Oral

For too long now, public health has not done enough for the hard to reach who exist in every community. There should be no ‘no-go areas’ and no ‘undeserving’ as far as health protection and health promotion are concerned if we are to promote healthy communities. For two reasons, the time is right for public health to take a more determined and systematic approach to promoting the health of the socially marginalised., First, there is a new confidence in public health. It comes from a heightened awareness about the social determinants of health, from the lessons learned in recent decades on promoting health and from hard experience gained in the control of new and resurgent communicable diseases. It is based on evidence of what works and has social justice as a driving core value. It is leading towards a clearer vision of what public health can achieve and to a new determination to tackle social injustices which lie behind health inequalities. Social injustice not only kills on a grand scale, it also lies behind the marginalisation of large numbers of disadvantaged people in all communities. A healthy community cannot ignore the health needs of the all too persistent sections of its population who are socially isolated for various reasons. Such people, including hose with mental illness, those in prisons or detention centres, or migrant and native populations, are often excluded from participation in beneficial social networks, and can be forgotten or seen by others as not really belonging to the community. To ignore their health needs can create a threat to the health of the community as a whole. The promotion of their health is difficult and is a challenge to both public health and to civil society. The second reason for action now is that there is evidence that worthwhile improvements can be made in the health of the socially marginalised.

Session Objectives: 1. Discuss the importance to public health of promoting the health of socially marginalised groups; 2. Describe strategies to realize worthwhile improvements in health for vulnerable groups in communities through the use of the achievements of the WHO health in prisons programme. 3. Describe the need for a new global commitment to improving the health of those at the margins of society.