Can research help to address inequalities faced by people with learning disabilities?

Ensuring that that our research considers and promotes equality, diversity and inclusion is central to the work we do at the School for Policy Studies. Working in partnership with communities and stake holders to identify research questions that matter and ensuring that studies are co-produced wherever possible helps achieve these aims. This series of blogs looks at some of the ways what we research and how we go about it incorporates EDI principles.


In this blog, Kate Bowen-Viner (Social Policy PhD student) explains how research in the Norah Fry Centre for Disability Studies is helping to tackle inequalities faced by people with learning disabilities.

Research can and should contribute to improved outcomes for people with learning disabilities. Academics in the Norah Fry Centre for Disability Studies have revealed the stark inequalities that people with learning disabilities face. Research from the Centre found that the difference in median age of death between people with a learning disability (aged 4 and over) and the general population is 23 years for men and 27 years for women. Projects led by academics in the Centre have also drawn attention to inequalities parents with learning disabilities face, including being more likely to have their children removed from their care compared to other parents whilst not receiving adequate support with parenting. In collaboration with disabled people, research from the Centre is also highlighting how services for people with learning disabilities can improve.

In this blog, I describe three projects carried out by academics in the Norah Fry Centre for Disability Studies, explain how this research is contributing to improved outcomes for people with learning disabilities and summarise what we can learn from Norah Fry researchers about tackling inequalities through research.

Addressing premature mortality

Research from academics at Norah Fry is helping to reduce premature mortality and health inequalities for people with learning disabilities. Led by the University of Bristol and Professor Pauline Heslop between 2015-2021, the national Learning Disabilities Mortality Review (LeDeR) supported local areas to review the deaths of people with learning disabilities and to take learning from those deaths to improve services. This programme is the first of its kind. It was established after the Confidential Inquiry into premature deaths of people with learning disabilities (CIPOLD), led by Professor Heslop, provided evidence that people with learning difficulties are significantly more likely to die at a younger age compared to the general population and do not receive the same quality of care as people without a learning disability.

The University of Bristol’s involvement in the LeDeR programme came to a planned end in May 2021, but the work undertaken by Professor Heslop and other researchers from the University will have a lasting impact. For instance, with support from the University of Bristol, the LeDeR programme established a central point where all deaths of people with learning disabilities are notified. This central point will continue to be used. During the contracted period with the University of Bristol, the project also analysed core data from local reviewers and produced national annual reports which highlighted key trends. Alongside other achievements of the LeDeR programme, key learning from this research supports improvements in the quality of health and social care services for people with learning disabilities.

NHS England will continue with LeDeR. After reflecting on the programme when their contract with the University of Bristol came to a planned end, they published a revised LeDeR policy which incorporates a review process that will include reviewing the deaths of people with autism.

Supporting parents with learning difficulties

Research in the Centre is also helping to support parents with learning difficulties/disabilities. Parents with learning disabilities are overrepresented in the child protection system largely because of concerns regarding neglect. Reports suggest that professionals do not have adequate time, skills and support to work with parents with learning disabilities and provide them with the help that they need.

In collaboration with groups of parents, Beth Tarleton led research to investigate what good support for parents with learning difficulties looked like in three local authorities. The project used the term ‘learning difficulties’ rather than ‘disabilities’ to refer to parents with learning disabilities and those who do not meet the threshold to receive support, but struggle with everyday life and protecting the welfare of their children. The project explored local authority sites that had been identified as ‘successful practice’ by Working Together with Parents Network which supports professionals who work with parents with learning disabilities.

Based on their research, the project team made key recommendations regarding support for parents with learning disabilities, including:

  • The need for professional support to be both consistent and flexible

Parents learning difficulties are life-long. Therefore, their support needs and circumstances may change over time.

  • Practitioners should build and maintain mutually trusting relationships with parents

This would help to avoid repeated crisis-driven interventions and make sure that ongoing light-touch support can be provided.

This project took a collaborative approach. Input from two advisory groups (one professional advisory group and one parent advisory group) was invaluable for making the research relevant and accessible to parents with learning disabilities. Both groups guided the approach to working with parents. The parent advisory group collaborated with researchers to produce a video to make findings accessible to others with learning difficulties.

Access to housing

Work from researchers in the Norah Fry Centre for Disability Studies is helping to improve people with learning disabilities’ access to housing. In collaboration with Deborah Quilgars from the University of York and The NIHR School for Social Care Research, academics from Norah Fry are working to understand the ways that people with learning disabilities can be better supported to access their own tenancies, when this is their choice.

The project involves a review of housing for people with mild to moderate learning disabilities, including what tenancy options are available to people with learning disabilities who are on the edge of social care. Detailed interviews will also take place with people with learning disabilities who are living in social housing and private rented tenancies, as well as their families and other people who support them.

This project is being co-produced with a steering group made up of people with learning disabilities. As with other projects in the Centre, guidance from people with lived experience has been invaluable to developing an inclusive approach to research. For instance, the steering group highlighted that advertising for research participants should explicitly request participants from black and minority ethnic backgrounds to avoid studies only listening to the voices of white people with learning disabilities. Prompts like this from people with lived experience are important for maximising inclusivity and taking an intersectional approach that acknowledges how different social justice issues (e.g. disability discrimination and racism) cross over with one another.

Research tackling inequalities

Projects in the Norah Fry Centre for Disability Studies highlights how research can contribute to addressing inequalities faced by people with learning disabilities and also draws attention to the need for:

  1. Co-production

Working with people with learning disabilities to research the inequalities they face helps to make research inclusive and relevant.

