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The purpose of this paper is to explore the perceived usefulness of a diabetes economic model as a potential tool for aiding evidence-based decision making in public health. Methods: Fifteen interviews and two focus groups, with four participants in each, were conducted with health and management professionals working in one public health department in a local council. Data were analysed using inductive thematic analysis to generate four themes. Findings: The findings reflect attitudes and beliefs of a diverse staff group situated in public health services. Findings reveal that the economic model was perceived as useful and participants reported positive views regarding the principles of economic modelling for decision making. However, it was potentially problematic in practice due to organisational constraints linked to limited resources, restricted budgets and local priorities. Differences in institutional logics of staff working across public health and local government departments were identified as a potential barrier to the use of the model in practice. Discussion: The findings highlight anticipated challenges that public health practice and policy decision-makers could face if they selected to implement an economic modelling approach to fulfil their evidence needs. Previous studies have revealed that healthcare decision makers would find evidence around the economic impacts of public health interventions useful, but this information was not always available in the format required. This paper provides insights into how public health staff perceive economic modelling, and explores how they use this type of evidence when making public health practice and policy decisions.

Ethnic diversity and racism have not featured strongly in English research, policy or practice centred on understanding and addressing health inequalities. However, the COVID-19 pandemic and the Black Lives Matter movement have shone fresh light on deep-rooted ethnic inequalities and mobilised large segments of the population into anti-racist demonstration. These recent developments suggest that, despite strong counterforces within national government and the mainstream media, there could be a shift towards greater public awareness of racism and potentially a willingness to take individual and collective action. This paper addresses these developments, and specifically engages with the contested notion of 'allyship'. We bring together the experiences of 25 young adults living across England and prior literature to raise questions about whether and how racialized White individuals can play a role in dismantling systemic racism and reducing ethnic inequalities in health. Our analysis reveals a variety of complexities and obstacles to effective and widespread allyship. Findings suggest the need to nurture contingent, responsive and reflexive forms of allyship that can attend to the harms inflicted upon racially minoritized people as well as push for systemic transformation. White allyship will need to take a variety of forms, but it must be underpinned by an understanding of racism as institutional and systemic and a commitment to tackling interlocking systems of oppression through solidarity. The issues addressed are relevant to those occupying public health research, policy and practice roles, as well as members of the public, in England and other multi-racial settings. [ABSTRACT FROM AUTHOR]

This paper draws on the experience of two Romani and three non‐Romani scholars in knowledge production on the health and social inequalities experienced by European Roma populations. Together, we explore how we might better account for, and work against, the complex web of dynamic oppressions embedded within processes of academic knowledge production. Our aim is to encourage careful scrutiny through which sociologists of health and illness might better recognise our own complicity with oppression and identify concrete actions towards transforming our research practices. Drawing on a well‐known domains of racism typology (Annual Review of Public Health, 40, 2019, 105), we use examples from our own work to illustrate three interconnected domains of oppression in which we have found ourselves entangled (structural, cultural and interpersonal). A new conceptual framework is proposed as an aid to understanding the spectrum of different "types" of complicity (voluntary–involuntary, conscious–unconscious) that one might reproduce across all three domains. We conclude by exploring how sociologists of health and illness might promote a more actively anti‐racist research agenda, identifying and challenging subtle, hidden and embedded negative ideologies and practices as well as more obviously oppressive ones. We hope these reflections will help revitalise important conversations. [ABSTRACT FROM AUTHOR]

Detailed qualitative data are used to explore the processes perpetuating labour market disadvantage among young UK-Bangladeshi men living in central London. Strong forces of inclusion within the Bangladeshi community are found to interact with forces of exclusion from 'mainstream' society to constrain aspirations and limit opportunities. Though diverse forms of young Bangladeshi masculinity are found, a common pattern is heavy dependency on intra-ethnic networks. Negative experiences of and isolation from 'mainstream' society further reinforce reliance on 'our own people'. However, acute ambivalence towards belonging to a dense Bangladeshi community exists, exemplified in the widespread denigration of the restaurant trade. Many respondents express the desire to 'break out' and access new experiences. The findings support current policy emphasis on 'connecting people to work' but highlight the more fundamental need to connect people across ethnic boundaries. The paper urges researchers to 'unpack' ethnicity--to consider carefully what ethnic identity implies in terms of access to resources and opportunities for different individuals in different contexts--in order better to understand the diversity of labour market outcomes and the persistence of disadvantage. Keywords: Bangladeshi; inclusion; employment; men; identity; exclusion.

