The advent of thousands of Usenet groups on the Internet, covering a vast range of medical and welfare issues and ostensibly devoted to the mutual social support of participating members, has raised the potential for the development of new forms of ‘virtual’ health care. This article critically analyses the use by people with diabetes of one such Usenet group. It seeks to establish, first, the extent to which such a site provides some demonstrable measure of social support to its participants. This is approached by undertaking a structural analysis of the site to identify the extent of usage, and the nature of supporting interventions using a fivefold classification (instrumental, informational, esteem and social companionship and other). Second, the article attempts to identify any disparity between the lay health‐knowledge in evidence and biomedical opinions proffered by the use of a panel of consultant diabetiologists. The results of the analysis suggest that the diabetes newsgroup provides an example of an active forum for largely well‐informed participants who routinely use the media as an aid to the reflexive management of their medical condition. It also raises the prospect of a renegotiated relationship between medical knowledge and lay experience based upon shared learning
Recent research into single homelessness and rough sleeping has begun to consider the issue using the concepts and the language of social exclusion. This paper considers the new literature and what it may mean in terms of changing our understanding of single homelessness and rough sleeping (called street homelessness in the United States). The paper begins by reviewing the concept of social exclusion and the recent literature on single homelessness and drawing associations between the analysis of social exclusion and the emerging academic work on the nature of single homelessness and rough sleeping. Drawing on this literature, it is argued that single homelessness needs to be reconceptualized and viewed as one of the products generated by the process of social exclusion. The paper concludes with the argument that single homelessness and rough sleeping are a form of social exclusion, characterized chiefly by the inability of a section of the socially excluded population to get access to welfare services and social housing, and that "homelessness" does not actually exist as a discrete social problem with unique characteristics and causes.
Housing First is now dominating discussions about how best to respond to homelessness among people with high and complex needs throughout the EU and in several countries within the OECD. Whilst recognised internationally as an effective model in addressing homelessness, little attention has been given as to whether Housing First also assists previously homeless people become more socially integrated into their communities. This paper reviews the available research evidence (utilising a Rapid Evidence Assessment methodology) on the extent to which Housing First services are effective in promoting social integration. Existing evidence suggests Housing First is delivering varying results in respect of social integration, despite some evidence suggesting normalising effects of settled housing on ontological security. The paper argues that a lack of clarity around the mechanisms by which Housing First is designed to deliver 'social integration', coupled with poor measurement, helps explain the inconsistent and sometimes limited results for Housing First services in this area. It concludes that there is a need to look critically at the extent to which Housing First can deliver social integration, moving the debate beyond the successes in housing sustainment and identifying what is needed to enhance people's lives in the longer-term.
The British policy response to rough sleeping, or street homelessness, has been characterised by increasing consensus between government, the voluntary sector and academics. The dominant paradigm suggests that people sleeping rough are often individuals who are predisposed to becoming homeless because their individual characteristics make them especially vulnerable to changes in housing supply, labour markets and other structural factors that precipitate homelessness. Policy responses, such as the Rough Sleepers Initiative, have been increasingly characterised by their emphasis on reintegrating people sleeping rough into society on the basis that many in this group are vulnerable people who have become homeless essentially because they need assistance and care. However, there is a marked contrast between this broad consensus and popular views of the causes of rough sleeping. In the popular imagination, rough sleeping is caused by fecklessness, moral weakness and an active choice to sleep on the streets. This view has its origins in pre-20th century views of poverty and exclusion but has recently been reinforced by the ideology of a succession of Neo-Liberal governments in the UK. This paper is concerned with the impact of the popular view of rough sleeping on the environment in which services for people sleeping rough have to work. It is also concerned with the more subtle impact that the popular view of rough sleeping continues to have on the design and operation of such services.
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