  1. An intersectional approach

Acknowledging how different aspects of a person’s identity (e.g. disability, gender, ethnicity) combine to create different forms of discrimination or privilege is important for addressing the inequalities different people with learning disabilities experience.

As demonstrated by projects in Norah Fry, research using these approaches can play an integral role in highlighting, and developing ways to tackle, the stark inequalities faced by people with learning disabilities.

 

 

 

Why Does Inclusion Matter? Physical Activity and Disability

Ensuring that that our research considers and promotes equality, diversity and inclusion is central to the work we do at the School for Policy Studies. Working in partnership with communities and stake holders to identify research questions that matter and ensuring that studies are co-produced wherever possible helps achieve these aims. This series of blogs looks at some of the ways what we research and how we go about it incorporates EDI principles.


In this blog, Kate Bowen-Viner (Social Policy PhD student) explores how research in the Centre for Exercise, Nutrition and Health is helping to make physical activity guidelines more inclusive.

The way we talk about physical activity matters. Instructions that try to encourage people to be more active like “stand up more often” or “chairs are killers” may be well-intentioned, but they are ableist and can harm disabled adults and children.

In the Centre for Exercise, Nutrition and Health Sciences, researchers have been working to improve physical activity guidelines, including collaborating with disabled adults, young people and children to develop sets of activity guidelines that are applicable to disabled people.

In this blog, I set out the problem with physical activity guidelines that do not consider disabled people and explain how co-produced research in the Centre for Exercise, Nutrition and Health Sciences is helping to ensure that guidelines for physical activity are not ableist, but more inclusive.

What’s the problem?

Research indicates that disabled people are twice as likely to be inactive compared to non-disabled people. In 2017 Sport England reported that 43% of disabled people were inactive (doing less than 30 minutes physical activity a day) compared to 21% of non-disabled adults in England. Inactivity is a problem for disabled people’s health as evidence suggests that engaging in physical activity is related to positive health outcomes. It is therefore vital that activity guidelines are inclusive of, and applicable to, disabled people.

In 2011, the Department of Health published UK physical health guidelines, issued by the Chief Medical Officers. These were the first nationwide activity guidelines in the UK and they included guidance for adults and children of all ages. A set of related infographics were also produced to support health professionals to promote healthy living and to empower individuals to stay active. However, with little evidence on disability and activity at the time they were produced, the guidelines had limited applicability to disabled adults and children. The 2011 guidelines did not specifically consider disabled people and disabled people’s voices were not included in the public health messaging around physical activity.

To promote health equitably, it is crucial that the development and roll-out of national activity guidelines include disabled people’s voices and take account of their experiences. This is especially important given that harmful ableist language features in many everyday discussions about the importance of physical activity (e.g. “don’t sit for too long”) and needs to be challenged.

In collaboration with disabled people and other researchers, Charlie Foster OBE from the Centre for Exercise, Nutrition and Health’s has been working to address these issues. Embracing inclusive practices and being open to challenge has been of utmost importance for this work. As Professor Foster explained:

We need to consider inclusivity at every stage of the research process and be open to challenge. If you’re not considering equalities, diversity and inclusion, you’re going to overlook the people who would benefit most from the work. I don’t mean the government; I mean the users and participants.”

Below, I describe two projects conducted in collaboration with disabled adults and children and explain how co-production and attentiveness to inclusivity has helped, and is helping, to improve activity guidelines for disabled people.

Collaborating with disabled adults

Starting in 2018, Professor Charlie Foster led a review of the UK Chief Medical Officers’ 2011 physical activity guidelines, which included analysing existing evidence regarding the benefits of physical activity in disabled adults. This involved collating evidence on disabled adults and physical activity for health benefits and comparing evidence to the CMO’s 2011 physical activity guidelines. The review found little evidence to show ‘that physical activity is unsafe for disabled adults when it is performed at an appropriate dose for their current level of activity and health conditions’ and provided evidence, aligning with the CMO’s 2011 guidelines, that disabled adults should do 150 minutes of physical activity at a moderate to vigorous intensity for health benefits.

Importantly, the review also involved collaborations with disabled adults, disability groups and healthcare professionals to produce public health recommendations. It also led to researchers and disabled people working together to create a set of infographics which summarised key evidence-based messages regarding physical activity. The colour and layout of the infographics were designed considering the needs of learning-disabled people. This resulted in more accessible infographics that would not have been possible without disabled adults’ input.

The co-produced review and infographics informed the CMO’s adult physical activity guidelines which were published in 2019, meaning that disabled people’s voices and experiences informed national guidelines. This was the first-time disabled adults were explicitly considered in physical activity guidelines.

 

Collaborating with disabled children

Professor Charlie Foster OBE is now supporting an evidence review of physical activity guidelines for children, with a particular focus on disabled children. This review will help to fill a gap in the existing physical activity guidelines. With limited evidence regarding disabled children and activity at the time the 2011 and 2019 guidelines were published, disabled children were not considered specifically in the guidelines.  Similar to the review of the benefits of physical activity for disabled adults, this review will involve analysing the existing research base regarding disabled children and activity. Publication is expected in mid-November 2021.

The project now involves collaborating with disabled school pupils to develop public health messaging and infographics to summarise and promote key messages about activity and health for disabled children, led by Professor Brett Smith at the University of Durham With a focus on prioritising disabled children’s voices and learning from their experiences, this is the first physical activity project of its kind.

