Participation and exclusion: a qualitative study of processes of power and inequality in area-based initiatives in an English town

The processes of three area-based initiatives relating to health provision, urban and neighbourhood renewal in Luton are used to examine whether political participation affects social exclusion. Government policies presume that increased participation reduces exclusion, while critical literature questions the type of participation produced in state initiatives, and also whether the discourse of exclusion adequately articulates social inequality. Participation is analysed in its relations to power, the political and to a social typology. Exclusion is analysed by delineating its contested meaning, and developing a dialectical model of inclusion and exclusion, that enables exclusion to be prefigured both as an analytical concept and as a critical component for exploring inequality. This thesis explores the processes of participation and exclusion via voluntary and community groups by presenting a predominantly qualitative analysis of the frameworks and processes of participation and the circumstances and experiences of exclusion. The study finds that: • The participation of the voluntary and community groups in the initiatives was on an unequal basis with the statutory sector, it was constrained by bureaucratic procedures, and led to a combative relationship between the sectors in two of the initiatives. • The voluntary and community sectors -elements of which are here characterised as "remedial movements" -had some effects on micro-and mesolevel processes, but no direct effect on macro-policy that controls the initiatives. Participation in the groups and initiatives faced a number of structural dilemmas. • Social exclusion in the areas was heterogeneous, but associated with the lack of interactional processes that enable inclusion. The range of experiences of exclusion demonstrated what I shall define as an "inequality of capabilities for inclusion". The research concludes that participation via initiatives does not necessarily result in the total incorporation of the voluntary and community sector, and claims for rights to be recognised had both achieved gains and reflected an antagonistic, if complementary, approach by some groups to the state. If the aim is to increase participation, however, the evidence implies that it needs to be consistently driven; that while the initiatives have affected exclusion, their effects have been limited and are fragile, and that reducing inequality is necessary to enable inclusive participation

Influencing policy and practice is work in progress

Focusing on policy impact without a functioning regional devolved government required Administrative Data Research Centre Northern Ireland (ADRC NI) researchers and staff to develop new ways of influencing policy and practice in Northern Ireland. The development of a co-production model with policymakers, service providers and third sector representatives has embedded pathways to impact within research programmes, to great success. This paper describes the efforts of the ADRC NI to influence policy and practice, in Northern Ireland in challenging political circumstances, outlining the context, approach, processes, strengths, challenges and lessons for the future

Unmet need for chronic mental ill health: A population-based record linkage study

Introduction It is widely recognised that many people with chronic mental ill health do not receive the treatment they need, with socio-demographic and socio-economic factors contributing to mental healthcare access and receipt of treatment. However, recently different perceptions have emerged following reports of over-treatment or over-medication of a proportion of the population presenting to primary care settings with poor mental health. Objectives This study aimed to investigate which factors are associated with the presence of poor mental health and the likelihood of being in receipt of pharmacological treatment for those who report chronic mental ill health. Methods The methodology was a record linkage of the 2011 Northern Ireland Census returns and a population-wide database of prescribed medications. The presence of a chronic mental health condition, as assessed through a self-reported question in the 2011 Census, was compared to electronic administrative records on psychotropic medication use in the twelve months following the Census. Results This study shows that those of non-white background (OR 0.38 95%CI 0.26-0.54), who were never married (OR 0.67 95%CI 061-0.73), unemployed (OR 0.65 95%CI 0.53-0.81) or living in a rural area (OR 0.88 95%CI 0.79-0.98) were less likely than their peers to receive medication for their poor mental health. Conclusions Some but not all of the observed variations may represent unmet need, but further studies are required to understand the knowledge of and attitudes towards healthcare services of groups (such as ethnic minorities and unemployed) who are identified as being less likely to receive treatment

Influence of Heterogamy by Religion on Risk of Marital Dissolution: A Cohort Study of 20,000 Couples

Heterogamous marriages, in which partners have dissimilar attributes (e.g. by socio-economic status or ethnicity), are often at elevated risk of dissolution. We investigated the influences of heterogamy by religion and area of residence on risk of marital dissolution in Northern Ireland, a country with a history of conflict and residential segregation along Catholic–Protestant lines. We expected Catholic–Protestant marriages to have elevated risks of dissolution, especially in areas with high concentrations of a single religious group where opposition to intermarriage was expected to be high. We estimated risks of marital dissolution from 2001 to 2011 for 19,791 couples drawn from the Northern Ireland Longitudinal Study (a record linkage study), adjusting for a range of compositional and contextual factors using multilevel logistic regression. Dissolution risk decreased with increasing age and higher socio-economic status. Catholic–Protestant marriages were rare (5.9 % of the sample) and were at increased risk of dissolution relative to homogamous marriages. We found no association between local population composition and dissolution risk for Catholic–Protestant couples, indicating that partner and household characteristics may have a greater influence on dissolution risk than the wider community