Drugs and AlcoholAdolescent alcohol use and parental and adolescent socioeconomic position in six European cities.MarinaBosque-ProusauthorMirte AGKuipersauthorAlbertEspeltauthorMatthiasRichterauthorArjaRimpeläauthorJulianPerelmanauthorBrunoFedericoauthorM TeresaBrugalauthorVincentLorantauthorAnton EKunstauthorBackground: Many risk behaviours in adolescence are socially patterned. However, it is unclear to what extent socioeconomic position (SEP) influences adolescent drinking in various parts of Europe. We examined how alcohol consumption is associated with parental SEP and adolescents’ own SEP among students aged 14–17 years. Methods: Cross-sectional data were collected in the 2013 SILNE study. Participants were 8705 students aged 14–17 years from 6 European cities. The dependent variable was weekly binge drinking. Main independent variables were parental SEP (parental education level and family affluence) and adolescents’ own SEP (student weekly income and academic achievement). Multilevel Poisson regression models with robust variance and random intercept were fitted to estimate the association between adolescent drinking and SEP. Results: Prevalence of weekly binge drinking was 4.2% (95%CI = 3.8–4.6). Weekly binge drinking was not associated with parental education or family affluence. However, weekly binge drinking was less prevalent in adolescents with high academic achievement than those with low achievement (PR = 0.34; 95%CI = 0.14–0.87), and more prevalent in adolescents with >€50 weekly income compared to those with ≤€5/week (PR = 3.14; 95%CI = 2.23–4.42). These associations were found to vary according to country, but not according to gender or age group. Conclusions: Across the six European cities, adolescent drinking was associated with adolescents’ own SEP, but not with parental SEP. Socio-economic inequalities in adolescent drinking seem to stem from adolescents’ own situation rather than that of their family.Alcohol consumptionAlcoholrisk factorsParental attitudeFamily roleRole of parentDrugs and alcohol related family problemsFinancial (money) problemsPovertyAdolescent / youth (teenager / young person)ParentEurope2017-08BioMed CentralEvidence resource

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Drugs and AlcoholImproving lives: helping workless families.This publication sets out plans to improve the support given to workless families and their children, so that they can overcome the complex problems they face. The proposals outlined in this document include: • launching the next phase of the Troubled Families Programme, which will place a greater emphasis on helping parents with complex needs into work • a new programme to reduce parental conflict by providing access to proven support for the most disadvantaged families, whether parents are together or separated • enhancing the role of Jobcentre Plus in working with local partners in a more joined-up way, to identify people with complex needs at the right time and better address their needs • greater support to help those with drug and alcohol dependencies into work, by implementing recommendations from Dame Carol Black’s review of employment and drug and alcohol dependencyrisk factorsVocational rehabilitation (employment / occupation)Family supportFamily roleFinancial (money) problemsPovertyEmployment and unemploymentServices for family and childrenEngland2017-04Department of Work and PensionsEvidence resource

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Drugs and AlcoholSocio-economic review 2017.This review argues that Ireland's present social contract is broken and that 2017 is the perfect opportunity to develop a new and radical social contract for Ireland’s second century. All democracies are founded on a social contract. The social contract is how the standard of living everyone expects and agrees on is implemented and delivered and how the balance of rights and responsibilities among citizens, communities, institutions and government is maintained. A progressive social contract is one where Government works in the interest of all, where social cohesion and the common good are the primary measures of progress, and the economy is nurtured for the benefit of society. This Review outlines a series of policies and recommendations which would deliver a progressive social contract.risk factorsSocial supportInclusion and exclusionPovertyGovernment and politicsEconomic policySocial workerIreland2017-04Social Justice IrelandReport

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Drugs and AlcoholDying from inequality: socioeconomic disadvantage and suicidal behaviour. Summary report.This report reviews literature on recent and ongoing economic shocks in the UK, Ireland and other countries, considering the impact of economic recession and periods of economic uncertainty on suicidal behaviour.This report also reviews accounts from people who have self-harmed (with differing levels of suicidal intent) or died by suicide (information based on suicide notes or coroners’ hearings). They constitute a diverse group, including both the less advantaged (eg, drug-dependent, incarcerated, homeless, living in poor housing, in poor urban and rural areas) and the more advantaged (eg, college students, school attendees, ‘high achievers’, and those who are employed). Presented below are four thematic understandings of suicidal behaviour relating to socioeconomic disadvantage: • as an outcome of factors arising due to disadvantage, typically early trauma and loss, but also including experiences of homelessness, poor housing, unemployment, job loss and financial crises • as a response to shame, associated with relationship breakdown, economic insecurity, job loss, and unemployment • as a way of ‘coping’ with distress, anger, difficult situations (including those related to money or housing), and relationship problems • as a method of enacting control over the self or body, often when an individual feels powerless. Recommendations • Individuals, communities and wider society can all play a part in reducing the risk of suicidal behaviour. Governments need to take a lead by placing a stronger emphasis on suicide prevention as an inequality issue. • National suicide prevention strategies need to target efforts towards the most vulnerable people and places, in order to reduce geographical inequalities in suicide. • Effective cross-governmental approaches are required, with mental health services improved and protected. Suicide prevention needs to be a government priority in welfare, education, housing and employment policies. • Workplaces should have in place a suicide prevention plan, and provide better psychological support to all employees, especially those experiencing job insecurity or those affected by downsizing. • Poverty and debt need to be destigmatised so that individuals feel valued and able to access support without fear of being judged. • Every local area should have a suicide prevention plan in place. This should include the development and maintenance of services that provide support to individuals experiencing socioeconomic disadvantage. • Staff and volunteers in services accessed by socioeconomically disadvantaged individuals or groups should receive specialist training in recognising, understanding and responding to individuals who are in distress and may be suicidal (even if they do not say they are feeling suicidal). • People bereaved or affected by suicidal behaviour, and therefore at higher risk of suicide themselves, should be offered tailored psychological, practical and financial support particularly in disadvantaged communities.suicidal behaviour / suicideSuicide preventionInclusion and exclusionSocial equality and inequalityPovertyIrelandUnited Kingdom2017-03SamaritansReport

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Drugs and AlcoholOutcomes: drug harms, policy harms, poverty and inequality.LucyDillonauthorTreatment outcomeSocial equality and inequalityPovertyPolicy on drugs and alcoholResearch outcomeDublin2016-10Health Research BoardArticle

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Drugs and AlcoholUnderstanding the relationship between poverty and alcohol misuse.LisaJonesauthorHarrySumnallauthorThis rapid review of the evidence on poverty and alcohol misuse was commissioned by the Joseph Rowntree Foundation as part of their programme to develop Anti-Poverty Strategies for the UK. The purpose of the rapid review is to provide an evidence base that the Joseph Rowntree Foundation can use in developing their Anti-Poverty Strategies, enabling them to decide how to address alcohol misuse within the Strategies. The findings of the rapid review are presented across five chapters. • Chapter 1 presents an introduction to the issues around alcohol consumption, summarising existing knowledge on the risks and benefits of alcohol consumption to health, to others and related issues of stigma and marginalisation. It also identifies the definitions used in this report for problem alcohol use and presents prevalence figures on problem alcohol use in the UK. • Chapter 2 provides a summary of the methods used to collate the evidence used in the rapid review. More detail on the methods is also provided in Appendix 1. • Chapter 3 presents the findings from a review of the correlations between poverty and problem alcohol use. This chapter also summarises the research evidence for the mechanisms and pathways that may link poverty and problem alcohol use. • Chapter 4 presents a summary of the evidence on the effectiveness and cost-effectiveness for policies and interventions targeting problem alcohol use. • Chapter 5 brings together and discusses the findings from the two review elements and attempts to draw out implications for research and policy.Alcohol consumptionAlcoholAlcohol dependencerisk factorsSocial equality and inequalityPoverty2016-06Liverpool John Moores UniversityEvidence resource