The process of collaborating with disabled children in this project highlights the benefits of inclusive approaches to research. Co-production will be integral for ensuring that disabled children’s voices inform national guidelines on physical activity. By drawing on their personal experience, the pupils who take part in this project will contribute to making physical activity guidelines relevant to disabled children.

Improving health outcomes equitably

To improve health outcomes equitably, disabled people must be considered and their voices must be included in the development of physical activity guidelines. Research in the Centre for Exercise, Nutrition and Health Sciences demonstrates the benefits of working with disabled adults and children to promote the health benefits disabled people can achieve by engaging in regular physical activity.

 

 

Another Blog on the C-Word.

Professor David Abbott, from the Norah Fry Centre for Disability Studies, looks at collaboration and power sharing in coproduced research.

It’s #CoProWeek if you’ll excuse the twitter short-hand. And with a whiff of, ‘This is what I did in my holiday’ news, I am not long back from a summer school about co-production at the rather glorious and gloriously named, University of the Highlands and Islands.

One of the things I liked about the course was that we were comprised of researchers, activists, heads of charities, community agitators and leaders, and policy and engagement types. We shared a commitment to making things change and making things better in our respective communities. I think some of us went searching for the perfect way to do coproduction and of course in that respect we were usefully disappointed. Two main learning points for me, about which more below, were: 1. Coproduction behoves us to rethink who is ‘we’ and who is ‘them’ and ‘they’? 2. In the overall endeavour of research, who has a say, who always has a say and who rarely or never has a say?

It seems to me that lots of folks are in search of ‘true’ co-production, some holy grail of perfect collaboration and power sharing. We are awash with toolkits, guidance, good practice, courses and webinars about coproduction. It’s an industry in and of itself. I wonder if there is more of this than actual coproduction.

In my field at the intersection of social policy and disability studies, there is a long history of problematising the role and historical dominance of non-disabled people doing research on disabled people. The movement towards more inclusive research with disabled children, youth, and adults, including those with learning disabilities, is now however fairly well established.

In my first research job with a disability focus, our young disabled people’s reference group held a fairly long, no-holds barred discussion about whether or not I should be in the room as a non-disabled person. It was very uncomfortable for me but they were rightly asserting their power and asking a legitimate question. So, coproduction for me sometimes has a feeling of ‘emperor’s new clothes’ but also something co-opted for better and sometimes worse to actually mask power differentials. I can still really only whisper in lower case about being part of a so-called coproduction team evaluating a so-called coproduced government policy programme “with” (lol) disabled people. The volume on coproduction was high but the reality was draconian and grim.

What I can say, from my own experience of being part of a project team made up of user-led organisations, disabled people’s organisations and university researchers, are three things:

  1. It felt like coproduction because it was hard and mostly uncensored. We had similar goals but I think the wider team sometimes felt I was a bit slavish to the research proposal and agreement with the funder. Others sometimes wanted to ‘get on with it’ or change things. I often did too but felt a bit uptight with the burden and privilege (?) of being the budget holder (see below).
  2. It worked well as coproduction because we played to our agreed strengths and interests.
  3. When we asked participants why they had decided to take part in research interviews, several said it was because of the team. Some said they would have put the paperwork in the bin straight away if it had just come from “the University”. The nature of the team reassured people about the underlying values of the research and that there was some presumption of trust and safety.

Money matters and I mentioned above that I had been the budget holder in our work together even though in fact the collaboration was well established and the need for research established before I was ever invited in as a researcher. (I liked this. To me it turned on its head the usual idea that coproduced research is about the researcher inviting the non-academics, the non-researchers into the tent. Plus, note the ‘non’ rather than what people actually are – experts in all kinds of domains.) But the reality is that many funders require the budget holder or principal investigator to be based in a University or the NHS or some other statutory service. This doesn’t rule out coproduced collaborations but the power is already and instantly a bit unequal.

This is why the Disability Research on Independent Living & Learning (DRILL) programme was so neat as the world’s first major research programme led by disabled people. Not to my credit, but I can recall feeling irked that such a big funding opportunity excluded me from applying missing, initially, the point that this was entirely right and massively exciting and important. My initial annoyance presumably mirrored by groups routinely excluded from or hampered by the set-up of research funding streams.

If I can end by directing you to elsewhere it’d be to this brilliant podcast which discusses what to my mind is a wonderful, authentic piece of coproduced research with young disabled women living shorter lives but exerting the value, joy and expertise that their lives engender. “Coproduction is not about having all the answers, but about learning together,” say the researchteam. Amen sisters.

David Abbott is a Professor of Social Policy in the School for Policy Studies at the University of Bristol and an Associate Director of NIHR School for Social Care Research. He tweets things about research, cake and the countryside at @davidabbottbris 

Women Studies Departments in Indian Universities face threat of closure

Dr Geentanjali Ganjoli, Senior Lecturer at the Centre for Gender and Violence Research, School for Policy Studies, discusses the future of Women’s Studies in India.

There are 163 Women’s Studies Centres (WSCs), funded under the University Grants Commission (UGC) in universities and colleges across India, most of which now face the threat of being wound up after September 2017.

Concerns over the future of the Centres were originally raised in March 2017 but were temporarily allayed when the UGC issued a public notice on 29th March stating that all existing schemes would continue for the fiscal year 2017-18. However, on 16th June, the UGC published a revised notice that ongoing schemes under the Plan Head would be funded only up to September 2017.

