Social prescribing and classed inequality: A journey of upward health mobility?

Gibson, Kate; Pollard, Tessa M.; Moffatt, Suzanne

doi:10.1016/j.socscimed.2021.114037

Cited by 49 publications

(68 citation statements)

References 36 publications

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“…Under schemes with the capacity, referrals by other professionals, such as social workers and job center employees, as well as self-referrals, are also possible ( Mercer et al, 2019 ; Fixsen et al, 2020 ). While anyone with non-medical needs might benefit from social prescribing it is particularly targeted at people with long-term health conditions ( Moffatt et al, 2017 ) and/or mental health issues ( Pescheny et al, 2018 ; Gibson et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

“…Arguments in favor of social prescribing as a valuable non-medical form of health care seem compelling ( Islam, 2020 ), however, the systematic evidence concerning effectiveness of social prescribing on reducing GP visits and increasing patient health and wellbeing is not strong ( Bickerdike et al, 2017 ; Gibson et al, 2021 ). Comparisons between social prescribing schemes are problematic as they adopt different models of healthcare ( Fixsen et al, 2020 ) and are situated in areas of greater or lesser socioeconomic need ( Costa et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

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Challenges and Approaches to Green Social Prescribing During and in the Aftermath of COVID-19: A Qualitative Study

Fixsen

Barrett

2022

Front. Psychol.

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The last decade has seen a surge of interest and investment in green social prescribing, however, both healthcare and social enterprise has been impacted by the COVID-19 crisis, along with restricted access to public green spaces. This study examines the challenges and opportunities of delivering green social prescribing during and in the aftermath of COVID-19, in the light of goals of green social prescribing to improve mental health outcomes and reduce health inequalities. Thirty-five one-to-one interviews were conducted between March 2020 and January 2022. Interviewees included Link Workers and other social prescribers, general practitioners (GPs), managers, researchers, and volunteers working in urban and rural Scotland and North East England. Interview transcripts were analyzed in stages, with an inductive approach to coding supported by NVivo. Findings revealed a complex social prescribing landscape, with schemes funded, structured, and delivered diversely. Stakeholders were in general agreement about the benefits of nature-based interventions, and GPs and volunteers pointed out numerous benefits to participating in schemes such as parkrun. Link Workers were more circumspect about suggesting outdoor activities, pointing out both psychological and practical obstacles, including health anxieties, mobility issues, and transport deficits. Exacerbated by the pandemic, there was a way to go before older and/multi-morbidity clients (their largest cohort) would feel comfortable and safe to socialize in open air spaces. Our findings support the premise that time spent in open green spaces can alleviate some of the negative mental health effects compounded by the pandemic. However, the creation of healthy environments is complex with population health intrinsically related to socioeconomic conditions. Social disadvantage, chronic ill health and health crises all limit easy access to green and blue spaces, while those in the most socially economically deprived areas receive the lowest quality of healthcare. Such health inequities need to be borne in mind in the planning of schemes and claims around the potential of future nature-based interventions to reduce health inequalities.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Challenges and Approaches to Green Social Prescribing During and in the Aftermath of COVID-19: A Qualitative Study

Fixsen

Barrett

2022

Front. Psychol.

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“…However, they fail to tackle the system which generates (and reproduces) maldistribution, for which system‐level interventions would prove more appropriate (Commission on Social Determinants of Health, 2008). Presenting SP as ‘the solution’ may hamper a broader understanding of and response to the social determinants of health, which also addresses its fundamental structural causes and asserts policy‐level responsibilities (Baum & Fisher, 2014; Gibson et al., 2021).…”

Section: Discussionmentioning

confidence: 99%

What does the literature mean by social prescribing? A critical review using discourse analysis

Calderón-Larrañaga

Greenhalgh

Finer

et al. 2022

Sociology Health & Illness

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Social prescribing (SP) seeks to enhance the role of the voluntary and community sector in addressing patients' complex needs in primary care. Using discourse analysis, this review investigates how SP is framed in the scientific literature and explores its consequences for service delivery. Theory driven searches identified 89 academic articles and grey literature that included both qualitative and quantitative evidence. Across the literature three main discourses were identified. The first one emphasised increasing social inequalities behind escalating health problems and presented SP as a response to the social determinants of health. The second one problematised people's increasing use of health services and depicted SP as a means of enhancing self‐care. The third one stressed the dearth of human and relational dimensions in general practice and claimed that SP could restore personalised care. Discourses circulated unevenly in the scientific literature, conditioned by a wider political rationality which emphasised individual responsibility and framed SP as ‘solution’ to complex and contentious problems. Critically, this contributed to an oversimplification of the realities of the problems being addressed and the delivery of SP. We propose an alternative ‘care‐based’ framing of SP which prioritises (and evaluates) holistic, sustained and accessible practices within strengthened primary care systems.

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“… Access : COVID is likely to have a long legacy in terms of mental health, social isolation and economic disadvantage so an increase in demand is to be expected. Social prescribing services need to agree their target audience (volume and suitability) and approach (adequately trained practitioners for their complex and demanding role) and ensure that they do not exclude or widen health inequalities (Fixsen et al., 2021 ; Gibson et al., 2021 ; Wildman et al., 2019 ). Engagement : services must ensure SPs are not pulled into other primary care business as the recovery progresses and can return to more transformative or holistic ways of engaging with people.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID‐19 on social prescribing across an Integrated Care System: A Researcher in Residence study

Westlake

Elston

Gude

et al. 2022

Health Social Care Comm

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Emerging evidence suggests that connecting people to non‐medical activities in the community (social prescribing) may relieve pressure on services by promoting autonomy and resilience, thereby improving well‐being and self‐management of health. This way of working has a long history in the voluntary and community sector but has only recently been widely funded by the National Health Service (NHS) in England and implemented in Primary Care Networks (PCNs). The COVID‐19 global pandemic coincided with this new service. There is wide variation in how social prescribing is implemented and scant evidence comparing different delivery models. As embedded researchers within an Integrated Care System in the Southwest of England, we examined the impact of COVID on the implementation of social prescribing in different employing organisations during the period March 2020 to April 2021. Data were collected from observations and field notes recorded during virtual interactions with over 80 social prescribing practitioners and an online survey of 52 social prescribing practitioners and middle managers. We conceptualise social prescribing as a pathway comprising access, engagement and activities, facilitated by workforce and community assets and strategic partnerships. We found that these elements were all impacted by the pandemic, but to different degrees according to the way the service was contracted, whether referrals (access) and approach (engagement) were universal (‘open’) or targeted (‘boundaried’) and the extent to which practitioners’ roles were protected or shifted towards immediate COVID‐specific work. Social prescribers contracted in PCNs were more likely to operate an ‘open’ model, although boundaries were developing over time. We suggest the presence of an explicit, agreed delivery model (whether ‘open’ or ‘boundaried’) might create a more coherent approach less likely to result in practitioner role drift, whilst allowing flexibility to adjust to the pandemic and enhancing practitioner satisfaction and well‐being. The potential consequences of different models are examined.

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Social prescribing and classed inequality: A journey of upward health mobility?

Cited by 49 publications

References 36 publications

Challenges and Approaches to Green Social Prescribing During and in the Aftermath of COVID-19: A Qualitative Study

Challenges and Approaches to Green Social Prescribing During and in the Aftermath of COVID-19: A Qualitative Study

What does the literature mean by social prescribing? A critical review using discourse analysis

Impact of COVID‐19 on social prescribing across an Integrated Care System: A Researcher in Residence study

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