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Drugs and AlcoholChillin, buzzin, getting mangled, and coming down: Doing differentiated normalisation in risk environments.AileenO'GormanauthorAims: This paper examines differentiated normalisation through the lens of young drug users from a marginalised Dublin neighbourhood where drugs are readily available, prevalence rates are high, and a flourishing drugs market operates. Findings: The narratives of these marginalised young people illustrate how drug use and drug choices are shaped by different intentions, avowed identities and diverse structural, temporal and socio-spatial settings. Their routines and drug repertoires echo the (mainly) reasoned consumption choices, the cost–benefit analyses and the emphasis on pleasure and fun ascribed to recreational drug users, including those who underpin the normalisation concept. However, their drug using practices continue to be rendered deviant due to their experience of social exclusion; exclusion from consumption-orientated lifestyles and from the night time economy; and their inclusion in the informal drugs economy. Conclusion: Normalisation is relative (not just differentiated) to the social status of the drug user. A reconstructed normalisation thesis inclusive of class (and race, and gender) could explore why the use of similar drugs and similar drug using behaviours by different social groups is differentially accommodated and accepted by mainstream society.Prevalence of drugs and alcohol userisk-taking behaviourrisk factorsRisk assessmentContext of initiation of drugs and alcohol useContext encouraging drugs and alcohol usePovertyYouth (juvenile) offendingAdolescent / youth (teenager / young person)Dublin2016-05Taylor & FrancisArticle

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Drugs and AlcoholChoices for equity and sustainability: securing solidarity and the common good.SeanHealyauthorSaraBourkeauthorAnnLeahyauthorEamonMurphyauthorMichelleMurphyauthorBrigidReynoldsauthorThe Review provides both an analysis of the present and a basis for future economic and social policy. It outlines a vision for the future and provides viable pathways to deliver policies that can build a fair and just society. It is a comprehensive resource that should be of interest to policy makers and those who will be directly affected by policy decisions. Using a number of subject headings that will be familiar to past readers, the Socio Economic Review will assist in enabling evidence-based proposals be considered by those who will design our future policy and will ensure social justice is a part of the agenda to be set. 1. Introduction and summary of main proposals p.7 2. A guiding vision and a policy framework p.16 3. Income distribution p.37 4. Taxation p.75 5. Work, unemployment and job-creation p.106 6. Housing and accommodation p.121 7. Healthcare p.150 8. Education and educational disadvantage p.177 9. Other public services p.196 10. People and participation p.209 11. Sustainability p.225 12. Rural development p.250 13. The global south p.263 14. Values p.27Health care economicsSocial supportSocial equality and inequalityPovertyEconomic policyIreland2016-04Social Justice IrelandReport

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Drugs and AlcoholAdolescents at risk. Psychosomatic health complaints, low life satisfaction, excessive sugar consumption and their relationship with cumulative risks.Sophie DWalshauthorZlataBruckaufauthorTaniaGasparauthorAdolescence is a time of transitions when experimentation, risk taking and active peer interactions can be viewed as a part of the development process. Yet, for some groups of young people with reported poor psychosomatic health, low life satisfaction or unhealthy eating habits these experiences may be different. Empirical evidence is limited in recognising the overlapping and cumulative risks of adolescents’ health disadvantage and multiple externalized risk behaviours and outcomes (smoking, drinking, binge drinking, regular fighting, injuries and bullying). Drawing on the most recent 2013/2014 data of the Health Behaviour of School Children (HBSC) study, this paper examines the risks of individual and cumulative risks (three or more types) associated with being in the bottom group of psychosomatic health complaints, life satisfaction and unhealthy eating (excessive sugar consumption) across 29 countres. Using multivariate logistic modelling, the association that was the strongest, most consistent and independent of family affluence (FAS) was that between cumulative risks and high levels of psychosomatic health complaints. Similarly consistent, although weaker, is the association found between adolescents’ low life satisfaction and unhealthy eating. Only in Greece and Hungary does the association between cumulative risks and life satisfaction seem to be mediated by family socio-economic status (SES). This is also the case for Denmark and Malta in the case of unhealthy eating.Coping skillsEmotionState of healthMental healthrisk factorsHealth care economicsInclusion and exclusionPovertyAdolescent / youth (teenager / young person)Europe2016-04UNICEF Office of ResearchEvidence resource

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Drugs and AlcoholFairness for children: a league table of inequality in child well-being in rich countries, Innocenti report card 13.This Report Card presents an overview of inequalities in child well-being in 41 countries of the European Union (EU) and the Organisation for Economic Co-operation and Development (OECD). It focuses on ‘bottom-end inequality’ – the gap between children at the bottom and those in the middle – and addresses the question ‘how far behind are children being allowed to fall?’ in income, education, health and life satisfaction. Across the OECD, he risks of poverty have been shifting from the elderly towards youth since the 1980s. These developments accentuate the need to monitor the well-being of the most disadvantaged children, but income inequality also has far-reaching consequences for society, harming educational attainment, key health outcomes and even economic growth. A concern with fairness and social justice requires us to consider whether some members of society are being left so far behind that it unfairly affects their lives both now and in the future. This Report Card asks the same underlying question as Report Card 9, which focused on inequality in child well-being, but uses the most recent data available and includes more countries.risk factorsSocial supportSocial equality and inequalityPovertyChildAdolescent / youth (teenager / young person)International aspects2016-04UNICEF Office of Research – InnocentiEvidence resource

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Drugs and AlcoholGrowing up unequal: gender and socioeconomic differences in young people's health and well-being.The report releases data from 42 countries on a range of new topics, such as peer relationships and family support, the school environment, migration, cyber-bullying and serious injury, with the more traditional data on alcohol and tobacco consumption, mental health and nutrition-related behaviour. The report provides data on gender differences and behaviour change in the 11–15-year age group, years that mark a period of increased autonomy that can influence how health and health-related behaviour develops and continues into adulthood. The report highlights socioeconomic differences and variations between countries and regions. It identifies opportunities for policy interventions, as the findings underline the importance of the wider social context and the effect it can have on young people's health.Prevalence of drugs and alcohol useAlcohol consumptionCannabis / MarijuanaAlcoholTobacco (cigarette smoking)risk factorsFinancial (money) problemsInclusion and exclusionSocial equality and inequalitySocial conditionPovertyChildAdolescent / youth (teenager / young person)Gender differencesEurope2016-03WHO Regional Office for EuropeEvidence resource

