ABSTRACT
ABSTRACT The links between financial insecurity and poor health and wellbeing are well established. Individuals experiencing financial insecurity are also more likely to face challenges in accessing the support services they need. There is evidence of unequal uptake of welfare support and benefits, particularly in some ethnic minority groups. The COVID-19 pandemic has further exacerbated financial insecurity for the most vulnerable and action is needed to improve the support provided for those affected during the recovery from the pandemic. One approach to improving uptake of benefits has been to deliver welfare services within health settings. This has the potential to increase income and possibly improve health. We conducted systematic review with a critical narrative synthesis to assess the health, social and financial impacts of welfare advice services co-located in health settings and explore the facilitators and barriers to successful implementation of these services, in order to guide future policy and practice. The review identified 14 studies published in the UK from 2010. The services provided generated on average £27 of social, economic and environmental return on investment per £1 invested. Individuals on average benefitted from an additional £2,757 household income per annum and cost savings for the NHS were demonstrated. The review demonstrated that improvements to health were made by addressing key social determinants of health, thereby reducing health inequalities. Co-located welfare services actively incorporated elements of proportionate universalism and targeted those, who due to predominately health needs, were most in need of this support. The nature of the welfare advice service, how it operates within a health setting, and how visible and accessible this service is to participants and professionals referring into the service, were seen as important facilitators. Co-production during service development and ongoing enhanced multi-disciplinary collaboration were also considered vital to the success of co-located services.
Subject(s)
COVID-19ABSTRACT
Background: Covid-19 vaccines can offer a route out of the pandemic, yet initial research suggests that many are unwilling to be vaccinated. A rise in the spread of misinformation is thought to have played a significant role in this vaccine hesitancy. In order to maximise vaccine uptake it is important to understand why misinformation has been able to take hold at this time and why it may pose a more significant problem within certain populations and places. Objective: To understand people's Covid-19 beliefs, their interactions with health (mis)information during Covid-19 and attitudes towards a Covid-19 vaccine. Design and participants: In-depth phone interviews were carried out with 20 people from different ethnic groups and areas of Bradford during Autumn 2020. Reflexive thematic analysis was conducted. Results: Participants spoke about a wide range of emotive misinformation they had encountered regarding Covid-19, resulting in confusion, distress and mistrust. Vaccine hesitancy could be attributed to three prominent factors: safety concerns, negative stories and personal knowledge. The more confused, distressed and mistrusting participants felt about their social worlds during the pandemic, the less positive they were about a vaccine. Conclusions: Covid-19 vaccine hesitancy needs to be understood in the context of the relationship between the spread of misinformation and associated emotional reactions. Vaccine programmes should provide a focused, localised and empathetic response to counter misinformation. Patient or public contribution: A rapid community and stakeholder engagement process was undertaken to identify Covid-19 related priority topics important to both Bradford citizens and local decision makers.