The women’s studies centres in India are organically allied to feminist movements in India, and are historically linked to the UN international decade for women (1975-85), and the Status of Women Report led by a group of Indian feminists in 1974, which revealed the myriad social and economic hardships and inequalities suffered by Indian women. Women’s Studies was introduced into the National Policy of Education in 1986. The late 1970s and 1980s also saw the rise of women’s movements’ campaigns against forms of violence against women, including rape, sexual harassment in public spaces and the workplace, dowry, domestic violence, representation of women in the media and female infanticide, and is also linked to wider secular movements.

These concerns have always been represented in the teaching and research interests of women’s studies departments in India. For instance, the Research Centre for Women’s Studies, SNDT University, which was the first women’s studies department set up in the country in 1974, conducts action research programmes on topics as varied as assessing the extent of sexual harassment in university campuses, research on problems faced by the girl child within the family, and teaches women’s studies at Masters and research PhD levels.

In spite of the intellectual and political insights provided by women’s studies scholars in India, the discipline itself has often been treated as marginal by universities and funding bodies. One suggestion is that the challenges to patriarchy and gender roles posed by the Women’s Studies Centres threaten the inherent misogyny within the academy, and this may the reason why this discipline is under threat now. As observers of Indian society are aware, women students have always been subjected to discriminatory policies. Examples of this include: curfews for women in hostels, women students being evicted from their hostels in the summer break and dress codes imposed on female students in different universities.

Within this context, the threat to women’s studies centres indicates the further shrinkage of secular and feminist spaces within Indian academia, and is concerning particularly within the wider context of the rise of misogyny and right-wing Hindu politics in the country, and indeed internationally.

The Centre for Gender and Violence Research has always had close working and personal connections with women’s studies departments in India, and elsewhere, and this is reflected in our new journal in its scope, editorial board and papers. The first issue of the journal has an interesting paper written by academics from the Women’s Studies Centre in Tata Institute of Social Sciences which showcases the work of women’s studies departments in India in terms of its links to activism and feminist concerns with regard to policy and practice on gender based violence.

To read more articles like this, sign up for a free trial of the Journal for Gender Based Violence.

European citizens who are disabled: what about them?

Val Williams, from the Norah Fry Centre for Disability Studies comments on the implications for disabled people of Brexit 

Val Williams
Val Williams

The shock of the BREXIT decision is not just an issue for disabled people who now have to live in a smaller, diminished country. It also has implications for disabled people across Europe, and particularly perhaps those with intellectual (learning) disabilities.

But what about our partnership with disabled people across Europe?  In 1973, when we joined the EU, disabled people in this country did not commonly have a ‘voice’, nor were they taken seriously as a political force. At that time, I had just started working with young people with learning disabilities, within a largely segregated system, which had only just started to recognise their right to an education. Since then, disabled people have themselves taken a lead, and are rightly proud of their achievements within the disabled people’s movement – for instance, over institutional closure, and the ideas of the social model and inclusion. During the 1990s and 2000s I took part in various EU Social Fund projects, where our experiences as UK partners was not just to speak English, but to offer progressive and supportive ideas, while learning alongside other member states. The European Disability Forum has posted the following since the BREXIT decision, which reminds us of some fundamental values:

We strongly believe that a common EU human rights agenda is better achieved together. The tone of the UK campaign, which was characterised by a divisive public debate on migration, reminds us of what is at stake and what we need to fight for, within a strong EU: common values of non-discrimination, human rights and freedom of movement.

Will UK ideas on disability now be discredited?  What of the gains in thinking on independent living?  Institutional closure across parts of Eastern Europe?  Turning specifically to the position of people with intellectual (learning) disabilities, during the latter part of the 1990s, People First groups in the UK set out to link with their European counterparts, and to set up a ‘Europe People First’, genuinely led by people with intellectual disabilities themselves. The movement in Europe has always been within the framework of families’ organisations, but the umbrella organisation ‘Inclusion Europe’ now has a self-advocacy section. This is a European Platform of Self-Advocates, which is composed of member organisations across Europe.  Nothing is perfect, but compared with the 1990s, there has been progress towards an understanding that Europeans with intellectual disabilities have a right to live like others, to self-organise and to get support to have a voice.  And importantly, UK self-advocates have always been strong in demanding these things, and in making a common cause across Europe.

In the UK we are still aware of the many steps that need to be taken towards including people with intellectual disabilities in the wider disabled people’s movement. There is also already a European network, not just through the Disability Forum and an EU umbrella organisation for disabled people’s organisations (DPOs) across Europe.  In the light of the BREXIT decision, they have themselves reached out to disabled people in the UK, as mentioned above in their moving statement on the need to continue the struggle for human rights together across Europe.

Not least, accessible information is key to a meaningful conversation with all disabled people, including those with intellectual disabilities – see the progress made for instance by public and Government organisations in communicating with all. One out of many examples would be Public Health England’s easy English guide to avoiding Flu. UK efforts to work for equality in information, in voice and within public debates and research are now widely recognised across Europe, with a recent publication in Austria on Inclusive Research for instance, written both in English and in German.