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Drugs and AlcoholEarly-life exposure to income inequality and adolescent health and well-being: evidence from the health behaviour in school-aged children study.Frank JElgarauthorCandaceCurrieauthorThe health of children and adolescents in high income countries negatively relates to income inequality. Theoretical interpretations of this association suggest that inequality intensifies social hierarchies, erodes social or material resources that support health, or impacts socioemotional development in childhood and subsequently harms health. The evidence in support of this causal interpretation is limited by a reliance on cross-sectional, ecological studies. Using multilevel panel data from the Health Behaviour in School-aged Children (HBSC) study, this paper examines lagged and contemporaneous associations between national income inequality and health and well-being during adolescence. Health symptoms and life satisfaction were measured in successive surveys of 11- to 15-year-olds in Europe and North America between 1994 and 2014. These data were linked to country-level income inequality for each survey year (contemporaneous effects) and for earlier developmental periods, at 0-4 years and 5-9 years (lagged effects), dating back to 1979 – the birth year of 15-year-olds in the 1994 survey cycle. Societal growth curve modelling was used to pool data from successive survey cycles and to isolate age, period, and cohort effects. The results show evidence of lagged effects of income inequality during childhood (5-9 years) on health symptoms and life satisfaction in adolescents (11-15 years), after differences in concurrent income inequality and income per capita, cohort, time period, and individual gender, age, and affluence were held constant. This period of development for income inequality exposure coincides with the early school years when social relationships extend from the family to school and community settings. Inequality may shape child developmental trajectories in ways that later manifest in reduced health and well-being. Though not causal evidence in the strictest sense, these findings establish antecedent-consequence conditions in the association between income inequality and health. The practical and theoretical implications of these results are discussed.State of healthInclusion and exclusionSocial conditionPovertyAdolescent / youth (teenager / young person)Europe2016UNICEF Office of ResearchEvidence resource

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Drugs and AlcoholChange in alcohol outlet density and alcohol-related harm to population health (CHALICE): a comprehensive record-linked database study in Wales.DavidFoneauthorFiona DMorganauthorRichardFryauthorSarahRodgersauthorScottOrfordauthorDanielFarewellauthorFrankDunstanauthorJamesWhiteauthorVasSivarajasingamauthorLaszloTrefanauthorIainBrennanauthorShinLeeauthorNarushigeShiodeauthorAlisonWeightmanauthorChrisWebsterauthorRonanLyonsauthorStudy found that important alcohol-related harms such as consumption of alcohol, hospital admissions and violent crime against the person were associated with change in alcohol outlet density, but there was no strong evidence that associations between harms and outlet density varied with social deprivation.Alcohol consumptionAlcoholAlcohol dependencerisk factorsDrugs and alcohol use harm reductionAlcohol beverage sales outletAvailability, accessibility, and useSocial availability or accessibilityurban societyPovertyWales2016National Institute for Health ResearchEvidence resource

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Drugs and AlcoholOutcomes: drug harms, policy harms, poverty and inequality.AileenO'GormanauthorAlanDriscollauthorKerriMooreauthorDoireannRoantreeauthorPrevalence of drugs and alcohol useCannabis / MarijuanaSedatives or tranquillisers (CNS depressants)CocaineHeroinNew (novel) psychoactive substancesAlcohol useDrug userisk factorsPovertyPolicy on drugs and alcoholDublin2016Clondalkin Drug and Alcohol Task ForceReport

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Drugs and AlcoholAlcohol use, socioeconomic deprivation and ethnicity in older people.RahulRaoauthorPeterSchofieldauthorMarkAshworthauthorObjectives: This study explores the relationship between alcohol consumption, health, ethnicity and socioeconomic deprivation. Participants: 27 991 people aged 65 and over from an inner-city population, using a primary care database. Primary and secondary outcome measures: Primary outcome measures were alcohol use and misuse (>21 units per week for men and >14 for units per week women). Results: Older people of black and minority ethnic (BME) origin from four distinct ethnic groups comprised 29% of the sample. A total of 9248 older drinkers were identified, of whom 1980 (21.4%) drank above safe limits. Compared with older drinkers, older unsafe drinkers contained a higher proportion of males, white and Irish ethnic groups and a lower proportion of Caribbean, African and Asian groups. For older drinkers, the strongest independent predictors of higher alcohol consumption were younger age, male gender and Irish ethnicity. Independent predictors of lower alcohol consumption were Asian, black Caribbean and black African ethnicity. Socioeconomic deprivation and comorbidity were not significant predictors of alcohol consumption in older drinkers. For older unsafe drinkers, the strongest predictor variables were younger age, male gender and Irish ethnicity; comorbidity was not a significant predictor. Lower socioeconomic deprivation was a significant predictor of unsafe consumption whereas African, Caribbean and Asian ethnicity were not. Conclusions: Although under-reporting in high-alcohol consumption groups and poor health in older people who have stopped or controlled their drinking may have limited the interpretation of our results, we suggest that closer attention is paid to 'young older' male drinkers, as well as to older drinkers born outside the UK and those with lower levels of socioeconomic deprivation who are drinking above safe limits.Alcohol consumptionAlcoholrisk factorsSociocultural drugs and alcohol useMinority group (racial group, immigrant, Traveller)PovertyElderly / Older personIrelandUnited Kingdom2015-08Article

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Drugs and AlcoholIreland and the Europe 2020 strategy: employment, education and poverty.This report was compiled by Social Justice Ireland in light of the Europe 2020 Strategy and its high-level targets, and of Ireland’s National Reform Programme, which sets out Ireland’s response to achieving those targets. The report covers three of the five headline targets established in the Europe 2020 Strategy and addressed in the Irish National Reform Programme, namely, employment, education and ‘poverty and social exclusion’. In each of these areas the report identifies the Europe 2020 target and Ireland’s corresponding headline target, and then: • Analyses the current context; • Assesses progress (or otherwise) in achieving the Irish headline target; • Reviews recent policy decisions and assesses their contribution (or otherwise) to Ireland achieving its targets; • Identifies a number of issues relevant to the achievement of the targets; and • Makes recommendations on adjusting the targets that Government has set in particular areas. A partnership approach to the development of National Reform Programmes is envisaged in the Europe 2020 Strategy, involving a range of stakeholders, including those from civil society. The report, therefore, also addresses the issue of governance relating to the consultation process on the framing and development of the Irish National Reform Programme. Suggestions are made on how that process may be improved. This report has been prepared by Social Justice Ireland drawing on data available from the EU and from Ireland’s Central Statistics Office (CSO) as well as on on-going work Social Justice Ireland is doing on European and global issues. It also builds on our previous series of reports (from 2011 on) on this same topic. Our findings include that the policies being pursued by government are resulting in the further exclusion of people who already find themselves on the margins of society and pushing Ireland further away from reaching many of its national targets under the Europe 2020 Strategy. This is of major concern to Social Justice Ireland. It also runs counter to the aim of inclusive growth which is central to the Europe 2020 Strategy. Implicit in the approach taken in the Europe 2020 Strategy is that economic development, social development and environmental protection are complementary and interdependent – three sides of the same reality. Overall, current trends in Irish public policy are running counter to the promotion of ‘inclusive growth,’ which is one of the three key priorities which underlie the Europe 2020 Strategy. Inclusive growth is not just about fostering a high-employment economy, it also aims to deliver social cohesion – it is integral to the Europe 2020 strategy and needs to be integral to the response of the Irish Government.Inclusion and exclusionSocial equality and inequalityPovertyEconomic policyEmployment and unemploymentEducation and trainingEuropeIreland2015-01Social Justice IrelandReport

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Drugs and AlcoholDynamics of child economic vulnerability and socio-emotional development: an analysis of the first two waves of the growing up in Ireland study.DorothyWatsonauthorBertrandMaitreauthorChristopher TWhelanauthorJamesWilliamsauthorThis research report draws on the longitudinal Growing Up in Ireland study to examine change over time in the economic vulnerability of families and its consequences for the socio-emotional development of children. Economic vulnerability refers to an increased risk of multidimensional material disadvantage, involving a distinctive profile in relation to low income, household joblessness and economic stress. Socio-emotional development is measured using the Strengths and Difficulties Questionnaire (SDQ). As well as examining the risk factors for economic vulnerability and socio-emotional problems, the report examines the factors associated with improved outcomes for children, enhancing their resilience. The report addresses the following research questions: 1. How did the economic vulnerability of families change as Ireland moved from boom to recession? 2. Which families are most at risk of economic vulnerability? Does this differ between the ’98 Cohort and the ’08 Cohort? 3. What is the relationship between family economic vulnerability and the child’s socio-emotional well-being? Does the relationship differ depending on whether the economic vulnerability is persistent or transient? 4. Are there factors which appear to protect children from the impact of economic vulnerability on socio-emotional development?risk factorsFamily backgroundInclusion and exclusionPovertyChildAdolescent / youth (teenager / young person)Ireland2014-11Department of Children and Youth AffairsReport