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1467-9566.2007.01044.x Byline: Sarah Salway (1), Lucinda Platt (2), Kaveri Harriss (3), Punita Chowbey (4) Keywords: ethnicity; welfare benefits; long-term ill-health; Disability Living Allowance; disability Abstract: Abstract Long-term health conditions affect a substantial proportion of working-age adults, often reducing their employment chances and their incomes. As a result, welfare benefits including those intended to off-set additional expenditure (primarily Disability Living Allowance [DLA]) can make an essential contribution towards maintaining living standards. Given the differences in rates of long-term health conditions for different ethnic groups, issues of access to relevant benefits may be particularly salient for certain communities. We lack, however, detailed examination of the factors that influence take-up of DLA across ethnic groups. In this paper, secondary analysis of Labour Force Survey data is combined with detailed new qualitative work, to examine patterns of receipt and issues of access to DLA across four ethnic groups. DLA receipt among individuals reporting long-term health conditions is low; but Bangladeshi, Pakistani and Black African individuals have significantly lower levels of receipt than White British respondents with comparable health and socioeconomic characteristics. Common factors that appeared to discourage DLA claims across the ethnic groups considered included: a desire to conceal impairment and a reluctance to assume a 'disabled' identity; limited benefit knowledge or specialist support; perceptions that the benefits system is complex and stressful; and concerns about the legitimacy of claiming. But our findings also suggest differences between the groups. For example, 'being' Ghanaian appeared to place particular constraints upon the assumption of a disabled identity. Ethnic identity also implied processes of inclusion and exclusion in social networks resulting in differential access to information and 'know-how' in relation to the benefits system. Policy clearly has a role in legitimising claiming and improving accurate information flows and thereby improving take-up of benefit among those in great need. Author Affiliation: (1)Centre for Health and Social Care Research, Sheffield Hallam University (2)Institute for Social and Economic Research, University of Essex (3)Centre for Population Studies, London School of Hygiene and Tropical Medicine (4)School of Nursing and Midwifery, University of Sheffield Article note: Address for correspondence: Sarah Salway, Centre for Health and Social Care Research, Sheffield Hallam University, 32 Collegiate Crescent, Sheffield S10 2BJ, e-mail: S.Salway@shu.ac.uk

The role of the younger U.K. educated women that are both better equipped to compete in the labour market than their migrant predecessor and would subscribe to gender role that view employment outside the home as a legitimate option is presented.

Abstract Background A key aim of countries with high maternal mortality rates is to increase availability of competent maternal health care during pregnancy and childbirth. Yet, despite significant investment, countries with the highest burdens have not reduced their rates to the expected levels. We argue, taking Pakistan as a case study, that improving physical availability of services is necessary but not sufficient for reducing maternal mortality because gender inequities interact with caste and poverty to socially exclude certain groups of women from health services that are otherwise physically available. Methods Using a critical ethnographic approach, two case studies of women who died during childbirth were pieced together from information gathered during the first six months of fieldwork in a village in Northern Punjab, Pakistan. Findings Shida did not receive the necessary medical care because her heavily indebted family could not afford it. Zainab, a victim of domestic violence, did not receive any medical care because her martial family could not afford it, nor did they think she deserved it. Both women belonged to lower caste households, which are materially poor households and socially constructed as inferior. Conclusions The stories of Shida and Zainab illustrate how a rigidly structured caste hierarchy, the gendered devaluing of females, and the reinforced lack of control that many impoverished women experience conspire to keep women from lifesaving health services that are physically available and should be at their disposal.

CONTEXT: Although gender inequality is often cited as a barrier to improving maternal health in Nepal, little attention has been directed at understanding how sociocultural factors may influence the use [...]

An integrated analysis of large-scale survey data and detailed ethnography is presented to examine the patterns of women's mobility and their relationships with contraceptive and antenatal care use in Pakistan. Findings confirm that women's mobility is circumscribed but also illustrate the complex and contested nature of female movement. No direct relationship between a woman's unaccompanied mobility and her use of either contraception or antenatal care is found. In contrast, accompanied mobility does appear to play a role in the uptake of antenatal care, and is found to reflect the strength of a woman's social resources. Class and gender hierarchies interact to pattern women's experience. Poor women's higher unaccompanied mobility was associated with a loss of prestige and susceptibility to sexual violence. Among richer women, such movement did not constitute a legitimate target for male exploitation, nor did it lead to a loss of status on the part of their families. The findings caution against the use of western notions of 'freedom of movement' and associated quantitative indicators. At the same time, the wider impact of mobility restrictions on women's reproductive health is acknowledged and policy implications tire identified. Keywords: Women's mobility: Pakistan: Reproductive health services

Drawing on survey data and ethnographic findings, this paper presents a profile of women's work participation among slum dwellers in Dhaka city. Overall, almost 50% of adult women are engaged in income-generating work outside the home. Life-cycle factors, socioeconomic status and residential location are associated with both level of work participation and type of employment. Women's contributions to household livelihoods via paid employment are found to be significant and multifaceted. The analysis highlights heterogeneity among poor women's work experiences and the intense 'informalization' of most employment options. Implications for policy aimed at improving the conditions of working women are identified. Key words--Asia, Bangladesh, women, work participation, informalization

This article—third in a series of three—uses theoretical frameworks described in Part 1, and empirical markers reported in Part 2, to present evidence on how power dynamics shifted during the early years of a major English community empowerment initiative. We demonstrate how the capabilities disadvantaged communities require to exercise collective control over decisions/actions impacting on their lives and health (conceptualized as emancipatory power) and the exercise of power over these communities (conceptualized as limiting power) were shaped by the characteristics of participatory spaces created by and/or associated with this initiative. Two main types of participatory spaces were identified: governance and sense-making. Though all forms of emancipatory power emerged in all spaces, some were more evident in particular spaces. In governance spaces , the development and enactment of ' power to ' emerged as residents made formal decisions on action, allocated resources and managed accountability. Capabilities for alliance building— power with —were more likely to emerge in these spaces, as was residents' resistance to the exercise of institutional power over them. In contrast, in sense-making spaces residents met informally and 'made sense' of local issues and their ability to influence these. These processes led to the development of power within capabilities and power to resist stigmatizing forms of productive power. The findings highlight the importance of designing community initiatives that: nurture diverse participatory spaces; attend to connectivity between spaces; and identify and act on existing power dynamics undermining capabilities for collective control in disadvantaged communities. [ABSTRACT FROM AUTHOR]