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      Complex problems require complex solutions: the utility of social quality theory for addressing the Social Determinants of Health

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          Abstract

          Background

          In order to improve the health of the most vulnerable groups in society, the WHO Commission on Social Determinants of Health (CSDH) called for multi-sectoral action, which requires research and policy on the multiple and inter-linking factors shaping health outcomes. Most conceptual tools available to researchers tend to focus on singular and specific social determinants of health (SDH) (e.g. social capital, empowerment, social inclusion). However, a new and innovative conceptual framework, known as social quality theory, facilitates a more complex and complete understanding of the SDH, with its focus on four domains: social cohesion, social inclusion, social empowerment and socioeconomic security, all within the same conceptual framework. This paper provides both an overview of social quality theory in addition to findings from a national survey of social quality in Australia, as a means of demonstrating the operationalisation of the theory.

          Methods

          Data were collected using a national random postal survey of 1044 respondents in September, 2009. Multivariate logistic regression analysis was conducted.

          Results

          Statistical analysis revealed that people on lower incomes (less than $45000) experience worse social quality across all of the four domains: lower socio-economic security, lower levels of membership of organisations (lower social cohesion), higher levels of discrimination and less political action (lower social inclusion) and lower social empowerment. The findings were mixed in terms of age, with people over 65 years experiencing lower socio-economic security, but having higher levels of social cohesion, experiencing lower levels of discrimination (higher social inclusion) and engaging in more political action (higher social empowerment). In terms of gender, women had higher social cohesion than men, although also experienced more discrimination (lower social inclusion).

          Conclusions

          Applying social quality theory allows researchers and policy makers to measure and respond to the multiple sources of oppression and advantage experienced by certain population groups, and to monitor the effectiveness of interventions over time.

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          Most cited references16

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          Nonresponse Rates and Nonresponse Bias in Household Surveys

          R. Groves (2006)
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            Reported response rates to mailed physician questionnaires.

            To examine response rate information from mailed physician questionnaires reported in published articles. Citations for articles published between 1985 and 1995 were obtained using a key word search of the Medline, PsychLit, and Sociofile databases. A 5 percent random sample of relevant citations was selected from each year. Citations found to be other than physician surveys were discarded and replaced with the next randomly assigned article. Selected articles were abstracted using a standardized variable list. The average response rate for mailed physician questionnaires was 61 percent. The average response rate for large sample surveys (> 1,000 observations) was 52 percent. In addition, only 44 percent of the abstracted articles reported a discussion of response bias, and only 54 percent reported any type of follow-up. (1) Response rates have remained somewhat constant over time, and (2) researchers need to document the efforts used to increase response rates to mailed physician questionnaires.
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              Dissolving the Public Realm? The Logics and Limits of Neo-liberalism

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                Author and article information

                Journal
                BMC Public Health
                BMC Public Health
                BioMed Central
                1471-2458
                2011
                5 August 2011
                : 11
                : 630
                Affiliations
                [1 ]Discipline of Public Health, Flinders University, Sturt Road, Bedford Park, Adelaide, 5042, Australia
                [2 ]Department of Social Work and Social Planning, Flinders University, Sturt Road, Bedford Park, Adelaide, 5042, Australia
                [3 ]Population Research & Outcome Studies, Discipline of Medicine, University of Adelaide, 122 Frome Street, Adelaide, 5000, Australia
                Article
                1471-2458-11-630
                10.1186/1471-2458-11-630
                3167771
                21819576
                f489739b-8268-4e8d-bca4-8e45f3c98a7b
                Copyright ©2011 Ward et al.; licensee BioMed Central Ltd.

                This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 23 November 2010
                : 5 August 2011
                Categories
                Research Article

                Public health
                Public health

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