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Drugs and AlcoholYouth mental health and substance misuse disorders in deprived urban areas.MargaretCurtinauthorMental healthDrugs and alcohol related mental disorderInclusion and exclusionurban societyPovertyAdolescent / youth (teenager / young person)Ireland2014-10Health Research BoardArticle

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Drugs and AlcoholDoes social disadvantage over the life-course account for alcohol and tobacco use in Irish people? Birth cohort study.JayatiDas-MunshiauthorGerardLeaveyauthorStephen AStansfeldauthorMartin JPrinceauthorAims: Few studies have examined how the settlement experiences of migrant parents might impact on the downstream adult health of second-generation minority ethnic children. We used prospective data to establish if childhood adversity relating to the settlement experiences of Irish-born parents might account for downstream adverse health-related behaviours in second-generation Irish respondents in adulthood. Design, setting and participants: Cohort data from the National Child Development Study, comprising 17 000 births from a single week in 1958, from Britain, were analysed. Respondents were followed to mid-life. Dependent variables were alcohol and tobacco use. The contribution of life-course experiences in accounting for health-related behaviours was examined. Findings: Relative to the rest of the cohort, the prevalence of harmful/hazardous alcohol use was elevated in early adulthood for second-generation men and women, although it reduced by age 42. Second-generation Irish men were more likely to report binge alcohol use (odds ratio 1.45; 95% confidence interval 0.99, 2.11; P = 0.05), and second-generation Irish women were more likely to smoke (odds ratio 1.67; 95% confidence interval 1.23, 2.23; P = 0.001), at mid-life. Childhood disadvantage partially mediated associations between second-generation Irish status and mid-life alcohol and tobacco use, although these were modest for associations with smoking in Irish women. Conclusions: The findings suggest mechanisms for the intergenerational 'transmission' of health disadvantage in migrant groups, across generations. More attention needs to focus on the public health legacy of inequalities transferring from one migrant generation to the next.Tobacco (cigarette smoking)Alcohol useMinority group (racial group, immigrant, Traveller)Poverty2014-08Article

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Drugs and AlcoholReducing poverty in the UK: a collection of evidence reviews.JRF is developing the first comprehensive, evidence-based strategy to reduce poverty for all age groups and each UK nation. To help build the evidence, we commissioned researchers to carry out reviews of existing policy and research on a wide range of social issues that are related to poverty. The 33 studies in this collection are the findings of those reviews, and there are links to more detailed reports by the research teams. CONTENTS • Foreword 06 • Demographic change and poverty 08 • Devolution and poverty 12 • Gender and poverty 17 • International anti-poverty strategies 22 • Regeneration and poverty 27 • Religion and poverty 33 • Sexual orientation and poverty 37 • Well-being and poverty 41PovertyUnited Kingdom2014-08Joseph Rowntree FoundationEvidence resource

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Drugs and AlcoholBetter outcomes brighter futures. The national policy framework for children & young people 2014 - 2020.Alcohol useDrug usePrevention approachEarly intervention (young children)PovertyChildAdolescent / youth (teenager / young person)Young adultIreland2014-04Stationery OfficeReport

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Drugs and AlcoholChildren of the recession. The impact of the economic crisis on child well-being in rich countries.GonzaloFanjulauthorThe data and observations in this Innocenti Report Card reveal a strong and multifaceted relationship between the impact of the Great Recession on national economies and a decline in children’s well-being since 2008. Children are suffering most, and will bear the consequences longest, in countries where the recession has hit hardest. For each country, the extent and character of the crisis’s impact on children has been shaped by the depth of the recession, pre-existing economic conditions, the strength of the social safety net and, most importantly, policy responses. Remarkably, amid this unprecedented social crisis, many countries have managed to limit – or even reduce – child poverty. It was by no means inevitable, then, that children would be the most enduring victims of the recession.PovertyEconomic policyChildAdolescent / youth (teenager / young person)2014UNICEF Office of ResearchReport

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Drugs and AlcoholDo societal wealth, family affluence and gender account for trends in adolescent cannabis use? A 30 country cross-national study.Tom F MTer BogtauthorMargreetde LoozeauthorMichalMolchoauthorEmmanuelleGodeauauthorAnneHubletauthorAnnaKokkeviauthorEmmanuelKuntscheauthorSaoirseNic GabhainnauthorIva PejnovicFranelicauthorBruceSimons-MortonauthorSharonSznitmanauthorAlessioVienoauthorWVolleberghauthorWilliamPickettauthorPurpose: To examine cross-national changes in frequent adolescent cannabis use (40+ times consumed over life-time at age 15) over time and relate these trends to societal wealth, family affluence and gender. Setting: Representative surveys in 30 European and North American countries. Participants: A total of 160 606 15-year-old students. Measurements: Respondents' life-time cannabis use, demographics, family affluence (FAS) and frequency of peer contacts were measured individually. Indicators of wealth (gross domestic product per capita, GDP) and perceived availability of cannabis were obtained from national public data bases. Findings: The frequency of life-time cannabis use decreased over time among adolescents in Europe and North America, particularly in western European countries and the United States (relative risk (RR) = 0.86: confidence interval (CI) 0.79–0.93). This trend was not observed consistently in rapidly developing countries in eastern, central and southern Europe. Over time (2002–10), cannabis use became: (i) less characteristic of high GDP countries in contrast to lower GDP countries (RR = 0.74: CI 0.57–0.95); (ii) less characteristic of youth from high FAS families in contrast to youth from low FAS families (RR = 0.83: CI 0.72–0.96); and (iii) characterized by an increasing gender gap, i.e. consumption was higher among males (RR 1.26: CI 1.04–1.53). Perceived availability of cannabis and peer contacts remained strong predictors of frequent cannabis use. Conclusions: Among 30 European and North American countries, cannabis use appears to have ‘trickled down’ over time, with developing countries taking on the former (heavier) use pattern of richer countries, and less affluent youth taking on the former (heavier) use pattern of more affluent youth. Cannabis use continues to be more common among adolescent males than females.Family roleIrelandrisk factorsCannabis / MarijuanaAfricaGender differencesPovertyEuropeFamily backgroundrisk-taking behaviourEconomic availability or accessibilityPrevalence of drugs and alcohol use2014Wiley-BlackwellArticle

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Drugs and AlcoholWho really took the hits during Ireland’s Bailout?Ireland’s poorest 10% lost 18.4% of their real disposable income since the start of the crash in 2008. By contrast the richest 10% lost 11.4%. This is just one of the statistics which show that low and middle-income Ireland have borne the major brunt of adjustments over the past five years according to the most recent analysis from Social Justice Ireland entitled 'Who really took the hits during Ireland's Bailout?' The situation would be even worse if cuts in services and increased charges were included in calculations. The analysis also shows that • The gap between low and middle-income Ireland on the one hand and the rich on the other hand has widened dramatically. • Budgets introduced under the tutelage of the Troika (2011-2014) were regressive, taking more as a percentage of income from those who have least. The real impact was even more regressive because this calculation does not include the impacts of reductions in services and increased charges introduced in these years, which impact disproportionately on the most vulnerable. • The richest 20% of the population were the only ones whose share of the total disposable income grew significantly in this period. This confirms the widening gap between low and middle-income Ireland on the one hand and the richest 20% on the other.IrelandInclusion and exclusionPovertyEconomic policy2013-11Social Justice IrelandReport

