3.3 Societal level: At a Societal level, the Dahlgren-Whitehead Rainbow Model (1991) highlights the significant structural
3.3 Societal level: At a Societal level, the Dahlgren-Whitehead Rainbow Model (1991) highlights the significant structural determinants contributing to health inequalities, particularly affecting musculoskeletal health in Lewisham. As one of the most deprived local authorities in the United Kingdom, Lewisham faces pervasive challenges such as high level of unemployment, poverty, and limited access to essential sources for maintaining a healthy lifestyle, including advanced medical care and physiotherapy (Lewisham Department for Work and Pensions, 2019). These socioeconomic factors significantly impede the ability of Lewisham’s population to engage in healthy behaviours, adopt active lifestyles, and address musculoskeletal issues (Bartley, 2017). Many residents are employed in sedentary desk jobs or juggle multiple jobs, leaving little time for physical activity or self-care, exacerbating their deteriorating health. Moreover, unemployed face additional barriers in accessing healthcare services, rending them highly vulnerable to musculoskeletal conditions (Marmot, 2023). To address these challenges effectively, targeted interventions addressing both the structural determinants and individual level factors are imperative.
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