Vulnerable Groups in Health and Social Care

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Mary Larkin

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    Dedication

    For Shaun, Ruth and Matt

    List of Illustrations

  • Glossary

    absolute poverty Also known as subsistence poverty, this refers to the lack of basic resources such as food and shelter that are necessary to sustain a physically healthy existence. This concept is frequently used in the analysis of poverty worldwide.

    acute illness Short-term illnesses, such as a chest infection or chicken pox.

    ageism When a person is discriminated against on the grounds of age.

    anti-psychiatry movement The work of a range of academics in the 1960s and 1970s from several different countries, which criticised traditional theory and practice in psychiatry.

    asylum seeker Someone who has fled from their home country because of war, civil unrest and conflict, has arrived in another country, has made a formal application for asylum and is awaiting a decision about their status.

    bed and breakfasts Temporary accommodation for homeless people that provides them with sleeping accommodation and one meal (breakfast) only. Bathrooms are often shared with other residents.

    biomedicine This rests on an assumption that all causes of disease—mental disorders as well as physical disease—are understood in biological terms and it views disease and sickness as deviations from normal functioning, which medicine has the power to put right with its scientific knowledge and understanding of the human body.

    chronic illness This is defined as a long-term health disorder that interferes with social interaction and role performance, for example, heart disease and asthma.

    citizenship A concept that has re-emerged in political and academic discourses since the late twentieth century. The main dimensions of the contemporary approach to citizenship are that all those who are full members of society are conferred with the status of citizenship. This locates them in reciprocal relationships with other individuals and with the state, involving equal rights and obligations.

    communitarianism: An ideology which has strong moral and ethical elements, is opposed to pure individualism, and stresses common interests and common values arising from communal bonds. While it does emphasise the responsibilities of the state and the rights of individuals, it also stresses the social responsibilities of individual citizens, families and communities.

    competition for scarce resources: A Weberian concept that refers to the way that social groups compete with each other for advantages in society, such as economic rewards, status, and employment opportunities.

    consumerism: The focus on consumption in capitalist societies, as opposed to production. Consumption is used in a very broad sense and refers to consumption in many areas of life, such as food, fashion, home improvements, leisure, healthcare and education.

    day shelters: Places where homeless people who sleep on the streets can go during the day. The services on offer not only address their immediate needs but can also include activities to help prevent their continued homelessness, such as learning and skills development.

    direct racism: Being subjected to verbal and/or physical abuse because of membership of an ethnic minority group.

    discourse The set of ideas and conceptualisations that shape ways of thinking about a particular subject. Use of language is central to the construction of discourses. A variety of discourses can exist at any one time; some discourses are more powerful than others and often reflect the interests of dominant groups.

    discrimination When members of a particular group in society are denied the resources, rewards and opportunities that are available to, and can be obtained by, others in society.

    dominant ideology A term used to indicate the dominant or prevailing ideas, beliefs and assumptions in a society (ideology), which tend to be those which serve the interests of the dominant social groups or classes in society.

    ethnicity A social concept applied to social groups, the members of which share common characteristics often perceived to be associated with ‘race’ and physical appearance but incorporating the broadly defined culture of the group, for example, family structures, music or literature. An ethnic group can also be defined in terms of its dominant cultural characteristics such as religion and language.

    extended family When a nuclear family (see below) is part of a larger kinship network of grandparents, brothers, sisters, aunts, uncles, nieces, nephews and so forth. The nuclear family either lives with or very near these close relatives and has a close and continuous relationship with them.

    failed asylum seeker Someone who has fled from their home country because of war, civil unrest or conflict, arrived in another country, and made a formal application that has been rejected. Some failed asylum seekers return to their home country voluntarily while others are forcibly returned.

    feminism A body of thought arguing that inequalities between the sexes are caused by patriarchal societies in which it is assumed that men should and can dominate and have most of the power because they are superior and that women should be subordinate to them. There are many different types of feminist theories (such as Marxist and liberal) but a central theme common to all of them is that it is men who have oppressed and excluded women from social, political and economic power.

    functionalism Views society as a biological organism, such as the body, made up of different integrated parts. In order for society to function properly and maintain its structure these parts or subsystems have to fulfil their role in accordance with cultural and social expectations.

