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Groups with additional health and social care needs

A number of genetic and biological factors (for example, diabetes or heart disease) as well as socially determined factors affect outcomes. Socially determined influences include individual risk factors such as smoking, nutrition and alcohol, as well as wider structural influences such as gender-based violence, discrimination, income, education, housing and the environment. Complex social circumstances can in themselves create groups with additional health and social care needs; however, often biological, genetic and social factors are inextricably linked – for  example, the relationship between diabetes, obesity and poor nutrition; or gender-based violence, substance misuse and poor mental health.

The available literature suggests that in relation to inequities of access to services and subsequent health inequalities the following groups are at ‘high risk’ of comparatively poorer health outcomes: 

  • BME groups
  • Families living in poverty
  • Families with parents and/or children with mental health problems
  • Families with parents and/or children with learning disabilities
  • Families living with gender-based violence
  • Young parents
  • Families experiencing substance misuse problems
  • Parents who have been ‘looked after’ as children

Clearly families do not fit neatly into these distinct groups and there may be many groups that overlap. Some families are likely to experience multiple and complex factors that influence their ability to access services and affect subsequent outcomes for themselves and their children, for example, a teenager with learning disabilities living in poverty and experiencing gender-based violence and mental health problems.