کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5046457 1475982 2017 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
A model of how targeted and universal welfare entitlements impact on material, psycho-social and structural determinants of health in older adults
ترجمه فارسی عنوان
یک مدل از اینکه چگونه حقوق و مزایای رفاهی هدفمند و تأثیرگذار بر عوامل مادی، روانی-اجتماعی و سازمانی سلامت در افراد مسن تاثیر می گذارد
کلمات کلیدی
انگلستان، شهروندان قدیمی تر رفاه، شرایط ادغام اجتماعی، سلامت عمومی، کیفی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی سیاست های بهداشت و سلامت عمومی
چکیده انگلیسی


- Welfare impacts on health through material, psycho-social and structural pathways.
- Older adults' understandings of the form of entitlement affect wellbeing outcomes.
- Universal entitlement facilitates access to resources, sociality and respect.
- Targeted entitlement deters uptake and fosters discourses of disrespect and division.
- Evaluations of welfare change need to focus on structural pathways to health outcomes.

A growing body of research attests to the impact of welfare regimes on health and health equity. However, the mechanisms that link different kinds of welfare entitlement to health outcomes are less well understood. This study analysed the accounts of 29 older adults in England to delineate how the form of entitlement to welfare and other resources (specifically, whether this was understood as a universal entitlement or as targeted to those in need) impacts on the determinants of health. Mechanisms directly affecting access to material resources (through deterring uptake of benefits) have been well documented, but those that operate through psychosocial and more structural pathways less so, in part because they are more challenging to identify. Entitlement that was understood collectively, or as arising from financial or other contributions to a social body, had positive impacts on wellbeing beyond material gains, including facilitating access to important health determinants: social contact, recognition and integration. Entitlement understood as targeted in terms of individualised concepts of need or vulnerability deterred access to material resources, but also fostered debate about legitimacy, thus contributing to negative impacts on individual wellbeing and the public health through the erosion of social integration. This has important implications for both policy and evaluation. Calls to target welfare benefits at those in most need emphasise direct material pathways to health impact. We suggest a model for considering policy change and evaluation which also takes into account how psychosocial and structural pathways are affected by the nature of entitlement.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Social Science & Medicine - Volume 187, August 2017, Pages 20-28
نویسندگان
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