    globalisation The set of global processes that are changing the nature of human interaction across a wide range of social spheres such as the economic, political and environmental. This has led to an increasing global cultural system and, because of the uneven impact of these processes, further inequalities.

    hidden homeless Those people without a home who do not appear in government statistics about homelessness. They are usually single people and couples without children who live in hostels, squats, bed and breakfasts or with family and friends.

    hostels These provide accommodation for those sleeping on the streets.

    ideology Ideas and beliefs reflecting the interests of a particular social group in society which may change over time.

    indirect racism The fear of being subjected to verbal and/or physical abuse because of membership of an ethnic minority group.

    individualism This stands for the rights of the individual and individual liberty against the power of the state or ruling elite.

    individualist explanations These emphasise the way that individuals themselves contribute to social problems. They maintain that individuals are autonomous and highlight the role of characteristics, such as personality and aptitudes, in shaping choices about their actions that individuals make. The impact of social factors are usually ignored in individualist explanations.

    institutional racism When a public or private body intentionally or unintentionally discriminates against people from ethnic minority groups.

    labelling theory Focuses on the reactions of others to perceived deviance and how that deviance is maintained by their reactions.

    life-course perspective Although there are different strands to this perspective, the predominant theme is that stages in life are not necessarily standardised, chronologically or biologically fixed, sequential or gendered but are subject to a variety of social, historical and cultural influences.

    lone/one-parent family A divorced, separated, single or widowed mother or a father living without a spouse (and not cohabiting) with his or her never-married dependent child or children.

    Marxist theory Approaches based on this theory maintain that the way the economy of a society is run determines the social relationships, such as inequalities, in that society. Marxists blame capitalism for these inequalities; they argue that in capitalist societies there is a minority who exploit the majority and it is this exploitation that leads to inequalities.

    modernisation agenda Introduced by New Labour across all sectors of the government. Its main themes were the promotion of parternerhips between government departments with the voluntary and private sector, consultation with service users, target setting, performance monitoring and greater valuing of public services.

    night shelters These provide overnight accommodation for the homeless.

    nuclear family Two adults living together in a household with their own or adopted children.

    outreach teams These are usually attached to day centres. They work on the street and advise people how to find accommodation and claim benefits.

    postmodernism A set of theories emphasising that it is impossible to uncover the ‘truth’ about society. This is because knowledge about the social world is socially constructed and therefore constantly changing.

    power A contested concept concerning the capacity of individuals, groups, social classes or institutions to shape and mobilize action, achieve goals and protect their interests.

    race Refers to physical differences between people such as skin pigmentation, hair texture and facial features.

    racism The belief that biologically rooted racial characteristics determine social activities and abilities. The result is that those groups who believe themselves to be inherently ‘superior’ discriminate against those who belong to groups deemed to be ‘inferior’. This can lead to discriminatory and aggressive behaviour towards members of ethnic groups believed to be ‘inferior’.

    reconstituted family A household unit including a step-parent as a consequence of divorce, separation and remarriage. This type of family is created when a new partnership is formed by a mother and/or father who already have dependent children. Since most children remain with their mother following divorce or separation, stepfamilies are more likely to have a stepfather than a stepmother.

    refugee Someone whose asylum application has been successful and has been granted permission to stay in the United Kingdom under the terms of the 1951 Refugee Convention because of a well-founded fear of persecution due to race, religion, nationality, political opinion or membership of a social group if they returned home.

    relative poverty Refers to poverty relative to standards in particular societies and reflects differences in living standards between societies and across time within the same society. It is used to indicate those groups who are excluded from full participation in their society because of a lack of resources.

    reserve army of labour Composed of groups of workers or potential workers (for example, unemployed people) who are most vulnerable to irregular employment, being employed (often on only a part-time basis) or laid off as the demand for labour from employees rises and falls.

    resettlement teams These are usually attached to hostels for the homeless. They can help people to find longer-term housing and may also help them to find work or enrol on a training scheme.

    rough sleepers People who sleep in the open in unsuitable places deemed unfit for habitation. Examples of these are doorways, parks and disused buildings.

    settled accommodation Accommodation in which residents have medium- to long-term security of tenure.

    social bonds A dimension of social networks denoting the connections within ethnic and/or faith communities.

