Addi van Bergen

Systematic review: social exclusion or inclusion and health 27 2 We retrieved full-texts of all articles considered potentially eligible by at least one reviewer. Two reviewers (AvB, plus MB, KS or BC) then independently assessed the full texts to ascertain that the inclusion criteria were met. In case of disagreement, one of the other reviewers was consulted to decide. To complement the electronic searches, we hand-searched the reference lists of included studies and other reviews. Citation tracking was performed using Web of Science (WoS) or Google Scholar if studies were unavailable in WoS. Studies identified through reference and citation tracking were screened and assessed by AvB. When uncertain, BC or HS were consulted. Data extraction For each included study, the following data were extracted: study design, country, study population, sample size, dimensions and measures of SE/SI, health measure(s), confounding variables, statistical analysis and key results. We classified the health outcomes into three groups: mental health related (MH), physical health related (PH), and general health related (GH). In this, we were guided by the lists of mental and physical adult health measures in the Patient-Reported Outcomes Measurement Information System (PROMIS http://www.healthmeasures.net/explore-measurement- systems/promis/intro-to-promis/list-of-adult-measures) and UK experience on general health measures [24]. Mental illness and its impacts, emotional distress and cognitive functioning were classified under MH, as were intravenous drug use and compulsory hospitalisation on grounds of health and safety risks due to mental illness. Physical functioning, impairments, and symptoms such as headache and sleeplessness, were classified under PH. Whereas physical health refers to the physiologic and physical status of the body, general health refers to overall health status. Typical general health measures are self-rated health, presence of chronic diseases (yes/no), and limitations due to health problems (yes/no) [24]. Indicators of SE/SI were classified into the four WHO dimensions of SE/SI: social (S), economic (E), political (P), and cultural (C) as operationalised by the Netherlands Institute for Social Research|SCP [3, 25, 26]. In the social dimension, we classified SE/SI indicators relating to social isolation, participation in formal and informal social networks, and social involvement. In the economic dimension, we classified SE/SI indicators relating to deficits that people experience as shown by debts and the absence of certain basic goods and services; in the political dimension we classified indicators on the ability to exercise the rights people normally have, such as adequate health care, sufficient education, proper housing, a safe living environment and access to public and commercial services; and finally, in the cultural domain, we categorised indicators referring to a lack of normative integration i.e. non-compliance with core values of society such as low work ethic, low training readiness, not voting, social security abuse or delinquent behaviour. Study populations were classified into two groups: 1) general population and 2) population groups at high risk of SE. Studies among adults in HIV treatment, problematic drug users and single mothers were classified in the latter category. We classified elderly as general population, viewing