How can social exclusion be most usefully defined and measured? This section of a report from the World Health Organisation’s Social Exclusion Knowledge Network (SEKN) proposes a relational model of exclusion, as a dynamic multi-dimensional process operating through relationships of power. Most of the available indicators for measuring exclusion, however, describe static ‘states’ of exclusion, largely neglecting causal processes. They also neglect the voices of those most severely affected. Policy and action need to be informed by both numerical indicators and people’s accounts of their experiences.
The concept of ‘social exclusion’ remains problematic, and differs even within global regions. It is most commonly used in a policy context to describe a state of extreme disadvantage. This limits the global relevance of the concept and restricts its operational value. A relational approach, however, focuses on exclusion as consisting of dynamic multi-dimensional processes embedded in unequal power relationships, interacting across cultural, economic, political and social dimensions and operating at multiple levels. According to this relational perspective, social exclusion results in a continuum of inclusion/exclusion characterised by unequal access to resources, capabilities and rights.
Exclusionary processes are located within social systems (such as the family, households, nation states and global regions). Within social systems, interactions between the four relational dimensions of power – social, political, economic and cultural – generate social stratification along lines of gender, ethnicity, class, caste, ability and age. These stratification systems and the unequal access to power and resources embedded in them, lead in turn to differential exposure to harmful circumstances. These systems also reduce people’s capacity to protect themselves and restrict access to services. This relational understanding of social exclusion offers such advantages as:
- Making explicit the links between exclusion and a ‘rights’ approach
- Directing attention to interactions between relationships and outcomes at different levels e.g. community, nation state and global regions
- Highlighting both active and passive exclusionary processes
- Recognising that exclusionary processes will impact differently on different groups and/or societies at different times
Measuring social exclusion is difficult because of its varying meanings and the limited availability and quality of relevant data. Available quantitative approaches, for example, can themselves be ‘exclusionary’, because people most severely affected by exclusionary processes – for instance, the stateless, homeless or institutionalised – are often the least likely to be counted. Further findings and implications include the following:
- Indicators and indices available at a global and country level can provide important insights. The Human Development Index (HDI), for example, is a composite measure across length of healthy life, education and material living standards and covers 175 out of 192 UN Member countries. The Gini index measures the extent to which the distribution of income (or consumption) among individuals or households within a country deviates from a perfectly equal distribution.
- More sophisticated approaches to measurement are being developed but these remain focused on ‘states’ rather than processes. They also have limited utility regionally and/or globally due to data limitations and the ‘Western’ orientation of the understanding of exclusion; for example, giving more emphasis to formal labour markets and welfare systems and less to cultural and political aspects of exclusion.
- Greater attention needs to be paid to capturing the wisdom of experience among people most severely affected by exclusionary processes and to ensuring that it informs policy and action.
The main authors of this report were: Jennie Popay, Sarah Escorel, Mario Hernández, Heidi Johnston, Jane Mathieson, Laetitia Rispel on behalf of the WHO Social Exclusion Knowledge Network. A full list of contributors and their affiliations are provided on pages 3-4 of the main report.