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Drugs and AlcoholFamily wellbeing on a limited income: a study of families living at risk of poverty in Ireland.LorraineSwordsauthorBrianMerrimanauthorMichelleO’DonnellauthorThe patterns of economic and structural change affecting family life in recent years mean that there is much to be learned about the wellbeing of families in Ireland today. To this end, Growing Up in Ireland, the National Longitudinal Study of Children, has made an important contribution to Irish and international research by providing a rich source of data relevant to the study of the wellbeing of parents, children, and the relationships they share. The present study is concerned with quantitative data collected during the first phase of Growing Up in Ireland between September 2007 and June 2008 with 8,568 nine-year-olds and their families. The specific sample focused on in this report are families drawn from this dataset whose household income categorises them as being at risk of poverty. Households are considered to be at risk of poverty when their equivalised disposable income is below a particular threshold. In Ireland, and indeed the European Union, this threshold has been set at 60% of the median income. Evidence from the Irish and international research literature suggests that such economic hardship can cast large shadows across many aspects of family members’ lives and have a negative impact upon family wellbeing (e.g. Daly & Leonard, 2002; McKeown, Pratschke, & Haase, 2003; Sell, Zlotnik, Noonan, & Rubin, 2010). Family wellbeing is conceptualised here as comprising the dimensions of parent wellbeing, child wellbeing and positive family relationships. The influences on the wellbeing of the individuals within the family and the relationships they share can be numerous, interrelated and reciprocal. The purpose of this report is to mine data from Growing Up in Ireland in order to describe the wellbeing of Irish families living on limited incomes and to shed light on the factors associated with the various aspects of their wellbeing. Specifically, this study seeks to answer the following two research questions: Research Question One: How are families identified as living on very limited incomes faring in comparison with families with higher incomes across a range of indicators of family wellbeing? Research Question Two: Among families living on limited incomes, what are the key factors associated with their wellbeing? From an evidence base of research and insights into the factors that most contribute to the wellbeing of children, their parents, and family relationships, priorities for limited resources can be identified so that families needing assistance can most benefit from responsive policies and service provision. Key study findings Characteristics of Families Living at Risk of Poverty. Examination of the characteristics of families living at risk of poverty indicated that: • Over a third of families were headed by single-parents and the vast majority of these lone parents were mothers. Almost two thirds of families had three or more children. • The majority of mothers and fathers had not continued education past lower secondary school level. For both parents, the odds of being at risk of poverty decreased as their level of educational attainment increased. • The socio-economic status of one third of families could not be classified as no parent in the household had ever been in employment. For the remaining families, the majority were represented in the manual labour categories and the minority in the managerial, technical or professional categories. • Almost forty per cent of families reported that they did not receive any Social Welfare payments in addition to Child Benefit. One third of families relied on various Social Welfare payments for all of their households’ income and, at the other end of the scale, almost one quarter received payments that amounted to less than 5% of their household’s total income. • Over a quarter of families at risk of poverty did not have any medical card.Financial (money) problemsFamily roleIrelandFamily supportPovertyFamily background2013-07Family Support AgencyReport

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Drugs and AlcoholEstimates of household income by county and region, statistical indicator and year.CSO statistical tables - you can choose to examine household income data by state, region and by year.IrelandSocial equality and inequalityPopulation dynamicsPoverty2013Central Statistics OfficeReport

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Drugs and AlcoholWhat would real recovery look like? Securing economic development, social equity and sustainability.SeanHealyauthorAdamLarragyauthorAnnLeahyauthorSandraMallonauthorMichelleMurphyauthorBrigidReynoldsauthorThis Review argues that Ireland needs to recognise the essentially complementary nature of economic and social development - two sides of the one reality. Economic development is essential to provide the resources necessary for social development. But social development, in turn, is essential because there can be no lasting economic development of any substance without the provision of social services and infrastructure. All one has to do is reflect on the importance of a good education system for the development of a ‘hi-tech, hi-spec, smart’ economy. At the same time we argue that both economic development and social development must be sustainable if it is to be of lasting value. All development must be sustainable economically, socially and environmentally. Otherwise it should not be accepted as development. Recognising the importance of sustainability presents new challenges which must be addressed, not ignored, in the rush to address the urgent rather than the important.IrelandSocial equality and inequalityPovertyEconomic policyGovernment and politicsEmployment and unemployment2013Social Justice IrelandReport

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Drugs and AlcoholThe impact of the European Crisis. A study of the impact of the crisis and austerity on people, with a special focus on Greece, Ireland, Italy, Portugal and Spain.AnnLeahyauthorSeanHealyauthorMichelleMurphyauthorSpainIrelandPortugalInclusion and exclusionPovertyItalyEconomic policyGreece2013Caritas EuropaReport

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Drugs and AlcoholAddiction treatment in deprived urban areas in EU countries: Accessibility of care for people from socially marginalized groups.MartaWelbellauthorAleksandraMatanovauthorJacekMoskalewiczauthorHenriqueBarrosauthorReamonnCanavanauthorEdinaGaborauthorAndreaGaddiniauthorTimGreacenauthorUlrikeKlugeauthorVincentLorantauthorMercedesEsteban PeñaauthorAart HScheneauthorJoaquim JFSoaresauthorChristaStraßmayrauthorPetraVondráčkováauthorStefanPriebeauthorAim: This study examines the accessibility of addiction treatment within services providing mental health care and support for people from socially marginalized groups in deprived urban areas across EU countries. Methods: Services providing mental health care and support in deprived areas of 14 EU capital cities were assessed with a questionnaire. We analysed the availability and accessibility of those services providing addiction treatment for people from six groups: the long-term unemployed, the homeless, street sex workers, asylum seekers and refugees, irregular migrants and people from travelling communities. Results: While 30% of all the assessed services provided addiction treatment, in 20% of services, addiction was a criterion for exclusion. Among services providing addiction treatment, 77% accepted self-referrals, 63% were open on weekends or in the evening, 60% did not charge any out-of-pocket fees, 35% provided access to interpreters, and 28% ran outreach activities. These results varied substantially among EU capitals. Conclusion: Access to addiction treatment for socially marginalized groups varies across Europe. Some of the models identified may constitute barriers to treatment. Developing care delivery models that facilitate access for vulnerable populations should be a priority for national and European policies.Inclusion and exclusionSocial equality and inequalityDrugs and alcohol disorder treatment methodurban societyDublinTreatment factorsPovertyEuropeCommunity-based treatment (primary care)2013Informa healthcareArticle

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Drugs and AlcoholDrugnet digest.SuziLyonsauthorItaCondronauthorJohnnyConnollyauthorBrigidPikeauthorWaiting timeCrime preventionDublinPublic order offenceInformation technologyDrugs and alcohol disorder treatment unitWaiting listPovertyMethadone maintenanceCrime associated with drugs and alcohol production and distribution2012-10Health Research BoardArticle

