This thesis addresses the question of health inequalities in relation to visible ethnic minorities in the UK Chapter 1 provides an overview of the international literature on health inequalities and concludes that social disadvantage is consistently associated with some degree of health disadvantage. However, the extent of health inequalities alter depending on the indicator of health used, the measure of socio-economic circumstances, the stage of the life course addressed, and the gender of research subjects. Chapter 2 begins with a brief history of visible ethnic minorities within the UK. The conceptual difficulties of the concepts of race, ethnicity and racism are considered. Despite the diversity in socio-economic patterns all UK minority ethnic groups pay an economic 'ethnic penalty'. The experience of racial hostility and abuse is reported to be a regular occurrence by members of minority ethnic groups. Chapter 3 provides an overview of the studies of health of UK minority ethnic group members and considers three theoretical approaches to explaining health differences between minority and majority groups. These approaches emphasise different aspects of the experiences of migration and of racism as determinants of socio-economic circumstances and health for members of minority ethnic groups. Chapter 4 discusses some of the methodological difficulties inherent in any such analysis, and considers the benefits and constraints of using the Sample of Anonymised Records from the 1991 UK census as the basis for empirical exploration of these questions. The next three chapters (5,6, and 7) report the results of the analysis of reported long term limiting illness in young adult and mid-life men (Chapter 5), young adult and mid-life women (Chapter 6) and children under 16 (Chapter 7), taking into account migrant status and socio-economic circumstances. ii Chapter 8 concludes this study by discussing these findings in comparison with the predictions from the different models of the links between ethnicity and health. The results are reviewed in the light of previous research

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This thesis develops and tests the new theory that beliefs in societal justice offer a distinctive self-regulatory benefit for members of socially disadvantaged groups. Integrating concepts from the social justice and goal motivation literatures I hypothesize that members of disadvantaged groups are more likely than members of advantaged social groups to calibrate their pursuit of long-term goals to their beliefs about societal justice. In Study 1, low but not high SES undergraduates showed greater intentions to persist in the face of poor exam performance to the extent that they believed in societal justice. In Study 2, low but not high SES participants reported more willingness to invest in career pursuits to the extent that they believed in societal justice. In Study 3, ethnic minority, but not ethnic majority, participants who read that societal justice was improving reported more willingness to invest resources in pursuit of long-term goals, relative to control participants. Study 4 replicated Study 3 using a more subtle manipulation of justice beliefs, and demonstrated that the moderating role of ethnic status operates due to a difference in the perceived self-relevance of societal justice. Study 5 examined the moderating role of SES and ethnic status in a large cross-national sample. Two additional studies indicated boundary conditions for the effect, showing that goals which are not perceived as relevant to justice operate in the opposite fashion: In Study 6, low SES participants primed with injustice withdrew their resources from their academic goals, and reinvested them in their social goals. Study 7 replicated this effect, and provided evidence that when the self-relevance of justice information is highlighted, it can influence motivation even among members of advantaged groups. Ethnic majority participants who read about discrimination against their group also withdrew their resources from their academic goals, and reinvested them in their social goals.

This thesis develops and tests the new theory that beliefs in societal justice offer a distinctive self-regulatory benefit for members of socially disadvantaged groups. Integrating concepts from the social justice and goal motivation literatures I hypothesize that members of disadvantaged groups are more likely than members of advantaged social groups to calibrate their pursuit of long-term goals to their beliefs about societal justice. In Study 1, low but not high SES undergraduates showed greater intentions to persist in the face of poor exam performance to the extent that they believed in societal justice. In Study 2, low but not high SES participants reported more willingness to invest in career pursuits to the extent that they believed in societal justice. In Study 3, ethnic minority, but not ethnic majority, participants who read that societal justice was improving reported more willingness to invest resources in pursuit of long-term goals, relative to control participants. Study 4 replicated Study 3 using a more subtle manipulation of justice beliefs, and demonstrated that the moderating role of ethnic status operates due to a difference in the perceived self-relevance of societal justice. Study 5 examined the moderating role of SES and ethnic status in a large cross-national sample. Two additional studies indicated boundary conditions for the effect, showing that goals which are not perceived as relevant to justice operate in the opposite fashion: In Study 6, low SES participants primed with injustice withdrew their resources from their academic goals, and reinvested them in their social goals. Study 7 replicated this effect, and provided evidence that when the self-relevance of justice information is highlighted, it can influence motivation even among members of advantaged groups. Ethnic majority participants who read about discrimination against their group also withdrew their resources from their academic goals, and reinvested them in their social goals.

