Table 2 Thematic analysis of structural and systemic inequality from survey comments
Theme | Codes | Examples of quotes |
|---|---|---|
Health inequalities | Barriers Employment Mental health Physical health Access to services | “Access to services causes a huge disparity e.g. low-level mental health service often closed to those with co-morbidities; work status often causes disparity e.g. adults of working age have difficulties getting healthcare appointments or being involved in research as usually scheduled during the day.” |
Social inequalities | Community Education Gentrification Isolation/loneliness Race and ethnicity Access to services Access to social prescribing | “…inequalities in relation to cultural provision and education, lack of cultural democracy.” “The reduction in community services reduces local support, isolates people.” “I have included gentrification and loneliness and isolation, as they are key aspects that affect community.” “A key issue for social prescribing research is whether it increases social inequalities. Wealthier areas have more community organisations that patients can be referred to.” |
Economic inequalities | Community Childhood/parenting Employment Infrastructure Isolation/loneliness Economic opportunities Access to services Volunteering | “Social and economic inequalities, lack of investment in early years to support young families on low incomes. Closing libraries, post offices, reducing public services (including police, health care and transport), isolating people and dismantling communities.” “I think volunteering offers a potential route into employment for those who face barriers to employment and also has potential to reduce inequalities by bringing together different parts of the community.” |
Environmental inequalities | Access to nature Eco-literacy Green space Infrastructure Living standards | “I can’t prioritise these issues. Suffice to say that I think the whole of our culture needs serious re-examination. I believe that we need to reconnect with nature, stop prioritising money as a solution to everything; develop a kinder and more compassionate society. I also believe that we need to decentralise power as much as possible.” |
Intersecting inequalities | Barriers Community Employment Industry Infrastructure Living standards Mental health Physical health Transport Access to services | “All are important, and also they intersect.” “… it is so hard to separate out specific disparities as each has an impact on others and can being excluded for one thing can lead to exclusion from others. For example, working a low-paid job may lead to financial issues, which may mean no access to personal transport and so being reliant on public transport, which in turn may cost more and be more disruptive of normal life, impacting on physical and mental health.” “We need more research that looks at the social determinants of health and how these are driven by policy and industry” |