into stable tenure, and an increased reliance on privately rented housing. Returns to the parental home occurred across the twenties and into the thirties in both cohorts, although occurred more frequently and were more concentrated among certain groups in the 1970 cohort compared to the 1958 cohort. Although fewer cohort members in the 1970 cohort experienced social housing, and did so at a later age, social housing was also associated with greater tenure immobility in this younger cohort. Conclusions. The housing experiences of the younger cohort became associated with more unstable tenure (privately rented housing) for the majority. Leaving the parental home was observed to be a process, as opposed to a one-off event, and several returns to the parental home were documented, more so for the 1970 cohort. These findings are not unrelated, and in the current environment of rising house prices, collapses in the (youth) labour market and rising costs of higher education, are likely to increase in prevalence across subsequent cohorts

A cross-cohort description of young people's housing experience in Britain over 30 years: An application of Sequence Analysis

Methods. Sequence Analysis supported by Event History Analysis. Key Findings. Despite only 12 years separating both cohorts, the younger 1970 cohort exhibited very different patterns of housing including a slower progression out of the parental home and into stable tenure, and an increased reliance on privately rented housing. Returns to the parental home occurred across the twenties and into the thirties in both cohorts, although occurred more frequently and were more concentrated among certain groups in the 1970 cohort compared to the 1958 cohort. Although fewer cohort members in the 1970 cohort experienced social housing, and did so at a later age, social housing was also associated with greater tenure immobility in this younger cohort. Conclusions. The housing experiences of the younger cohort became associated with more unstable tenure (privately rented housing) for the majority. Leaving the parental home was observed to be a process, as opposed to a one-off event, and several returns to the parental home were documented, more so for the 1970 cohort. These findings are not unrelated, and in the current environment of rising house prices, collapses in the (youth) labour market and rising costs of higher education, are likely to increase in prevalence across subsequent cohorts.Housing, Young People, Sequence Analysis, Housing Tenure

A scoping review characterising the activities and landscape around implementing NICE guidance

Clinical, public health and social care guidance provide evidence-based recommendations on how professionals and commissioners working within these fields should care for patients, service users and the wider public. Evidence-based clinical guidance aims to reduce variation in practice and improve levels of patient and service user care, while at the same time allowing clinical freedom for individual practitioners. The guidance produced by the National Institute for Health and Care Excellence (NICE) are not mandatory, although NICE does set out a business case in terms of the clinical and cost-effectiveness for implementation. Implementation in this sense signifies the active planned processes that take place to enable guidance-based best practice to become routinely embedded within day-to-day activity. There is growing recognition that getting evidence to influence and change practice is a complex undertaking. Despite a growth in the evidence base in this area, there remain gaps in understanding which types of implementation strategies are most effective for which types of guidance, for which audiences and in which circumstances. This review sought to investigate the strategies used to implement NICE guidance in routine practice, and particularly to examine the impact of implementation strategies operationalised by national level organisations and networks

Understanding the friendship networks of older Black and Minority Ethnic people living in the United Kingdom

Older Black and Minority Ethnic (BME) people living in the United Kingdom (UK) are vulnerable to the experiences of social isolation and loneliness. Despite this, it is widely assumed that they adhere to traditional family practices and living arrangements that protect them from social isolation and loneliness. Such assumptions are problematic and can reify family networks as the main area of research for older BME people to the detriment of friendship networks which are also crucial. However, few researchers have explored this area. With the older BME population increasing at a faster rate than the older white population, further research is needed. Utilising data from Wave 6 of Understanding Society (N = 7,499, 4.3% of whom self-identified as BME), this study explores the ways in which the friendship networks of older BME people differ compared to older white people using logistic regression analyses. After controlling for potential confounding socio-demographic characteristics, older BME people were more likely to report having fewer close friends and fewer friends who live locally, suggesting that their friendship networks may be restricted in quantity and accessibility. Not only do these findings raise important questions about the varying needs of older minority ethnic people who have been largely overlooked in recent government policy, but they also highlight the continuing challenges of using large-scale surveys to research older BME people in the UK

Identifying and appraising promising sources of UK clinical, health and social care data for use by NICE