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People who go missing are often perceived to have done so voluntarily, and yet, many missing persons in Canada are Aboriginal, visible minorities, homeless, and are fleeing from violence, abuse, and neglect. Integrating the concept of social exclusion and an intersectional perspective with a sample of 724 missing persons cases drawn from one Canadian police service, this dissertation examines the systemic issues underlying peoples’ disappearances. This dissertation also explores the role of social and economic disadvantage in the risk of a long term disappearance. A combination of univariate (descriptions), bivariate (cross-tabulations), and multivariate (logistic regression) analyses identify correlates and causes of going missing and correlates and causes of long term disappearances. The concept of social exclusion explains how structural processes prevent particular groups and individuals from gaining access to valued social relationships and economic opportunities in a particular society, resulting in considerable hardship and disadvantage. This dissertation argues that people who are marginalized and excluded have few resources to rely on to cope with stress and strain and may resort to going missing if confronted with adversity. Groups who are overrepresented among missing persons compared to the general population are identified by cross-tabulations and chi-square tests. Multivariate analysis (partial tables and logistic regression) is used to control for possible sources of spuriousness, in order to have more confidence in imputing causal relationships between membership in disadvantaged groups and going missing. Moreover, if disadvantaged groups go missing, they further sever ties with families, the labour market, and other mainstream institutions. As a result of extreme disadvantage, they may find it difficult to (re)connect with conventional social relationships and mainstream society. For example, youth who are escaping violence and abuse at home often end up on the streets and sever ties with schools, families, and other conventional support networks and become engaged in street culture. As a result of extreme disadvantage these young people are at risk of a long term disappearance. In other words, social exclusion is expected to be a risk and causal factor in long term disappearances. Groups who are overrepresented among long term disappearances compared to short term disappearances are identified by cross-tabulations and chi-square tests. Logistic regression analysis is used to draw conclusions about causal factors in long term disappearances. This research finds that excluded groups such as disadvantaged youth, Aboriginal people, women and other visible minorities, victims of violence, and youth in care are at disproportionate risk of going missing. Consistent with an intersectional perspective, this dissertation shows that certain groups who are multiply marginalized such as Aboriginal women and young women face an especially high risk of going missing. Aboriginal identity, labour force status, and homelessness are also implicated as causal factors in peoples’ disappearances. Moreover, this research finds that social exclusion is a risk and causal factor in long term disappearances as Aboriginal people, homeless people, minorities and other excluded groups face a high risk of a long term disappearance. Linking missing persons with the concept of social exclusion highlights the role of structural issues in peoples’ disappearances and refutes the common misperception that going missing is a choice. In terms of policy, the findings from this research indicate that prevention and intervention depend on targeting poverty, discrimination, gender inequality, violence, and other structural issues associated with social exclusion.

People who go missing are often perceived to have done so voluntarily, and yet, many missing persons in Canada are Aboriginal, visible minorities, homeless, and are fleeing from violence, abuse, and neglect. Integrating the concept of social exclusion and an intersectional perspective with a sample of 724 missing persons cases drawn from one Canadian police service, this dissertation examines the systemic issues underlying peoples’ disappearances. This dissertation also explores the role of social and economic disadvantage in the risk of a long term disappearance. A combination of univariate (descriptions), bivariate (cross-tabulations), and multivariate (logistic regression) analyses identify correlates and causes of going missing and correlates and causes of long term disappearances. The concept of social exclusion explains how structural processes prevent particular groups and individuals from gaining access to valued social relationships and economic opportunities in a particular society, resulting in considerable hardship and disadvantage. This dissertation argues that people who are marginalized and excluded have few resources to rely on to cope with stress and strain and may resort to going missing if confronted with adversity. Groups who are overrepresented among missing persons compared to the general population are identified by cross-tabulations and chi-square tests. Multivariate analysis (partial tables and logistic regression) is used to control for possible sources of spuriousness, in order to have more confidence in imputing causal relationships between membership in disadvantaged groups and going missing. Moreover, if disadvantaged groups go missing, they further sever ties with families, the labour market, and other mainstream institutions. As a result of extreme disadvantage, they may find it difficult to (re)connect with conventional social relationships and mainstream society. For example, youth who are escaping violence and abuse at home often end up on the streets and sever ties with schools, families, and other conventional support networks and become engaged in street culture. As a result of extreme disadvantage these young people are at risk of a long term disappearance. In other words, social exclusion is expected to be a risk and causal factor in long term disappearances. Groups who are overrepresented among long term disappearances compared to short term disappearances are identified by cross-tabulations and chi-square tests. Logistic regression analysis is used to draw conclusions about causal factors in long term disappearances. This research finds that excluded groups such as disadvantaged youth, Aboriginal people, women and other visible minorities, victims of violence, and youth in care are at disproportionate risk of going missing. Consistent with an intersectional perspective, this dissertation shows that certain groups who are multiply marginalized such as Aboriginal women and young women face an especially high risk of going missing. Aboriginal identity, labour force status, and homelessness are also implicated as causal factors in peoples’ disappearances. Moreover, this research finds that social exclusion is a risk and causal factor in long term disappearances as Aboriginal people, homeless people, minorities and other excluded groups face a high risk of a long term disappearance. Linking missing persons with the concept of social exclusion highlights the role of structural issues in peoples’ disappearances and refutes the common misperception that going missing is a choice. In terms of policy, the findings from this research indicate that prevention and intervention depend on targeting poverty, discrimination, gender inequality, violence, and other structural issues associated with social exclusion.

