Addi van Bergen

Chapter 2 38 CONCLUSIONS To our knowledge, this is the first paper that succeeded in systematically synthesizing evidence on the association between the multidimensional concept of SE/SI and health. Preliminary evidence was promising. Most studies confirmed the expected relationship between high SE/low SI and adverse health outcomes, particularly for mental health. We recommend a greater focus on the valid measurement of SE/SI in future research. KEY POINTS • Social exclusion is generally regarded as an important social determinant of health, yet, its evidence base is still weak. • In this systematic review we operationalised social exclusion as the cumulation of deprivations in four dimensions i.e. social, economic, political and cultural and social inclusion as full involvement in these dimensions. • Evidence was found for the interconnectedness of social exclusion and inclusion and health. Available evidence is stronger for mental and general health than for physical health. • There is need for the development and use of validated multidimensional, and preferably composite, measures for social exclusion and inclusion. FUNDING No funding was received for this work. SUPPLEMENTARY MATERIALS Supplementary file 1: Literature search strategy details Supplementary file 2: CASP risk of bias tool for cross-sectional studies Supplementary file 3: CASP risk of bias tool for cohort studies Supplementary file 4: Details about the specific methodological limitations Supplementary file 5: Tables S1a-S3b Description of observational studies: mental health, physical health and general health in the general population (a) and in high risk groups (b)