The New Deal: jeopardised by the geography of unemployment?

The New Deal is the Labour government's flagship programme to "end the tragic waste of youth and long-term unemployment" by getting people off welfare benefits and into work. This paper argues that the principal weakness of the New Deal is that it seeks to influence the character of labour supply (i.e. the motivation and skills of the unemployed) while neglecting the state of labour demand, which varies greatly between places. The uneven geography of unemployment in the UK is likely to have a crucial bearing on the programme's impact and effectiveness, but this has been largely ignored in its development. The paper outlines some of the practical consequences of this imbalance and suggests how it could be rectified for the programme to be more effective

Moving prison health promotion along: Towards an integrative framework for action to develop health promotion and tackle the social determinants of health

The majority of prisoners are drawn from deprived circumstances with a range of health and social needs. The current focus within ‘prison health’ does not, and cannot, given its predominant medical model, adequately address the current health and well-being needs of offenders. Adopting a social model of health is more likely to address the wide range of health issues faced by offenders and thus lead to better rehabilitation outcomes. At the same time, broader action at governmental level is required to address the social determinants of health (poverty, unemployment and educational attainment) that marginalise populations and increase the likelihood of criminal activities. Within prison, there is more that can be done to promote prisoners’ health if a move away from a solely curative, medical model is facilitated, towards a preventive perspective designed to promote positive health. Here, we use the Ottawa Charter for health promotion to frame public health and health promotion within prisons and to set out a challenging agenda that would make health a priority for everyone, not just ‘health’ staff, within the prison setting. A series of outcomes under each of the five action areas of the Charter offers a plan of action, showing how each can improve health. We also go further than the Ottawa Charter, to comment on how the values of emancipatory health promotion need to permeate prison health discourse, along with the concept of salutogenesis

A population-based investigation into inequalities amongst Indigenous mothers and newborns by place of residence in the Northern Territory, Australia

BACKGROUND: Comparisons of birth outcomes between Australian Indigenous and non-Indigenous populations show marked inequalities. These comparisons obscure Indigenous disparities. There is much variation in terms of culture, language, residence, and access to services amongst Australian Indigenous peoples. We examined outcomes by region and remoteness for Indigenous subgroups and explored data for communities to inform health service delivery and interventions. METHODS: Our population-based study examined maternal and neonatal outcomes for 7,560 mothers with singleton pregnancies from Australia’s Northern Territory Midwives’ Data Collection (2003–2005) using uni- and multivariate analyses. Groupings were by Indigenous status; region (Top End (TE)/Central Australia (CA)); Remote/ Urban residence; and across two large TE communities. RESULTS: Of the sample, 34.1% were Indigenous women, of whom 65.6% were remote-dwelling versus 6.7% of non- Indigenous women. In comparison to CA Urban mothers: TE Remote (adjusted odds ratio [aOR] 1.47, 95%CI: 1.13, 1.90) and TE Urban mothers (aOR 1.36 (95% CI: 1.02, 1.80) were more likely, but CA Remote mothers (aOR 0.43; 95% CI: 0.31, 0.58) less likely to smoke during pregnancy; CA Remote mothers giving birth at >32 weeks gestation were less likely to have attended ≥ five antenatal visits (aOR 0.55; 95%CI: 0.36, 0.86); TE Remote (aOR 0.71; 95%CI: 0.53, 0.95) and CA Remote women (aOR 0.68; 95%CI: 0.49, 0.95) who experienced labour had lower odds of epidural/ spinal/narcotic pain relief; and TE Remote (aOR 0.47; 95%CI: 0.34, 0.66), TE Urban (aOR 0.67; 95%CI: 0.46, 0.96) and CA Remote mothers (aOR 0.52; 95%CI: 0.35, 0.76) all had lower odds of having a ‘normal’ birth. The aOR for preterm birth for TE Remote newborns was 2.09 (95%CI: 1.20, 3.64) and they weighed 137 g (95%CI: -216 g, -59 g) less than CA Urban babies. There were few significant differences for communities, except for smoking prevalence. CONCLUSIONS: This paper is one of few quantifying inequalities between groups of Australian Indigenous women and newborns at a regional level. Indigenous mothers and newborns do worse on some outcomes if they live remotely, especially if they live in the TE. Smoking prevention and high-quality antenatal care is fundamental to addressing many of the adverse outcomes identified in this paper.Malinda Steenkamp, Alice Rumbold, Lesley Barclay and Sue Kilde

Towards Better Sexual Health: a Survey of Sexual Attitudes and Lifestyles of Young People in Northern Ireland, 2000-2002

Abstract copyright UK Data Service and data collection copyright owner.Towards Better Sexual Health was a three-year mixed methods study of sexual attitudes and lifestyles of 14-25-year-old young people in Northern Ireland. The study was undertaken jointly by the University of Ulster and the Family Planning Association (Northern Ireland) (fpaNI) from 2000-2002. The study consisted of a large scale self-administered survey, based on an opportunistic sample, which was completed by 1,013 respondents. Within the study, 71 focus group discussions and 15 one-to-one in-depth interviews were also conducted. Users should note that the UKDA collection contains the quantitative survey only. The study was initiated by fpaNI due to the failure to include Northern Ireland in the National Surveys of Sexual Attitudes and Lifestyles (NATSAL) which covers Great Britain only (available from the UKDA under GN 33353).Main Topics:The first part of the survey questionnaire included background questions, questions on experiences of sex education, attitudes towards different sexual lifestyles, knowledge of sexually transmitted infections and access to, and experience of use of, sexual service providers. This section was completed by all respondents. The second part of the questionnaire was completed by respondents who had had sex. This part included questions on the age at first sex and age of first sexual partner, experience of first sex, the use and source of contraception(s) (if any), the number of sexual partners as well as the number of pregnancies and pregnancy terminations. A number of questions duplicate questions asked in the NATSAL studies.<br