New Lancet Report Examines Dramatic Health Impacts of Social Exclusion, Effective Interventions

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Socially excluded groups are the canaries in the mine – they point to something toxic in our society.


People isolated from mainstream society in developed countries have a tenfold increased risk of death, according to a ground breaking series of articles published this week in The Lancet by researchers from University College London (UCL) and other leading academic and health care institutions, including Allegheny Health Network (AHN) in Pittsburgh.

The articles highlight the extreme rates of death and disease faced by excluded people, and provide evidence for interventions that can help save lives and prevent people from finding themselves in such desperate situations.

Researchers found the mortality rate among the socially excluded, including people with experiences of homelessness, imprisonment, drug use and sex work, was nearly eight times higher than the population average for men, and nearly 12 times for women. In total, researchers analyzed data from 38 countries with the US, Canada, UK, Sweden, and Australia providing the highest amount of data.

“It is no surprise that socially excluded groups have poor health outcomes, but the extent of the disparities in wealthy countries is an affront to our values. Socially excluded groups are the canaries in the mine – they point to something toxic in our society,” said Andrew Hayward, Professor, UCL Institute of Epidemiology and Healthcare, and senior author of the first paper.

In the second paper, of which Patrick Perri, MD, of AHN is an author, inclusion health is defined as a service, research, and policy agenda that aims to prevent and redress health and social inequities among the most vulnerable and excluded populations.

Dr. Perri, Medical Director of AHN’s Center for Inclusion Health, says that this is the first time that inclusion health and its underpinning epidemiologic research has been formally described in medical literature. The Lancet is one of the world’s oldest and most respected peer-reviewed medical journals.

“This is a significant milestone for inclusion health as a unique approach supported by evidence-based care models that are designed to respond to the extreme adverse health impacts of social exclusion,” said Dr. Perri. “I am honored to have had the opportunity to contribute to this literature which aims to inspire further research, collaboration and dedication of resources to prevent exclusion globally.”

Based in Pittsburgh, Pa., AHN’s Center for Inclusion Health was formed in early 2014 as one of the nation’s first comprehensive programs of its kind focused on meeting the health care needs of the socially marginalized and vulnerable populations.

As part of the Center for Inclusion Health, AHN recently launched the Center of Excellence for Opioid Use Disorder. This comprehensive program helps patients with opioid-related substance use disorders receive the health and community-based care and support they need to overcome addiction and maintain long-term wellness.

AHN this year also started the first and only medical respite program in the tristate region. To better meet the healthcare needs of the homeless and unstably-housed population, the respite program provides patients recovering from illnesses with a safe place to recuperate and receive ongoing non-acute care and support following a hospital stay.


About Allegheny Health Network

Allegheny Health Network (, a Highmark Health company, is an integrated healthcare delivery system serving the greater Western Pennsylvania region. The Network is composed of eight hospitals, including Allegheny General Hospital, its flagship academic medical center in Pittsburgh, Allegheny Valley Hospital in Natrona Heights, Canonsburg Hospital in Canonsburg, Forbes Hospital in Monroeville, Jefferson Hospital in Jefferson Hills, Saint Vincent Hospital in Erie, West Penn Hospital in Pittsburgh and Westfield Memorial Hospital in Westfield, NY. The Network provides patients with access to a complete spectrum of advanced medical services, including nationally recognized programs for primary and emergency care, cardiovascular disease, cancer care, orthopaedic surgery, neurology and neurosurgery, women’s health, diabetes and more. It also is home to a comprehensive research institute; Health + Wellness Pavilions; an employed physician organization, home and community based health services and a group purchasing organization. The Network employs approximately 17,000 people, has more than 2,800 physicians on its medical staff and serves as a clinical campus for Drexel University College of Medicine, Temple University School of Medicine, and the Lake Erie College of Osteopathic Medicine.

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Brad Bennett

Brad Bennett

Brad grew up in a small town in northern Iowa. He studied chemistry in college, graduated, and married his wife one month later. They were then blessed with two baby boys within the first four years of marriage. Having babies gave their family a desire to return to the old paths – to nourish their family with traditional, homegrown foods; rid their home of toxic chemicals and petroleum products; and give their boys a chance to know a simple, sustainable way of life. They are currently building a homestead from scratch on two little acres in central Texas. There’s a lot to be done to become somewhat self-sufficient, but they are debt-free and get to spend their days living this simple, good life together with their five young children.
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