As with all disabled people, the position of people with intellectual disabilities has moved on. In the 1990s I was able to visit both Germany and France, on some visits accompanying people with intellectual disabilities. Both countries had strong segregated (albeit meaningful) policies on employment – people lived within a ‘network’ of services, particularly in Germany, and in both countries, they were to some extent treated (and addressed) as children, unlikely to have anything useful to say or to contribute to the debates.  Compare that with the debates in those countries today. On June 26th, the Frankfurter Allgemeine newspaper in Germany led its Society section with a discussion of sexual rights of disabled people with autism. The headline is that people with intellectual disabilities would have aspired merely to be ‘satt und sauber’ (fully fed and clean) until now; the argument is that they can also aspire to enjoy life!   That would not have happened before the progress made by bringing disabled people together, through the European Union. The UK voice is important, and the connection between disabled people across Europe needs to continue, so that disability rights remains a common cause.

Val Williams is Reader in Disability Policy and Practice, Head of the Norah Fry Centre for Disability Studies, and Executive Editor of Disability and Society.

 

From the narrative of failure to the narrative of potential?


DB_photo
David Berridge, Professor of Child and Family Welfare at the School for Policy Studies, considers the process of making an impact on policy and practice by discussing his research on looked after children. 

It is interesting, and advisable, at the completion of a research project to reflect on how it went.  There can be a tendency to delay this process, encouraged by feelings of relief as well as no doubt the need to catch-up with other responsibilities that are now overdue.

These thoughts were with me at the end of 2015 on the conclusion of our joint-research with the Rees Centre, University of Oxford, funded by the Nuffield Foundation, on the Educational Progress of Looked After Children in England.  We were certainly pleased to complete what for us was a major piece of work. There were many challenges in the work (to borrow a well-used euphemism), including: obtaining and analysing large government databases; negotiating access to six contrasting local authorities; contacting groups of older teenagers in care, their social workers, carers and teachers; obtaining and analysis large amounts of qualitative data; and writing-up the results.

Social researchers are familiar with these processes, with varying degrees of success. But we also give particular attention to the dissemination of research and trying to ensure that it impacts on the worlds of policy and practice.  These stages need proper planning throughout the research process, not just at the end.

We were certainly pleased with our research results, which we feel contain important, new messages.  Comparing large groups of children in care who took their GCSEs in 2013 with ‘children in need’ (receiving social work support at home) and the wider pupil population, we found that, once controlling for a wide variety of factors, those in care (particularly foster care) made greater educational progress than did children in need.  This is despite, one would assume, having less acute problems.  Generally, therefore, the care system appears to operate as an educational protective factor.

This is a new message as commentators in the past have generally focused on the often disappointing attainments of young people in care (exam/test results etc), rather than their educational progress after becoming looked after – an important distinction. Indeed, there was an overwhelming view from the young people interviewed that leaving home and entering care had benefited them educationally. Furthermore, it was mainly late adolescent entrants to care who experienced particular educational problems.  Clearly, we should not overlook that high attainment is important and our research is intended to contribute to this by a detailed examination of the nature of the problem and its causes.

Other important findings include that children’s emotional and behavioural problems often underlie educational difficulties.  Taking into account pupil variation and school effectiveness, there was little difference between Councils in the educational progress of children in care.  Responses of school and care systems were important, including the level of stability provided.  Nonetheless, this questions aspects of a ‘league table’ approach and of the OFSTED inspection framework.  Other results are available on the website, including the individual technical reports.

We were grateful that the Minister for Children and Families, Ed Timpson MP, spoke at our launch event at the Nuffield Foundation.  He concluded his speech by repeating the statement made by Robbie Gilligan earlier in the day, that we need to move ‘…from the narrative of failure to the narrative of potential’.  This is an important observation and it is interesting to reflect on what it means and its implications. The statement is ambiguous. On the one hand it could be referring to the fact that we should not label individual children in care as unintelligent or incapable, as their school performance has been hampered by their social and emotional development and poor parenting.  On the other, the ‘narrative of potential’ comment could denote the need to recognise that the care and school systems makes positive progress with these disadvantaged pupils, especially when there it a reasonable period of time for there to be an effect. The statement could have both micro and macro meanings; although for me ‘narrative’ usually has broad application.

In his autumn 2015 Conservative Party conference speech the Prime Minister referred to the poor outcomes for children in care: ‘These children are in our care; we, the state, are their parents – and what are we setting them up for…the dole, the streets, an early grave?  I tell you: this shames our country and we will put it right’.

A fortnight after the launch of our research the Prime Minister announced further proposals to take over failing local authority children’s services: reported to be as transformative a policy as the Academisation programme in the last Parliament.  It is unclear if children’s services’ failures relate specifically to child protection and child tragedies, to poor outcomes for children in care, or to both.  The Prime Minister’s conference speech located it in a section on entrenched family poverty.

Reform of children’s services, therefore, is signalled as a flagship policy for this Conservative administration.  We hope that our research findings, and other sources of evidence, are allowed to contribute to this debate: to help pinpoint the exact nature of child welfare problems, their complexity and the effectiveness of responses. It will be interesting to see if a narrative of potential or a narrative of failure will be maintained 2016.

 

Bridge Learning Campus visit to ENHS

Mark EdwardsRecently a group of Year 8 students from Bridge Learning Campus spent the day with staff in the centre for Exercise, Nutrition, and Health Sciences. Two of the girls (Amy Manning and Jess Martin) were winner and runner-up respectively of the Bristol Bright Night (Healthy Bodies, Healthy Minds) award. As part of their prize Mark Edwards (ENHS) and Chloe Anderson (Centre for Public Engagement) arranged for the girls to visit the health-focused Centre. Mark reflects here on the fun and insightful day that ENHS spent with the girls.

