• Homelessness Is Socially Created: Cluster Analysis of Social Determinants of Homelessness (SODH) in North West England in 2020

      Mabhala, Mzwandile; Esealuka, Winifred Adaobi; Nwufo, Amanda Nkolika; Enyinna, Chinwe; Mabhala, Chelsea Nonkosi; Udechukwu, Treasure; Reid, John; Yohannes, Asmait; University of Chester; University of East Anglia; École des Hautes Études en Santé Publique; Asmait Skincare and Design
      Abstract: Poverty creates social conditions that increase the likelihood of homelessness. These include exposure to traumatic life experiences; social disadvantages such as poor educational experiences; being raised in a broken family, care homes or foster care; physical, emotional, and sexual abuse; and neglect at an early age. These conditions reduce people’s ability to negotiate through life challenges. This cross-sectional study documents the clustering and frequency of adverse social conditions among 152 homeless people from four cities in North West England between January and August 2020. Two-step cluster analysis showed that having parents with a criminal record, care history, and child neglect/abuse history was predictive of homelessness. The cluster of indicator variables among homeless people included sexual abuse (χ2 (N = 152) = 220.684, p < 0.001, Cramer’s V = 0.7), inappropriate sexual behaviour (χ2 (N = 152) = 207.737, p < 0.001, Cramer’s V = 0.7), emotional neglect (χ2 (N = 152) = 181.671, p < 0.001, Cramer’s V = 0.7), physical abuse by step-parent (χ2 (N = 152) = 195.882, p < 0.001, Cramer’s V = 0.8), and physical neglect (χ2 (N = 152) = 205.632, p < 0.001, Cramer’s V = 0.8). Poverty and homelessness are intertwined because of the high prevalence of poverty among the homeless. Poverty sets up a chain of interactions between social conditions that increase the likelihood of unfavourable outcomes: homelessness is at the end of the interaction chain. Interventions supporting families to rise out of poverty may also reduce entry into homelessness.
    • Mind your Language: Discursive Practices Produce Unequal Power and Control Over Infectious Disease: A Critical Discourse Analysis

      Mabhala, Mzwandile; Yohannes, Asmait; Massey, Alan; Reid, John; University of Chester
      Abstract Background: Power, socioeconomic inequalities, and poverty are recognized as some of the fundamental determinants of differences in vulnerability of societies to infectious disease threats. The economic south is carrying a higher burden than those in the economic north. This raises questions about whether social preventions and biomedical preventions for infectious disease are given equal consideration, and about social institutions and structures that frame the debate about infectious disease. This article examines how institutionalized ways of talking about infectious disease reinforces, creates, and sustains health inequalities. Methodology: Critical discourse analysis was considered to be epistemologically and ontologically consistent with the aims and context of this study. Results: The study examined three types of infectious disease: • Emerging infectious diseases/pathogens • Neglected tropical diseases • Vector-borne infections. Examination revealed that poverty is the most common determinant of all three. Conclusion: A sustainable reduction in infectious disease in the southern countries is most likely to be achieved through tackling socioeconomic determinants. There is a need for a change in the discourse on infectious disease, and adopt a discourse that promotes self-determination, rather than one that reinforces the hero-victim scenario and power inequalities. Keyword: Critical discourse, inequalities, infectious disease, poverty, power
    • Natural herd immunity should not be used as a means of pandemic control

      Davidovitch, Nadav; Signorelli, Carlo; Chambaud, Laurent; Tenenbaum, Arianne; Reid, John; Middleton, John; ASPHER COVID-19 Task Force, Brussels, Belgium; School of Public Health, Ben Gurion University of the Negev, Be’er Sheva, Israel; Università Vita-Salute, San Raffaele (UniSR), Milan, Italy; École des Hautes Études en Sante Publique (EHESP), Rennes, France; Department of Public Health and Wellbeing, University of Chester, Chester, United Kingdom; Association of Schools of Public Health in the European Region – ASPHER, Brussels, Belgium
      Short opinion article advising against relying on natural herd immunity and need for vaccine derived population immunity. "We need to focus on using successful virus suppression strategies until we reach herd immunity with the new vaccines. We need to track the epidemiology of the virus using population serology, but it is dangerous, and unfounded in science, to advocate natural herd immunity as a means to pandemic control".
    • Planning for a second wave pandemic of COVID-19 and planning for winter : A statement from the Association of Schools of Public Health in the European Region

      Middleton, John; Lopes, Henrique; Michelson, Kai; Reid, John; Wolverhampton University; Universidade Cato´lica; Fulda University; University of Chester
      Planning for a second wave pandemic of COVID-19 and planning for winter : A statement from the Association of Schools of Public Health in the European Region