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peer-reviewed ; Background Social inclusion is a complex concept, and its relationship to health has been widely debated. Across the European Union, there has been a move towards policies promoting social inclusion. Despite this, there has been a limited analysis of how the concept of social inclusion is operationalised in Irish policy. The aim of this research was to document and map the development of social inclusion policies in the Irish context. The objectives were to identify all the relevant stakeholders and policies and to describe the relevance of social inclusion policy in the domain of health. Methods We utilised a widely recognised policy analysis framework. We conducted a systematic search of relevant government policies, grey literature databases, statutory agencies and stakeholders in the Irish context since 2006. The researchers initially identified a total of 954 results. Results The relevant stakeholders discovered were the research community, service providers, civil society organisations, policy makers and government, philanthropists and socially excluded people. Most policy documents included refer to one of two national policies created to drive social inclusion activities. Social inclusion was being operationalised in the context of health, but the relationship between policymakers and those planning and providing services was unclear. Conclusions The concept of social inclusion was being operationalised in the Irish policy context. A multitude of stakeholders were involved, reflecting the wide reach of this concept in society. Social inclusion was a particularly important concept in the realm of health, and in the primary care domain in particular.

Introduction: Since the first case of COVID-19 was confirmed in February 2020, Brazil has reported more than 20 million cases and more than 600,000 deaths on October 31, 2021. The behavior of the pandemic was also different in the various regions of the country, from those with less economic development to those with greater economic development, such as the state of São Paulo. Objective: to describe step-by-step time series for analyzing trends in mortality, lethality and incidence of COVID-19 in Brazil. Methods: a protocol for an ecological study of time series, covering the 26 states and the federal district (Brasilia). Results: The descriptions have the potential to provide information for the government and society in decision-making, about knowledge and conduct, clinical, epidemiological and research investments in health care for the Brazilian people. It is focused on fully understanding the spread of SARS-COV-2 infection in the Brazilian territory, and developing a database for public and universal access for comparative studies between countries and continents. Conclusion: database built from ecological studies are essential for a full understanding of the virus behavior, its transmissibility, lethality and mortality, and a repository for data that's been collected and integrated from multiple sources. It is a relevant tool for the search of information and decision-making in global health.

peer-reviewed ; Social exclusion is a complex concept that is relevant in terms of the health of vulnerable groups. Attempts have been made in the past to measure it, both at the population and the individual level. The aim of this research was to engage with a broad range of relevant stake holders in Ireland in order to learn how they defined and conceptualised social exclusion. Semi-structured interviews were carried out with 24 participants selected using maximum variation sampling. One quarter of the interviewees were experts by experience. Partici pants included academic experts, the heads of organisations working nationally with socially excluded groups, politicians, clinicians, support workers and health service managers all with experience of working with socially excluded groups. The resulting definition of social exclusion was "the experience of lack of opportunity, or the inability to make use of available opportunities, thereby preventing full participation in society." From this, we developed a new model of the concept comprising three elements; Opportunities, Influencing factors and Social outcomes. Opportunities are the fundamental needs that are required to be met for a person to begin leaving social exclusion. Influencing factors are a mixture of the personal characteristics and more complex problems such as the intergenerational effects of disad vantage. Social outcomes include a person being accepted by wider society, and subse quently being able to participate. The conceptual framework we developed can contribute to a better understanding of the concept of social exclusion. The traditional policy focus on improving the needs of excluded people at the Opportunities level must continue, but must be complemented by tackling the problems at the levels of the Influencing factors and Social outcomes also. In terms of changes to practice, the measurement of the social exclusion status of people engaging with primary care and other services would be an important start in order to better understand ...

Social exclusion is a complex concept that is relevant in terms of the health of vulnerable groups. Attempts have been made in the past to measure it, both at the population and the individual level. The aim of this research was to engage with a broad range of relevant stakeholders in Ireland in order to learn how they defined and conceptualised social exclusion. Semi-structured interviews were carried out with 24 participants selected using maximum variation sampling. One quarter of the interviewees were experts by experience. Participants included academic experts, the heads of organisations working nationally with socially excluded groups, politicians, clinicians, support workers and health service managers all with experience of working with socially excluded groups. The resulting definition of social exclusion was "the experience of lack of opportunity, or the inability to make use of available opportunities, thereby preventing full participation in society." From this, we developed a new model of the concept comprising three elements; Opportunities, Influencing factors and Social outcomes. Opportunities are the fundamental needs that are required to be met for a person to begin leaving social exclusion. Influencing factors are a mixture of the personal characteristics and more complex problems such as the intergenerational effects of disadvantage. Social outcomes include a person being accepted by wider society, and subsequently being able to participate. The conceptual framework we developed can contribute to a better understanding of the concept of social exclusion. The traditional policy focus on improving the needs of excluded people at the Opportunities level must continue, but must be complemented by tackling the problems at the levels of the Influencing factors and Social outcomes also. In terms of changes to practice, the measurement of the social exclusion status of people engaging with primary care and other services would be an important start in order to better understand the magnitude of the work required.

BACKGROUND: While the non-communicable disease (NCD) burden in the countries of the Gulf Cooperation Council (GCC) (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates) has surged over the past decades, the costs and return on investment (ROI) of implementing cost-effective, WHO-recommended NCD interventions have not been established. METHODS: We performed an economic analysis to estimate the ROI from scaling up four sets of NCD interventions over 15 years. We estimated the direct costs of the four main NCDs (cancer, diabetes, cardiovascular diseases and chronic respiratory diseases) using a prevalence-based, bottom-up cost-of-illness approach. We estimated indirect costs based on productivity loss due to absenteeism, presenteeism and premature deaths. We costed the scaling up of interventions using the WHO Costing Tool and assessed the health impact of interventions using the OneHealth Tool. We calculated ROI by comparing productivity and social benefits with the total costs of implementing the interventions. RESULTS: The four main NCDs cost the GCC economy nearly US$50 billion in 2019, equal to 3.3% of its gross domestic product. The indirect costs are estimated at US$20 billion or 40% of the total burden. Implementing the four modelled intervention packages in the six GCC countries over 15 years will cost US$14 billion, with an ROI of US$4.9 for every US$1 invested and significant health and social benefits, including 290 000 averted premature deaths. CONCLUSION: Based on the results of these six investment cases, we recommend actions to scale up current WHO-recommended cost-effective interventions, strengthen whole-of-government action, drive the NCD legislative agenda, build out the evidence base, generate additional advocacy material, and increase regional collaboration and data-sharing to establish best practices and monitor impact.