Five girls, accompanied by their Science teacher, Ms Williams, spent the day learning about the research we do and gave us some great insights into the barriers they face to being physically active. Almost all of our work into physical activity is assessed by accelerometers (which give a sophisticated measure of physical activity). Byron Tibbitts from ENHS offered a tour de force of the little red device we use to measure activity. In true Blue Peter fashion, the girls made a rudimentary accelerometer and then did their own mini controlled trial with the real things! The girls not only conducted the experiment with Byron, but then went on to analyse and interpret the data too.

Next up, Emma Solomon, Bex Newell and Rosina Cross (the B-Proac1v team) taught the girls all about blood pressure (a measure used in the BHF-funded study into young children’s physical activity). The girls confirmed our hypotheses that music and physical activity both affect blood pressure levels.

Finally, Kate Banfield built on the work we do in our FAB Kids outreach project to discuss sugar content in drinks. In an illuminating study, the girls were genuinely shocked to see the amount of sugar in drinks commonly consumed by people their age.diagram

After a great lunch in the Refectory we headed back to have a roundtable discussion on the barriers girls face to being physically active. The declining physical activity levels of female adolescents is a real public health concern (and the focus of the Acitve7 and PLAN-A studies), so this gave staff in ENHS a great opportunity to hear about the issues girls face. Mark Edwards and Sarah Harding led the discussion and were hugely impressed with the candid and insightful observations the girls made.

The final part of the day was always going to be the most nerve racking for the girls. But they excelled. Speaking to a room packed full of academics – scary for even a seasoned prof! – the girls gave a brief presentation on what they learnt throughout the day, with a wonderful practical example of how accelerometers work. The girls then spoke about the barriers they face to being active and presented some possible solutions for getting around them. The key messages we heard were that physical activities need to be FUN! There also needs to be the opportunity for girls-only activity, a chance to try new activities in a welcoming arena, and girls want to dress in whatever they feel comfortable. In making our research effective and getting it to truly speak to the people it is aimed at, it is vital we hear the voices of the girls.

It was a pleasure having the Bridge Learning Campus girls and Ms Williams come in – the girls did themselves, their teachers, and the school proud. We hope that they not only learnt some interesting things about physical activity but also had a good deal of fun too. None of the girls knew anybody who had been to university, and none of them had ever visited a university before. We hope to have inspired them to consider university as a viable option for them when they begin thinking about their future beyond secondary school.DSC_0290

Due to the success of the day, we hope to team up with the Centre for Public Engagement to make this an annual event.

Presenting at academic conferences: embracing discomfort

Natasha Mulvihill, Andrea Matolcsi, and Catherine Briddick reflect on their experiences of academic conference presentations in the field of prostitutiongvr-slider

The truth is that our finest moments are most likely to occur when we are feeling deeply uncomfortable […]. For it is only in such moments, propelled by our discomfort, that we are likely to step out of our ruts and start searching for different ways or truer answers. (M. Scott Peck)

The academic conference is an established forum for colleagues to present early findings and to road-test theories.  Ranging from mutually affirming spaces, thronged with like-minded and well-acquainted delegates to more diverse, loosely-knit events where participants strike up haphazard groups, conferences offer different opportunities for communication and intellectual challenge.  But how far should we actively seek out academic conferences that engender some discomfort to, in Peck’s terms, nudge us out of our particular research perspectives?

In April, we attended the first international conference organised by PROSPOL (Comparing European Prostitution Policies:  Understanding Scales and Cultures of Governance), a funded strand of work under the European COST Action IS1209 initiative.  Held in Vienna, delegates were asked to submit papers under the conference banner ‘Troubling prostitution: Exploring intersections of sex, intimacy and labour’.  As researchers on prostitution policy for a number of years, we submitted and each had an individual paper accepted, as well as panel proposal, co-presented with a colleague at Oxford.

The delegate list boasted many of the contemporary researchers across the world writing on prostitution and prostitution policy: and was for this reason a landmark event.  For those unfamiliar with this field of work, there is common demarcation made between researchers who understand selling sex as labour which deserves a statutory footing, with attendant rights and work to reduce harm, and researchers who understand prostitution as a reflection of patriarchy, characterised often by exploitation and abuse, and who lobby for measures to reduce demand for paid sex and support for women to exit.  While this division glosses over the significant diversity of views within and across these positions, it is palpable in its effects.  Researchers adopt terms consistent with the polar perspective (“sex work”, “prostitution”) and first encounters with other researchers can involve a few moments of careful neutrality, like poker players trying to read the other’s hand.  Differences in standpoint have at times been personal and appear increasingly to be played out beyond the academic journals and in to social media.  Institutions on name badges and delegate lists can suggest allegiances: ‘Centre for Gender and Violence Research at the University of Bristol’, for example, positions us as likely ‘prohibitionists’.  Broadly, the PROSPOL conference was sympathetic to the sex work perspective.

We offer three observations.  First, the discussion on prostitution and sex work can echo the story of the blind men and the elephant: researchers are often talking about different aspects of the sex industry and projecting their findings across the piece.  For example, the experience of migrants working in parlours, female street workers, single mothers working independently from home, internet workers ‘on tour’, male escorts or female sex tourists are all characterised by different individual circumstances and different relations of power.  So all researchers need to be careful about how they evidence their claims.