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Drugs and AlcoholSurvey on income and living conditions (SILC). Thematic report on children 2004-2010.Annual SILC data has previously been published from 2004 to 2010 on income, poverty and deprivation rates. Further analysis of this data has now been carried out to specifically look at the circumstances of children, those aged less than 18 years. In the majority of tables, the analysis is presented for all persons living in households with children, compared with persons living in households without children. Some tables in this report also compare age groups of the overall population. Also contained in this publication is a further breakdown of income, which details child-related social transfers separately. Summary of main findings • In 2010, the average income (ie equivalised gross weekly disposable income) of individuals living in households with children was €482.83, down 8.8% on the 2009 figure of €529.20. This compares with an income for those living in households without children of €575.15 in 2010, down 2.1% on the 2009 figure of €587.32. See table 1b. • In 2010 the at risk of poverty rate for those living in households with children was 18.7% compared with the rate of 11.8% for those in households without children. A similar pattern is evident between these two household types across all years. See table 2a. • Excluding family allowances from the analysis for 2010 would increase the at risk of poverty rate for persons living in households with children from 18.7% to 38.6%. This shows the effect that such family related social transfers had in shielding individuals from poverty in households with children. See table 2a. • Among children, the highest at risk of poverty rate in all years occured in the 12-17 age band. This rate was 26.1% in 2010 compared with a rate of 19.2% for 6-11 year olds and a rate of 12.0% for children in the 0-5 year old band. See table 2b. • The level of enforced deprivation (lacking two or more basic items) for individuals living in households with children was 28.2% in 2010 compared with a level of 14.6% for those living in households without children. See table 3a. • In all years the rate of consistent poverty was higher for individuals living in households with children than for those living in households without children (8.0% compared with 3.8% respectively in 2010). See table 4a.Adolescent / youth (teenager / young person)Social equality and inequalityIrelandInclusion and exclusionLifestylePovertyHousingChild2012-09Stationery OfficeReport

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Drugs and AlcoholFindings from a study of homeless women in Ireland.MartinKeaneauthorIrelandInclusion and exclusionWoman (women / female)Homeless personPovertyHomeless services2012-06Health Research BoardArticle

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Drugs and AlcoholUnderstanding youth homelessness.MartinKeaneauthorAdolescent / youth (teenager / young person)IrelandInclusion and exclusionHomeless servicesHomeless personPoverty2012-06Health Research BoardArticle

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Drugs and AlcoholUnderstanding childhood deprivation in Ireland.DorothyWatsonauthorBertrandMaitreauthorChristopher TWhelanauthorIn Ireland, as in many European countries, the rate of poverty and deprivation is higher for children than it is for adults. This is important, not only because of a concern with the well-being of children but also because childhood deprivation can have long-term negative consequences that persist into adulthood. This report examines childhood deprivation in Ireland in 2009 in the context of this concern for the current well-being of children and their future prospects. The goal of this report is to address five questions: 1. How much child-specific deprivation is there in Ireland and what form does it take? 2. What are the main risk factors for child-specific deprivation? 3. How well do the national measures of basic deprivation and consistent poverty identify children who are deprived? 4. How do the risk factors for child-specific deprivation differ from the risk factors for basic household-level deprivation? 5. What are the implications for policy?Inclusion and exclusionIrelandFamily supportPovertyChild2012-04Department of Social Protection and The Economic and Social Research InstituteReport

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Drugs and AlcoholIMO position paper on health inequalities.IMO President, Dr. Ronan Boland said; “Factors such as poverty, inequality, social exclusion, employment, income, education, housing conditions, transport access to health care, lifestyle stress all impact significantly on an individual’s health and wellbeing. “Evidence shows that lower socio-economic groups have relatively high mortality rates, higher levels of ill health and fewer resources to adopt healthier lifestyles when compared to better off sections of society.” He said; “Life expectancy at birth for male professionals is 6.1 years higher and 5 years higher for female professionals than their unskilled counterparts.” Dr. Boland said; “The Institute of Public Health in Ireland also estimates that, as a result of Ireland’s ageing population, by 2020 the number of people living with Coronary Heart Disease (CHD) and stroke will rise by almost 50% (49.4% and 47.8% respectively) while the number of people with diabetes is likely to rise by 62% due principally to a marked increase in maturity-onset diabetes, the primary risk factor for this condition being obesity which is more prevalent among poorer socio-economic groups.” In addition further research found children, particularly girls, from less socio-economically advantaged households were more likely to be overweight. The research shows that 19% of boys and 18% of girls from professional households are overweight or obese. This increases to 29% of boys and 38% of girls from semi-and unskilled social-class households. Dr. Boland added; “International research examined found that countries with the greatest income inequality are most likely to have higher levels of health and social problems. While countries such as Sweden, Denmark and Finland with high levels of social protection and comprehensive social safety nets, have lower income inequality and thus lower levels of health and social problems. Policies are therefore needed that address the unequal distribution of wealth.” The IMO have outlined a number of recommendations in it position paper including the establishment of a Minister for Public Health with direct responsibility for overseeing the delivery and implementation of Public Health Policy and tasked with ensuring that public policy is health proofed across all Government departments. They are also calling for an explicit statement from Government that health is a basic human right and its protection should be a core aim of Government and the State. “Improving the health of all our citizens, particularly the poorest and most deprived, will reap long-term dividends by ensuring a healthier population, and more productive workforce, who will have less need for expensive health interventions and social economic supports, said Dr. Boland.State of healthWaiting timeSocial equality and inequalityIrelandMinority group (racial group, immigrant, Traveller)Public healthPovertyHealth information and educationHealth care delivery2012-03Irish Medical OrganisationReport

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Drugs and AlcoholThe vicious circle of social exclusion and crime: Ireland’s disproportionate punishment of the poor.This Position Paper has endeavoured to paint a clear picture of the interwoven nature of social exclusion and crime by drawing attention to the social profile of prisoners; the criminal law’s targeting of marginalised groups; the uneven application of the law to different socio-economic groups; the causes of crime; issues of reintegration and poverty following imprisonment and the urgent need to shift the focus of public policy to investment in crime prevention and early intervention instead of wasting its energy and resources on punitive criminal justice policies.PrisonIrelandInclusion and exclusionOffenderPovertyCriminal penaltyPrison Inmate (prisoner)2012-02Irish Penal Reform TrustReport

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Drugs and AlcoholSocial inequalities in mental health: results from the EU contribution to the World Mental Health Surveys Initiative.AlejandraPinto-MezaauthorMaria VictoriaMonetaauthorJordiAlonsoauthorMatthias CAngermeyerauthorRonnyBruffaertsauthorJosé MiguelCaldas-de-AlmeidaauthorGiovannide GirolamoauthorRonde GraafauthorSilviaFlorescuauthorVivianeKovess-MasfetyauthorSiobhanO'NeillauthorSvetlozarVassilevauthorJosep MariaHaroauthorPURPOSE: The objective of the present study was to provide updated data from nine European countries about the impact of social inequalities in the prevalence of common mental disorders. METHODS: Cross-sectional household survey of a representative sample of the adult general population of Belgium, Bulgaria, Germany, Italy, The Netherlands, Northern Ireland, Portugal, Romania and Spain. In total, 34,395 individuals were included. Social inequalities in 12-month mood, anxiety and alcohol-related disorders were evaluated. RESULTS: In Europe, income seems not to be related to the prevalence of mental disorders. Unemployment and disablement are associated with mental disorders. Lower educational level augments the risk for mood disorders. Living in small (rural) areas decreases the risk for mood disorders and living in urban settings increases it. Northern Ireland, Portugal and Belgium are the countries with the highest risks for mental disorders. CONCLUSIONS: Despite some contradictions with previous literature, in Europe there are social inequalities in the prevalence of mental disorders. However, income showed not to be associated with inequalities in mental health. Being younger, unemployed or disabled, with no education or incomplete primary studies, living in urban settings, and in Northern Ireland, Portugal or Belgium were associated to an augmented prevalence of mental disorders. Policy makers could focus on mental health promotion and mental disorders prevention programmes for risk groups such as unemployed/disabled individuals. Support to vulnerable groups (unemployed or those with less education) and mental health literacy can improve European citizens' mental health.Mental healthProblem drugs and alcohol useNorthern Irelandurban societyEducational levelDrugs and alcohol related mental disorderAlcohol dependenceSocial equality and inequalityPovertyEurope2012SpringerArticle