The purpose of the critical review is understood to be a critical reflection and comment on the work presented in the papers. The critical review is centred on the papers, as they form the substance of the submission, and the wider tobacco control literature. This review has not attempted to re-analyse the findings of the studies but attempts to draw wider lessons from the studies and to contribute to the future implementation of tobacco control policy and programmes. It will be claimed that the contribution to the research studies, the publications and the critical review represents a significant body of work and contribution to the advancement of knowledge in tobacco control. The aim of the thesis is to present and critically review six publications on the social de-normalisation of tobacco use, as it relates to public and private smoke-free environments and professional engagement in Scotland. The publications are treated as a coherent body of tobacco control research and draw upon three studies conducted over the period 1999-2007. Breathing Space Study 1: 1999-2002 evaluated an intervention which aimed to produce a significant shift in community norms towards non-smoking in a lowincome area. A process evaluation, as part of a quasi-experimental design, was undertaken in the intervention area, using a range of qualitative methods, including observation, in-depth interviews and focus groups. Papers 1 and 2 explore the context of health promotion professional practice in the development and implementation of tobacco control interventions in one disadvantaged community. The Qualitative Community Study 2: 2005-2007 aimed to explore the impact of the Scottish smoke-free legislation on attitudes and behaviour, at both individual and community levels, in four socio-economically contrasting localities in Scotland. A longitudinal qualitative evaluation was conducted using observation, in-depth interviews with smokers and ex-smokers, key stakeholders and focus groups. Papers 3 and 4 explore qualitative differences in the experience of smoke-free legislation in advantaged and disadvantaged communities, with particular consideration of the unintended consequences of the legislation for some smokers. The Smoke-free Homes Study 3: 2006-2007 aimed to describe changes in smoking behaviour and attitudes to smoking following implementation of the smoke-free legislation. It sought to identify the potential enablers and barriers to reducing SHS exposure in the home. A cross-sectional study was conducted using qualitative interviews. Papers 5 and 6 explore the changing discourses about second-hand smoke exposure, and the development of smoking restrictions in the home, with a particular focus on motivation to protect children. In addition, insight into the changing culture of professional practice in creating smoke-free homes was gained. Key findings A synthesis of key findings from these publications supports the identification of three major themes: the experience of power at each stage of the process of the social de-normalisation of tobacco use; the experience of stigmatisation of smoking as a consequence of policy; and health promotion practice as both barrier to and enabler of the implementation of smoke-free environments in the community and the home. The thesis also highlights the benefits and challenges of two research methodologies, process evaluation and qualitative longitudinal research (QLLR), in capturing both intended and unanticipated aspects of policy and practice implementation. This synthesis of the key findings that cut across the three studies has generated four research questions that are explored in this critical review: 1. How can policy be evaluated in community settings and in the home? 2. How do smokers, particularly disadvantaged smokers, engage with tobacco control policies and interventions? 3. Is professional practice a barrier or facilitator to understanding the impact of tobacco control policies and interventions? 4. What are some of the key unintended consequences of recent tobacco control policies? Conclusion This thesis contributes to knowledge through a critical account of the reshaping of smoking as a collective lifestyle, in both public and private domains. The social de-normalisation of tobacco use is experienced differently in advantaged and disadvantaged social contexts. Population tobacco control strategies may benefit from contextual adjustments, particularly for those smokers who live in areas of disadvantage and thus experience dual stigmatisation. Additionally, the effectiveness of future interventions would be enhanced by a more nuanced understanding of smoking behaviour, as a collective social practice, embedded in specific spaces, places and times.