This report aimed to aid the National Institute of Health and Care Excellence (NICE) in identifying opportunities for greater use of real-world data within its work. NICE identified five key ways in which real-world data was currently informing its work, or could do so in the future through: (i) researching the effectiveness of interventions or practice in real-world (UK) settings (ii) auditing the implementation of guidance (iii) providing information on resource use and evaluating the potential impact of guidance (iv) providing epidemiological information (v) providing information on current practice to inform the development of NICE quality standards. This report took a broad definition of ‘real-world’ data and created a map of UK sources, informed by a number of experts in real-world data, as well as a literature search, to highlight where some of the opportunities may lie for NICE within its clinical, public health and social care remit. The report was commissioned by the NICE, although the findings are likely to be of wider interest to a range of stakeholders interested in the role of real-world data in informing clinical, social care and public health decision-making. Most of the issues raised surrounding the use and appraisal of real-world data are likely to be generic, although the choice of datasets that were profiled in-depth reflected the interests of NICE. We discovered 275 sources that were named as real-world data sources for clinical, social care or public health investigation, 233 of which were deemed as active. The real-world data landscape therefore is highly complex and heterogeneous and composed of sources with different purposes, structures and collection methods. Some real-world data sources are purposefully either set-up or re-developed to enhance their data linkages and to examine the presence/absence/effectiveness of integrated patient care; however, such sources are in the minority. Furthermore, the small number of real-world data sources that are designed to enable the monitoring of care across providers, or at least have the capability to do so at a national level, have been utilised infrequently for this purpose in the literature. Data that offer the capacity to monitor transitions between health and social care do not currently exist at a national level, despite the increasing recognition of the interdependency between these sectors. Among the data sources we included, it was clear that no one data source represented a panacea for NICE’s real world data needs. This does highlight the merits and importance of data linkage projects and is suggestive of a need to triangulate evidence across different data, particularly in order to understand the feasibility and impact of guidance. There exists no overall catalogue or repository of real-world data sources for health, public health and social care, and previous initiatives aimed at creating such a resource have not been maintained. As much as there is a need for enhanced usage of the data, there is also a need for taking stock, integration, standardisation, and quality assurance of different sources. This research highlights a need for a systematic approach to creating an inventory of sources with detailed metadata and the funding to maintain this resource. This would represent an essential first step to support future initiatives aimed at enhancing the use of real-world data

Interventions for autumn exacerbations of asthma in children

The objectives are as follows: To assess the effects of pharmacotherapy and behavioural interventions enacted in the lead-up to the school return during autumn which are designed to reduce asthma exacerbations in school-aged children during this period

Is social exclusion still important for older people?

The concept of social exclusion builds on the longstanding recognition of the relationship between material and non-material forms of disadvantage. Theoretically, the concept of social exclusion describes a detachment between the values and practices of the socially excluded and mainstream society, in part through the exclusionary practices of the socially included. While social exclusion for younger adults and children may revolve around the labour market, educational achievement and future potential, for older people the notion of social exclusion is grounded more in the preservation of independence and autonomy. Socially excluded older people are often those who are regarded as having lost their independence. Older people may be at risk of social exclusion because of (based on Philipson and Scharf, 2004): (i) age-related characteristics that are more likely to occur in later life, such as disability, low income and widowhood; (ii) cumulative disadvantage, where cohorts become more unequal over time due to, for instance, the impact of labour market experiences on pension outcomes; (iii) community characteristics (and the interaction with age and cohort characteristics) which make older people more vulnerable to changing conditions like population turnover, economic decline and crime, in their local areas; (iv) experience of age-based discrimination. In this report, we examine the concept of social exclusion among older people using data from the English Longitudinal Study of Ageing (ELSA). We adopt both a cross-sectional and longitudinal approach to analysing data collected in 2002 and 2008, building on earlier seminal work exploring social exclusion among older people by Barnes et al (2006). We recognise social exclusion as a multifaceted state, involving both material and non-material factors, and measure exclusion from the following domains: 1. Social Relationships; 2. Cultural Activities; 3. Civic Activities and Access to Information; 4. Local Amenities; 5. Decent Housing and Public Transport; 6. Common Consumer Goods; 7. Financial Products. We find that levels of social exclusion rose slightly between 2002 and 2008 among older people aged 50 and above. In 2002, 54.4 per cent were not excluded on any domain, reducing to 52.3 per cent in 2008. Between 2002 and 2008, becoming excluded from social relationships, civic activities and access to information, cultural activities, and local amenities was associated with a lower quality of life score; becoming excluded from social relationships and decent housing and public transport was associated with becoming lonelier between sweeps, while becoming excluded from social relationships was additionally associated with worsening self-perceived financial circumstances. These results suggest that the impact of being socially excluded influences outcomes reflecting both material and non-material circumstances