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Drugs and AlcoholSocial networks: their role in addressing poverty.AsifAfridiauthor'Social networks' – the ties between individuals or groups – are receiving more attention in public policy discourse as people are encouraged to help each other at a time of austerity and the Coalition Government's emerging 'Big Society' ideas. Evidence and ideas are needed to ensure that strategies intended to do more with fewer public resources do not have a negative effect on the most vulnerable. This paper by brap (formerly Birmingham Race Action Partnership): • explains what social networks are, and their benefits; • explores how social networks can help address poverty and be made more accessible; and • discusses the impacts of government spending cuts on social networks.Social supportInterpersonal interaction and group dynamicsUnited KingdomPovertyCommunity action2011Joseph Rowntree FoundationReport

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Drugs and AlcoholArea of residence and alcohol-related mortality risk: a five-year follow-up study.SheelahConnollyauthorDermotO'ReillyauthorMichaelRosatoauthorChrisCardwellauthorDesign: A 5-year longitudinal study of individual and area characteristics of those dying and not dying from alcohol-related deaths. Participants: A total of 720 627 people aged 25–74, enumerated in the Northern Ireland 2001 Census, not living in communal establishments. Findings: There was an increased risk of alcohol-related mortality among disadvantaged individuals, and divorced, widowed and separated males. The risk of an alcohol-related death was significantly higher in deprived areas for both males [hazard ratio (HR) 3.70; 95% confidence interval (CI) 2.65, 5.18] and females (HR 2.67 (95% CI 1.72, 4.15); however, once adjustment was made for the characteristics of the individuals living within areas, the excess risk for more deprived areas disappeared. Both males and females in rural areas had a reduced risk of an alcohol-related death compared to their counterparts in urban areas; these differences remained after adjustment for the composition of the people within these areas. Conclusions: Alcohol-related mortality is higher in more deprived, compared to more affluent areas; however, this appears to be due to characteristics of individuals within deprived areas, rather than to some independent effect of area deprivation per se. Risk of alcohol-related mortality is lower in rural than urban areas, but the cause is unknown.Problem drugs and alcohol useNorthern IrelandDrugs and alcohol related mortality / deathType of society and cultureAlcohol usePovertyrisk factors2011Wiley-BlackwellArticle

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Drugs and AlcoholNational reform programme for Ireland under the Europe 2020 Strategy.Contents: Macro economic scenario Macro economic surveillance Thematic co-ordination • Target 1 – employment • Target 2 – research and development • Target 3 – climate change • Target 4 – education • Target 5 – poverty Horizontal and methodological issuesPolicyIrelandProgramme planning (strategy)PovertyGovernment and politics2011Department of the TaoiseachReport

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Drugs and AlcoholHuman rights and extreme poverty in Ireland.BrigidPikeauthorSocial equality and inequalityInclusion and exclusionIrelandPoverty2011Health Research BoardArticle

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Drugs and AlcoholNational poverty indicators.BrigidPikeauthorSocial equality and inequalityIrelandPoverty2011Health Research BoardArticle

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Drugs and AlcoholDoes income inequality cause health and social problems?KarenRowlingsonauthorKey points • The literature shows general agreement about a correlation between income inequality and health/social problems. • There is less agreement about whether income inequality causes health and social problems independently of other factors, but some rigorous studies have found evidence of this. • The independent effect of income inequality on health/social problems shown in some studies looks small in statistical terms. But these studies cover whole populations, and hence a significant number of lives. • Some research suggests that inequality is particularly harmful beyond a certain threshold. Britain was below this threshold in the 1960s, 1970s and early 1980s, but rose past it in 1986–7 and has settled well above it since 1998–9. If the threshold is significant it could provide a target for policy. • Anxiety about status might explain income inequality’s effect on health and social problems. If so, inequality is harmful because it places people in a hierarchy which increases competition for status, causing stress and leading to poor health and other negative outcomes. • Not all research shows an independent effect of income inequality on health/social problems. Some highlights the role of individual income (poverty/material circumstances), culture/history, ethnicity and welfare state institutions/social policies. • The author concludes that there is a strong case for further research on income inequality and discussion of the policy implications. Background The UK witnessed a dramatic growth in income inequality in the 1980s, and since then the level of inequality has increased further, though at a slower rate (National Equality Panel, 2010, An Anatomy of Economic Inequality in the UK). But should we be concerned about this? Wilkinson and Pickett's The Spirit Level (2009) argued strongly that it should indeed be a matter of concern, and has placed income inequality firmly within public debate. This study provides an independent review of the research in this field, paying particular attention to the evidence and arguments put forward in The Spirit Level. That book presented a 'big idea' in social science, using data on a wide range of countries and a wide range of variables. It is perhaps not surprising, therefore, that it attracted criticism. This study considers the points made in various critiques, alongside the broader peer-reviewed literature in this field. It is not intended to be the final word on this debate, not least because new research findings are frequently published. It is intended, instead, to contribute to the ongoing debate on this important topic. Correlations between income inequality and health and social problems Evidence from a range of studies suggests that there is a correlation between income inequality and health and social problems. For example, Table 1 shows the strength of relationships between income inequality in rich countries and various health and social problems, drawing on data from the United Nations (UN) and the Organisation for Economic Co-operation and Development (OECD). Table 1 (see PDF document) shows correlation coefficients for the relationships, ranging from −1 to 1. A value of 1 implies a direct linear relationship between two variables, with all data points lying on a line for which the value of one variable increases directly as the other variable increases (for example, as inequality increases so does social immobility). In a similar way, a value of −1 implies that the value of one variable decreases directly as the other increases (for example, as inequality increases, trust declines). A value of 0 implies that there is no linear correlation between the two variables. Correlation levels above 0.5 (or below -0.5) suggest a strong relationship in social science analysis. The correlation coefficients shown in Table 1 using UN data thus show high correlation levels between income inequality and social immobility, teenage births, imprisonment, low trust, mental illness and obesity. Other health and social problems fall below the 0.5 (or -0.5) threshold, but only just; these are homicides, educational performance, life expectancy and infant mortality. Some recent high-profile critiques of The Spirit Level have, in particular, queried its correlation analysis (Saunders, 2010; Snowdon, 2010), but the consensus in the broader academic literature is that a correlation does exist between income inequality and health and social problems. This literature has moved on to discuss whether or not there is a causal relationship (see below). However, the strength of the correlations between income inequality and health and social problems is sensitive to factors such as: different measures of income inequality; different measures of social stratification; variations in the countries selected; and other factors. Therefore, some further 'sensitivity' analysis would be helpful, even though the general conclusion about the existence of a correlation between income inequality and health and social problems is widely accepted. Causal relationships More recent studies have moved away from simple correlation analysis to investigate whether income inequality causes such problems, independent of other factors. The literature is less agreed about whether or not there is a causal relationship, but some rigorous studies indicate that income inequality has an independent effect on health and social problems. In studies which show that income inequality has a negative effect on health and social problems, the size of this effect looks small in statistical terms. However, since these studies cover whole populations, the numbers of lives involved are significant. One study, for example, suggested that the loss of life from income inequality in the US in 1990 was the equivalent of the combined loss of life due to lung cancer, diabetes, motor vehicle accidents, HIV infection, suicide and homicide (Lynch, J., et al., 1998, 'Income inequality and mortality in metropolitan areas of the United States', American Journal of Public Health, Vol. 88, pp. 1074–1080). Some research suggests that income inequality is particularly harmful after it reaches a certain threshold. Britain was below this threshold in the 1960s, 1970s and early 1980s, but rose past it in 1986–7 and has settled well above that threshold since 1998–9. If this threshold is indeed significant it could provide a target for policy. The most plausible explanation for the apparent effect of income inequality on health and social problems seems to be people’s anxiety about their status (The Spirit Level, Richard Wilkinson and Kate Pickett, 2009). This suggests that income inequality is harmful because it places people in a hierarchy which increases competition for status and causes stress, leading to poor health and other negative outcomes. Further theorising about 'status anxiety' would be helpful, to consider how it works in practice given that people compare themselves to different groups in different situations, their knowledge (or lack of it) about social stratification and the complex nature of status and self-esteem. However, not all research studies have shown an independent effect of income inequality on health and social problems. Some have highlighted the causal effect of other factors, such as individual income (poverty/material circumstances), culture/history, ethnicity and welfare state institutions/social policies. Once again, the theorising behind these relationships could be further advanced and further empirical research carried out to test competing hypotheses. Effects of income inequality A key issue is whether inequality affects all groups in society to the same extent, or some groups more than others. Some research comparing different groups in different countries suggests that people in lower socio-economic groups in more equal countries do better than those in lower socio-economic groups in more unequal countries. They may even sometimes do better than people in higher socio-economic groups in more unequal countries. Further studies on this topic would be welcome. This study focuses on the health and social effects of income inequality, but there may also be economic effects (positive or negative). It is outside the scope of this review to assess in more detail the arguments about the relationship between economic inequality, productivity, growth and financial stability. However, there appears to be remarkably little evidence that income inequality promotes economic growth, so it is difficult to find any positive effects of income inequality. Debate about the financial crash is contentious and continues, but a number of commentators suggest that high levels of economic inequality played a role in the crash in some way. This is a highly complex issue, both theoretically and methodologically, with disagreement among academics on many related areas. But the main conclusion of this study is that there is some evidence that income inequality has negative effects, and hardly any evidence of positive effects. Conclusion and policy implications The main aim of this study was to review the evidence concerning the impact of income inequality on health and social problems. It also considered a range of policy implications. Given that the study’s main conclusion is that both individual income (in terms of poverty/material circumstances) and income inequality (relative income) make a difference to health and social problems, it seems clear that both issues need to be tackled. A range of policy mechanisms could be used to do this, ranging from redistribution through the tax and benefit system to innovative income and wealth policies, stronger public services and a greater focus on equal opportunities.Inclusion and exclusionHealth care economicsrisk factorsEconomic policyState of healthSocial equality and inequalityUnited KingdomPublic healthPoverty2011Joseph Rowntree FoundationReport