Second, as researchers writing from a feminist perspective, we are nevertheless interested in the interconnections between experiences of women and men across the sex industry and how these relate to gender-power relations.  We are mindful that despite some diversity in those selling sex, and despite the intersectional relations of race, economic status, migration status (or lack thereof), sexuality or disability within the prostitution encounter, the purchase of sex remains an overwhelmingly masculine practice.  This deserves further analysis.

Third, we note that prostitution as a practice rooted in patriarchy has been re-envisioned through the sex work movement and imbued with new meanings of freedom, choice, rights and transgression.  Much of the current research is exploring the tensions between this understanding of prostitution and a less sympathetic legal and political context.   However, rather than a brave new world, our concern would be that that this perspective reinforces prevailing power relations.  For example, there was discussion within one panel that gender equality within sex work would mean more equal numbers of men and women paying for sex.  Yet, this is surely the old gender politics where role equity for women has required women to move in to male constructed domains (politics, the workplace, front-line combat etc.) but rarely requires role change for men, or a significant challenge to the rationale, operation or normative status of those domains.

Despite our different viewpoints, we learnt a great deal from the breadth of research presented.  We got to meet the people behind the printed word and exchanged stories of how we found ourselves researching this difficult area.  We had common experiences on methods, on ethics, and on working with other organisations such as the police and health services and indeed with the women and men selling sex.  There was universal agreement that these individuals should not be criminalised.

So while our experience at the conference was at times taxing, we came away from Vienna with new knowledge, new friendships and the recognition that a little discomfort can be a good thing.

Authors                                                                              

Dr Natasha Mulvihill is a Research Associate and teacher at the University of Bristol’s Centre for Gender and Violence Research.

Andrea Matolcsi is a third-year PhD student at the University of Bristol’s Centre for Gender and Violence Research. Her participation in this conference was fully supported by the University of Bristol Alumni Foundation.

Catherine Briddick is studying for a DPhil in Law at the University of Oxford where she teaches international law and the protection of refugees, migrants and displaced persons.

Men experiencing or perpetrating domestic violence linked with two to three-fold increase in mental health problems

Marianne Hester, from the Centre for Gender Violence Research in the School for Policy Studies is leading research on domestic violence involving men as perpetrators or victimsMH

Men visiting their GP with symptoms of anxiety or depression are more likely to have experienced or carried out some form of behaviour linked to domestic violence and abuse, according to a new University of Bristol study. Researchers say the findings highlight the need for GPs to ask male patients with mental health problems about domestic abuse.

The study, led by Professor Marianne Hester OBE, and involving Dr Emma Williamson from the School, and published in BMJ Open, aimed to find out whether there is an association between men who have experienced or carried out domestic violence and abuse with men visiting their GP with mental health problems or who are binge drinking and using cannabis.

Researchers distributed a questionnaire across 16 GP practices in the South West that was completed by 1,368 men aged 18 years and above. The survey asked the men whether they had experienced or perpetrated any of four negative behaviours linked to domestic violence and abuse, such as feeling frightened, physically hurt, forced sex, or having to ask permission from a partner.

The survey then asked about experiences of these negative behaviours, followed by questions about their relationship with the perpetrator, frequency and escalation of the experience. Subsequent questions were then asked about the perpetration of any of the four negative behaviours towards a current or former partner in the past 12 months.

The study found 309 men, [22.7 per cent or nearly a quarter] of the 1,368 participants  experienced at least one of the four negative behaviours associated with domestic violence and abuse, and 212 [16.9 per cent or one-sixth] of 1,294 respondents reported perpetration of these behaviours at least once.

Researchers also found that men who used some form of negative behaviour towards their partners were three-to-five times more likely to report symptoms of anxiety than non-perpetrators. However, the study found no strong association between domestic violence and abuse with excessive drinking or cannabis use.

These findings indicate there is a higher likelihood of men who present symptoms of anxiety and depression in primary care could be the victims or perpetrators of domestic violence and abuse.

Professor Marianne Hester OBE, lead author of the study “Research on domestic violence and abuse has largely focused on women and there is a lack of research on men, both as victims and perpetrators.  The findings from this study are important as they suggest that when men present to GPs with anxiety or depression, they should be asked about domestic violence and abuse as there is a higher likelihood that they will be victims or perpetrators. The findings are consistent with previous studies, which found that mental health problems are more common in men who either perpetrate or experience domestic violence and abuse, and serve as an important indicator to clinicians.”

Professor Gene Feder, co-author on the study from the Centre for Academic Primary Care  at the School for Social and Community Medicine said: “The extent and health impact of negative behaviours consistent with domestic violence and abuse among male patients is largely invisible to GPs.  Our study will help focus attention on this hidden problem in general practice and provides a basis for training GPs in how to identify and respond safely to men experiencing or perpetrating domestic violence and abuse.”

Paper

Occurrence and impact of negative behaviour, including domestic violence and abuse, in men attending UK primary care health clinics: a cross-sectional survey by M Hester, G Ferrari, S K Jones, E Williamson, L J Bacchus, T J Peters and G Feder in BMJ Open.

Further information:

National DVA help service for men:

http://respect.uk.net

Deprivation of necessities has become more widespread in Britain since 1999

134179Deprivation of necessities has become more widespread in Britain since 1999

The 2008 financial crisis and subsequent austerity measures have seen the most sustained decline in household incomes since the 1930s. In this post, Eldin Fahmy examines their impacts on public perceptions of minimally adequate living standards, and on the extent of deprivation. Based upon analysis of survey data for 1999 and 2012, it seems that as households have been forced to ‘tighten their belts’, perceptions of minimum living standards have become less generous. At the same time the extent of deprivation has increased dramatically.