    social bridges A dimension of social networks relating to connections between members of migrant communities and communities that do not share the same ethnicity and/or faith.

    social capital The resources, trust and social networks within a community which, when accessed by individuals, are beneficial as they empower them and enable them to improve their lives.

    social causation This refers to those perspectives that focus on how various social processes lead to particular social issues or problems.

    social closure Practices whereby groups preserve their status by restricting entry into their ranks (for example, through setting various conditions for entry such as certain qualifications) and separate themselves from other groups.

    social construction This refers to the way that aspects of society or behaviour are actively viewed or ‘constructed’ in a particular way as a result of social relations and human agency rather than being ‘natural’ or biological in origin. Social constructions vary historically, socially and culturally.

    social divisions These are the substantial differences between people in society, which involve some people being in better positions than others. Examples are class, gender and race. Social divisions often interconnect and can reinforce inequalities. They are socially constructed and hence change over time.

    social drift hypothesis This is based on Darwinist theories of natural selection and has been used to explain why those who are poor have higher rates of ill health. It hypothesises that those who are physically and mentally ill move down the social system and accumulate at the bottom.

    social exclusion A contested concept that addresses the range of factors that constrain an individual's full participation in society. Examples of such factors are a lack of material resources, discrimination, chronic ill health, geographical location and cultural identification.

    social inequalities Differences in people's share of resources in society. This can involve a wide range of such resources, such as wealth, education, health, housing, power, status and life chances.

    social integration This concept is about the relationships between individuals and societal institutions, such as the family, employment, and religious, political and voluntary groups. Integration into these societal institutions helps people to cope when facing stressful life events because they provide mutual moral support and access to resources.

    social justice This will be achieved when existing inequalities are eradicated and there are equal rights and equity for everyone in society.

    social links A dimension of social networks that refers to the relationships that individuals and/or groups have with institutions, agencies and services.

    social networks The patterns of individuals’ social relationships and interactions with those to whom they are connected by ties such as kinship, friendship and work relationships.

    social position The social identity a person has in a given group or society.

    social support This is provided by positive involvement in social networks. It has been shown to act as a buffer to stress, particularly if intimate and confiding reelationships are involved.

    statutory homeless Those who do not have a home but are regarded as being legally homeless and entitled to help from their local authority.

    statutory services Services to which prescribed individuals and/or groups have a legal right, such as local authorities, social services and health services. They are paid for out of taxation, with their function prescribed by law, and have a large bureaucratic structure.

    stigma The social consequences of socially constructed negative characteristics that are associated with members of a particular social group.

    street homelessness Those who live on the streets in the day and have nowhere to sleep at night. Some end up sleeping in the sorts of places that are unfit for habitation (such as doorways, parks, disused buildings) while others sleep at friends’ houses for short periods of time, in a squat, hostel, prison or hospital.

    structuralist explanations Focus on the way that macro-level political, economic and social factors which are beyond an individual's control cause social problems.

    unaccompanied asylum-seeking child (UASC) An individual under 18 who is applying for asylum in his or her own right and is either separated from both parents or is not being cared for by an adult who has responsibility to do so by law or custom.

    underclass Those groups who fall below the lowest occupational class because they are dependent on benefits, live in poor housing, do not have a job, and have a poor employment history and limited prospects of acquiring an occupation.

    unpaid carer Someone who cares for a dependant who cannot care for himself/herself and, excluding benefits, this is on an unpaid basis.

    voluntary organisations These are self-governing, non-profitmaking and not directly controlled by a private (for-profit) entity or by the state. There is usually a meaningful degree of voluntarism in terms of money or time through philanthropy or voluntary citizen involvement.

    Weberian perspectives These argue that class, status and authority determine the distribution of power in society. Each of these has an effect on life chances. With reference to class, scarce resources (such as educational and economic resources) give people the capacity to acquire income and assets. Where a particular category of individuals have similar resources and use these to secure certain advantages for themselves, a class relationship is formed. Class situation determines life chances, which are protected and enhanced by those individuals within the class through the exclusion of others.

    welfare-to-work These policies aim to reduce the numbers of those in receipt of out-of-work benefits by encouraging as many of them to take up paid employment as possible. They have been produced in response to concerns over the costs of benefits and as part of efforts to tackle poverty and social exclusion.

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