The two recent messages from Dennis Raphael appear to have come through as
attachments.  ***Please do NOT send attachments to this listserv!***  The
list-owners may soon be blocking messages with attachments from being posted
to try and stop the spread of such viruses and 'worms' as the one that hit
this list last week - the SIRCAM  worm.

I am re-posting the plain text version of the message that Dennis Raphael
sent from the British Medical Journal 'editor's choice' on "Social
Exclusion: old problem, new name"

Alison Stirling, co-facilitator Click4HP

-----Original Message-----
From: Dennis Raphael [mailto:[log in to unmask]]
Sent: Friday, July 27, 2001 3:13 PM
To: [log in to unmask]
Subject: Re: Inter-coder reliability

BMJ 2001;323 (28 July )


Editor's choice
Social exclusion: old problem, new name


In 1842 the BMJ published an editorial deploring that "a professional man, a
gentleman, or the family of such living in Bath" could expect to live into
their 50s, whereas labourers and their families in Liverpool could expect no
more than 15 years of life. In 1865 the Lancet set up a special commission
to inquire into London workhouse infirmaries. The  commission was instigated
by Ernest Hart, who later became the greatest editor of the BMJ. He helped
to start the Association for the Improvement of Workhouse Infirmaries, which
included Charles Dickens and John Stuart Mill as members. The principal
feature of the BMJ during the three decades of Hart's editorship was its
emphasis on social medicine.

More than a century later the BMJ is concerned with the same issues, but we
seem to lack the vision, vigour, and optimism of Hart. This is not a theme
issue that we planned a year ago. This issue has arisen because we noticed
that we had accepted for publication many studies that related to social
exclusion. Rather than scatter the studies through several issues we decided
to bring them together. Why are there so many studies? One answer is the
huge increase in
social inequity that occurred in Britain in the 1980s. The number of
children living in poverty tripled during the '80s, "catapaulting the UK to
the highest rates of any country in the European Union" (p 175). These
increases were partly
the result of global forces and partly the result of political choices. Then
came a change of government, with a new emphasis on social exclusion. Among
other initiatives, it funded research into social exclusion.

Social exclusion is defined as "the inability of our society to keep all
groups and individuals within reach of what we expect as a society and the
tendency to push vulnerable and difficult individuals into the least popular
places." The
result is that children living in poverty may enter a cycle of poor
educational achievement, unmanageable behaviour, drug misuse, unemployment,
teenage pregnancy, homelessness, crime, and suicide. This is hugely
expensive for
society, not only in human but also in economic terms (p 191). It can also
lead to a society that is unpleasant for all. These problems are not
uniquely British and some studies (p 207) and commentaries (p 197) are from
outside Britain  but Britain leads the world in this research, because it
has both severe problems and a long history of studying them.

What might depress Hart if he were to return would not be so much the
continuation of the problems, but the failure of a great social experiment
to make important inroads into them (pp 177 and 179).

Footnotes
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http://www.bmj.com/cgi/customalert

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Related editorials in BMJ:

Policies to tackle social exclusion.
Graham Watt
BMJ 2001 323: 175-176. [Full text]

Social capital.
Tom Welsh and Mike Pringle
BMJ 2001 323: 177-178. [Full text]

One Bristol, but there could have been many.
Richard Smith
BMJ 2001 323: 179-180. [Full text]


Other related articles in BMJ:

PAPERS
Financial cost of social exclusion: follow up study of antisocial children
into adulthood.
Stephen Scott, Martin Knapp, Juliet Henderson, and Barbara Maughan
BMJ 2001 323: 191. [Abstract] [Abridged text] [Full text]


PAPERS
Multicentre controlled trial of parenting groups for childhood antisocial
behaviour in clinical practice ? Commentary: nipping conduct problems in the
bud.

Stephen Scott, Quentin Spender, Moira Doolan, Brian Jacobs, Helen Aspland,
and
Carolyn Webster-Stratton
BMJ 2001 323: 194. [Abstract] [Abridged text] [Full text]


PAPERS
Mortality in children registered in the Finnish child welfare registry:
population based study.
Mirjam Kalland, Tiina H Pensola, Jouni Meriläinen, and Jari Sinkkonen
BMJ 2001 323: 207-208. [Full text]