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Drugs and AlcoholReport of the independent expert on the question of human rights and extreme poverty in IrelandMagdalenaSepúlveda CarmonaauthorPage 9 34. A number of recent measures are concerning in this respect, especially reductions in child benefits and benefits for job seekers, carers, single parent families, persons with disabilities and blind persons. The impact of these measures will be exacerbated by funding reductions for a number of social services which are essential for the same vulnerable people, including disability, community and voluntary services, Travellers supports, drug outreach initiatives, rural development schemes, the Revitalising Areas by Planning, Investment and Development (RAPID) programme and Youthreach. 35. By adopting these measures, Ireland runs a high risk of excluding those most in need of support and ignoring the needs of the most vulnerable. In particular, due to multiple forms of entrenched discrimination, women are especially vulnerable to the detrimental effects of reductions in social services and benefits. The independent expert notes the commitment in the PGNR to refrain from further reducing social protection benefits,26 but urges the State to take immediate steps to put in place protections to ensure that the situation of the most excluded and disadvantaged groups do not deteriorate further as a result of these measures.Financial (money) problemsProblem drugs and alcohol useIrelandSocial equality and inequalityPoverty2011United Nation Human Rights CouncilReport

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Drugs and AlcoholThe children left behind: a league table of inequality in child well-being in the world's rich countries.PeterAdamsonauthorThis Report Card presents a first overview of inequalities in child well-being for 24 of the world’s richest countries. Three dimensions of inequality are examined: material well-being, education, and health. In each case and for each country, the question asked is ‘how far behind are children being allowed to fall?’ The report argues that children deserve the best possible start, that early experience can cast a long shadow, and that children are not to be held responsible for the circumstances into which they are born. In this sense the metric used - the degree of bottom-end inequality in child well-being - is a measure of the progress being made towards a fairer society. Bringing in data from the majority of OECD countries, the report attempts to show which of them are allowing children to fall behind by more than is necessary in education, health and material well-being (using the best performing countries as a minimum standard for what can be achieved). In drawing attention to the depth of disparities revealed, and in summarizing what is known about the consequences, it argues that ‘falling behind’ is a critical issue not only for millions of individual children today but for the economic and social future of their nations tomorrow.Social equality and inequalityInternational aspectsPovertyChild2010UNICEFReport

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Drugs and AlcoholSocio-economic review 2010. An agenda for a new Ireland: policies to ensure economic development,social equity and sustainability.MichaelCollinsauthorSeanHealyauthorBrigidReynoldsauthorHealth care economicsIrelandInclusion and exclusionPovertyEconomic policy2010Social Justice IrelandReport

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Drugs and AlcoholPoverty and social exclusion.Europe is one of the richest areas in the world, yet around 84 million Europeans live below the poverty line, and many face serious obstacles in accessing employment, education, housing, social services and financial services. Inspired by its founding principle of solidarity, the European Union has joined forces with its Member States to make 2010 the European Year for Combating Poverty and Social Exclusion. Its goals cover four broad objectives and guiding principles:Problem drugs and alcohol useInclusion and exclusionDrug dependenceAlcohol dependenceHomelessnessSocial equality and inequalityPovertyEurope2010European CommissionReport

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Drugs and AlcoholIn brief.BrigidPikeauthorRole of childIrelandInternational aspectsPovertyCannabis / MarijuanaPolicy on drugs and alcoholLegal availability or accessibility2010Health Research BoardArticle

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Drugs and AlcoholGrowing up in Ireland: National longitudinal study of children. The infants and their families.JamesWilliamsauthorSheilaGreeneauthorSineadMcNallyauthorAislingMurrayauthorAmandaQuailauthorGrowing Up in Ireland is a national study of children. It is the most significant of its kind ever to take place in this country and will help us to improve our understanding of all aspects of children and their development. The study will take place over seven years and follow the progress of two groups of children; 8500 nine-year-olds and 11,000 nine-month-olds. During this time we will carry out two rounds of research with each group of children. The main aim of the study is to paint a full picture of children in Ireland and how they are developing in the current social, economic and cultural environment. This information will be used to assist in policy formation and in the provision of services which will ensure all children will have the best possible start in life.Context encouraging drugs and alcohol useFamily roleCommunity environmentPregnancyIrelandPregnant womanAlcohol consumptionParent-child relationsChildEconomic aspects of drugs and alcohol (cost / pricing)Poverty2010Stationery OfficeReport

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