This academic paper explores the creation, use and influence of ‘SMD’ as a way of describing social harm.

It situates ‘severe and multiple disadvantage’ within a much longer cultural history of trying to describe and intervene upon groups of people identified as particularly problematic. Whilst noting the influence of ‘SMD’ terminology in policy and funding initiatives, it also questions the underlying narrative of needs, deficits and costs, and asks whether discourse around disadvantage could recognise structural factors as well as individual ones.