The 2012 UK Poverty and Social Exclusion survey (2012-PSE) is the latest and most comprehensive in a series of household surveys conducted since the early 1980s adopting a ‘consensual’ approach to poverty which reflect public views on minimally adequate living standards. Since our last survey in Britain in 1999, public perceptions of what constitute the ‘necessities of life’ have become less generous.  Nevertheless, the proportion of adults in Britain deprived of these necessities has increased substantially since 1999.

Poverty in Britain today is widely understood in relative terms as an inability to take part in lifestyles and activities which are customary or widely approved in contemporary society due to insufficient resources.  This requires direct observation of living standards and cannot be established simply be using arbitrary income thresholds. Since Mack and Lansley’s ground-breaking 1983 survey, surveys on poverty in 1990, 1999 and 2012 have therefore examined public views on minimally acceptable living standards and have incorporated these views within the definition and measurement of poverty itself.

One consistent finding emerging from these surveys has been the striking degree of public consensus across social groups (e.g. by gender, age, social class, income level, etc.) concerning the relative importance of different items and activities.  Nevertheless, as deprivation is here understood to be relative to prevailing societal standards we should expect that perceptions of necessities will vary across time to reflect changing living standards, tastes and customs. What, then, do the British public view as necessities of life today and in what ways has this changed since our last survey in 1999?

Table 1 (below) shows the percentage of adults in 2012 and 1999 describing a comparable set of items and activities as ‘necessities’. In both 1999 and 2012 there is widespread agreement on many items, and perceptions of necessities extend far beyond what might be described as ‘basic’ needs to encompass a range of ‘social’ necessities.  As predicted by relative deprivation theory, perceptions of necessities also reflect changes in prevailing living standards and consumption norms, for example, in relation to technological items which have become more widely available (and widely encouraged) over the 1999-2012 period.

Table 1: Percentage of people viewing items as necessities for adults in 1999 and 2012 in Britain

 

table-1

However, one implication of a relative approach is that during periods of declining living standards public perceptions of necessities may also become less generous.  Given the sustained decline in household incomes and living standards arising from the 2008 financial crisis, it would be astonishing if this was not also reflected in public attitudes to the necessities of life.  Table 1 suggests that this is indeed the case.

Many items record a substantial fall in the proportion of respondents who view them as necessities in 2012 compared with 1999, with those items where public support was more equivocal in 1999 witnessing an especially dramatic decline in approval. As household incomes have become more constrained, more basic necessities (towards the top of Table 1) are increasingly prioritised over more discretionary items.  As we argue in our preliminary report, it seems that the public have scaled back their expectations regarding minimum living standards in ways which reflect the prevailing climate of austerity and pessimism.  One consequence of recession and austerity program may be that the British public have ‘tightened their belts’ and now consider many things which in the past were viewed as essential to no longer be necessities.

However, even though public perceptions of minimum living standards became less generous, the extent of deprivation of necessities has nevertheless increased for adults in Britain over this period.  Table 2 (below) shows the percentage of adults in Britain who lack different necessities in 1999 and 2012 because they cannot afford them.  The proportion of adults unable to afford items and activities considered by the British public to be ‘necessities of life’ in 2012 has increased dramatically compared with 1999.  For example, the percentage of adults unable to adequately heat their home has increased seven-fold, and the percentage unable to afford a damp-free home, or to replace broken electrical goods, or to afford appropriate clothes for job interviews has at least doubled over this period.

Table 2: Percentage of adults lacking items because they cannot afford them in 1999 and 2012 in Britain

 table 2 Eldins blog

There is now widespread agreement on what constitutes a minimally acceptable diet for adults, including two meals a day, fresh fruit and vegetables daily, and meat and fish every other day.  However, an increasing number of adults are unable to afford to eat properly, with the percentage of British adults who are unable to afford at least one of these dietary essentials increasing from 5% in 1999 to 8% in 2012.  Since Table 2 focuses on the same items measured in comparable ways in 1999 and 2012, there has been an absolute increase in social and material deprivation over this period amongst the British adult population.

Underpinning the growth in deprivation over this period has been a rising tide of income inequality over the 1999-2008 period which ensured that despite a period of sustained economic growth until 2008, the benefits of growth were for the most part not enjoyed by poorer households whose incomes and wages fell further and further behind those of the better-off in relative terms.

Following the 2008 recession there has been a modest decline in income inequality and relative income poverty, but this reflects an overall decline in societal standards rather than any absolute improvement in the circumstances of poorer households.  Although this decline in living standards is also reflected in more restrictive public perceptions of necessities, the extent of social and material deprivation amongst adults in Britain has clearly increased substantially since 1999.  Indeed, these findings reflect the situation in 2012 before the majority of proposed changes to welfare benefits came into effect.  Since these measures are set to hit the poor hard, our findings almost certainly underestimate the true extent of social and material deprivation in Britain today.

Note: A longer version of this article was published in the Journal of Poverty and Social Justice (Vol 22, Issue 2) in October 2014.

This post was first published on the British Politics and Policy blog

About the Author

Dr Eldin Fahmyis Senior Lecturer in the School for Policy Studies at the University of Bristol. He is a member of the ESRC-funded 2012 UK Poverty and Social Exclusion Survey research team (Ref: RES-060–25–688 0052).