Severe and multiple disadvantage (SMD)
What we know
It is often difficult to measure the extent of severe and multiple disadvantage (SMD) due to the categorisation of people's experiences into separate boxes and data not being connected between different services. However, it is known that some domains of disadvantage are more likely to coincide than others. The co-existence of offending and substance use is the most common form of SMD2, followed by the co-existence of homelessness and substance use.
There are a number of risk factors associated with SMD, often linking to negative experiences in childhood.
This includes:
- childhood trauma
- poor educational experiences
- wider social and economic determinants
Those experiencing SMD face significant negative consequences across various domains of their lives. This includes an impact on physical and mental health, employment and ultimately premature mortality. There is also a significant financial cost on wider society due to the use of services and the health and care needs of individuals.
Communities with a higher prevalence of SMD are also likely to experience higher rates of:
- crime
- anti-social behaviour
- street drinking
Around 60% of those experiencing SMD3 live with or have contact with children, many of whom will experience disadvantage as a consequence of parental SMD. This has negative effects on physical, social, and cognitive development. It also increases a child's risk of later experiencing SMD themselves, which leads to intergenerational cycles of disadvantage.
