JSNA Inclusion Health Groups


Inclusion health is a ‘catch-all’ term used to describe people who are socially excluded. These people typically experience multiple overlapping risk factors for poor health (such as poverty, adverse childhood experiences, violence, substance use, mental illness and complex trauma), experience stigma and discrimination, and are not consistently accounted for in electronic records (such as healthcare databases).

People belonging to inclusion health groups frequently suffer from multiple health issues, which can include mental and physical ill health and substance dependence issues. This leads to poor health outcomes, often much worse than the general population, lower average age of death, and it contributes considerably to increasing health inequalities. As such, these groups are included in the NHS Core 20 PLUS 5.

Evidence shows that people who are socially excluded underuse some services, such as primary and preventative care, and often rely on emergency services such as A&E when their health needs become acute. This results in missed opportunities for preventive interventions, serious illness, and inefficiencies, and further exacerbates existing health inequalities.

There will be differences in needs within socially excluded groups (for example by gender) as intersectionality still applies to individuals’ experiences within Inclusion Health Groups. It is important to remember that people may not be aware that they are part of an Inclusion Health Group or may not identify themselves to be part of one. Additionally, people may pass through multiple Inclusion Health Groups throughout their lifetime and will take these experiences and potential health issues with them throughout their life. Links between the different Inclusion Health Groups are identified in both national and local evidence and are discussed throughout this report.

This JSNA Chapter considers inclusion health groups across Hampshire and Isle of Wight and where possible aims to quantify these communities in our population, where they live, their demographics and describe the potential health outcomes and challenges they may face. The inclusion health groups identified in this report are coastal communities (including Left Behind Neighbourhoods), people with drug and alcohol dependency, Gypsy, Roma and Irish Traveller community, people experiencing homelessness, people in contact with the justice system, sex workers, veterans, victims of modern slavery and vulnerable migrants (including Afghan nationals).

Notes and references:

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Hampshire and Isle of Wight summaries