• Journal of Preventive Medicine and Public Health
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• 제54권4호
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• pp.265-274
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• 2021

Objectives: Given the importance of social determinants of health in promoting the health of slum residents, this study was conducted with the aim of identifying the main dimensions and components of these determinants. Methods: This scoping review study was conducted according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). A comprehensive search was performed of PubMed, ProQuest, Scopus, and Web of Science for articles conducted from 2010 to the end of 2019. Studies were selected based on inclusion criteria, with a special focus on studies dealing with the social determinants of physical and mental health or illness. Results: Thirty-three articles were selected to extract information on the social determinants of health. After reviewing the articles, 7 main dimensions (housing, socioeconomic status of the family, nutrition, neighborhood characteristics, social support and social capital, occupational factors, and health behaviors) and 87 components were extracted as social determinants of health among slum dwellers. Conclusions: This framework could be used by planners, managers, and policy-makers when making decisions affecting the health of these settlements' residents due to the common characteristics of slums around the world, especially in developing countries.

• Journal of Preventive Medicine and Public Health
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• 제56권4호
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• pp.327-337
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• 2023

Objectives: Considering the importance of social determinants of health (SDHs) in promoting the health of residents of informal settlements and their diversity, abundance, and breadth, this study aimed to identify, measure, and rank SDHs for health promotion interventions targeting informal settlement residents in a metropolitan area in Iran. Methods: Using a hybrid method, this study was conducted in 3 phases from 2019 to 2020. SDHs were identified by reviewing studies and using the Delphi method. To examine the SDHs among informal settlement residents, a cross-sectional analysis was conducted using researcher-made questionnaires. Multilayer perceptron analysis using an artificial neural network was used to rank the SDHs by priority. Results: Of the 96 determinants identified in the first phase of the study, 43 were examined, and 15 were identified as high-priority SDHs for use in health-promotion interventions for informal settlement residents in the study area. They included individual health literacy, nutrition, occupational factors, housing-related factors, and access to public resources. Conclusions: Since identifying and addressing SDHs could improve health justice and mitigate the poor health status of settlement residents, ranking these determinants by priority using artificial intelligence will enable policymakers to improve the health of settlement residents through interventions targeting the most important SDHs.

• Journal of Preventive Medicine and Public Health
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• 제53권3호
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• pp.189-197
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• 2020

Objectives: Our aim was to answer the following questions: (1) Can mental health variance be partitioned to individual and higher levels (e.g., neighborhood and district); (2) How much (as a percentage) do individual-level determinants explain the variability of mental health at the individual-level; and (3) How much do determinants at the neighborhood- or district-level explain the variability of mental health at the neighborhood- or district-level? Methods: We used raw data from the second round of the Urban Health Equity Assessment and Response Tool in Tehran (in 2012-2013, n=34 700 samples nested in 368 neighborhoods nested in 22 districts) and the results of the official report of Tehran's Center of Studies and Planning (in 2012-2013, n=22 districts). Multilevel linear regression models were used to answer the study questions. Results: Approximately 40% of Tehran residents provided responses suggestive of having mental health disorders (30-52%). According to estimates of residual variance, 7% of mental health variance was determined to be at the neighborhood-level and 93% at the individual-level. Approximately 21% of mental health variance at the individual-level and 49% of the remaining mental health variance at the neighborhood-level were determined by determinants at the individual-level and neighborhood-level, respectively. Conclusions: If we want to make the most effective decisions about the determinants of mental health, in addition to considering the therapeutic perspective, we should have a systemic or contextual view of the determinants of mental health.

• Asian Pacific Journal of Cancer Prevention
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• 제15권16호
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• pp.6499-6504
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• 2014

Health information-seeking behavior (HISB) is active need-fulfillment behavior whereby health information is obtained from diverse sources, such as the media, and has emerged as an important issue within the transforming medical environment and the rise of medical consumers. However, little is known about the factors that affect HISB and its associations, and the health outcome of HISB. The aim of this study was to examine individual and social contextual factors associated with HISB and to systematically review their effects on health status among post-treatment cancer patients. Individual determinants of HISB included demographic factors, psychosocial factors, perceived efficacy and norms, and health beliefs. Contextual determinants of HISB encompassed community characteristics, neighborhood social capital, and media advocacy. Improving through factors on these two levels, HISB raised individuals' self-care management skills and medical treatment compliance, and enhanced shared decision-making and medical treatment satisfaction. Moreover, because HISB can differ according to individuals' social contextual conditions, it can give rise to communication inequalities. Because these can ultimately lead to health disparities between groups, social interest in HISB and balanced HISB promotion strategies are necessary.

• Human Ecology Research
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• 제54권5호
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• pp.515-527
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• 2016

This study investigated social determinants and their interaction effects on the health of school-aged children in diverse environmental factors pertaining to the individual, family, and peers from an ecological systematic perspective. Data were drawn from the first wave of the Korean Children and Youth Panel Survey (KCYPS) developed by the National Youth Policy Institute and conducted in 2010. Data were analyzed by descriptive statistics, Cronbach ${\alpha}$, correlation, and hierarchical regression analysis using SPSS ver. 18. The results from this study showed that sex and age were related to the health of school-aged children, as social determinants. Self-rated levels of the health of boys and younger children were more positive than girls and older children; in addition, levels of self-resilience, satisfaction of peer relation, and parenting rearing attitude were found to have a positive impact on self-rated levels of the health of school-aged children as protective factors. Especially, according to the result of interaction analysis between factors, self-resilience, and parenting rearing attitude were moderators of the effects on between sex and household income and self-rated level of the health of school-aged children respectively. The findings from this study suggested the need to expand the social intervention range to improve school-aged children's health.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.311-316
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• 2016

Breast cancer is one of the most common causes of cancer mortality in Iran. Social determinants of health are among the key factors affecting the pathogenesis of diseases. This cross-sectional study aimed to determine the social determinants of breast cancer survival time with parametric and semi-parametric regression models. It was conducted on male and female patients diagnosed with breast cancer presenting to the Cancer Research Center of Shohada-E-Tajrish Hospital from 2006 to 2010. The Cox proportional hazard model and parametric models including the Weibull, log normal and log-logistic models were applied to determine the social determinants of survival time of breast cancer patients. The Akaike information criterion (AIC) was used to assess the best fit. Statistical analysis was performed with STATA (version 11) software. This study was performed on 797 breast cancer patients, aged 25-93 years with a mean age of 54.7 (${\pm}11.9$) years. In both semi-parametric and parametric models, the three-year survival was related to level of education and municipal district of residence (P<0.05). The AIC suggested that log normal distribution was the best fit for the three-year survival time of breast cancer patients. Social determinants of health such as level of education and municipal district of residence affect the survival of breast cancer cases. Future studies must focus on the effect of childhood social class on the survival times of cancers, which have hitherto only been paid limited attention.

• 지역사회간호학회지
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• 제25권4호
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• pp.237-247
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• 2014

Purpose: The purpose of this study was to examine the social determinants of health (SDH) associated with health-related quality of life (HQOL) among the community-dwelling elderly, based on the conceptual framework of the Commission on Social Determinants of Health (CSDH). Methods: A survey was conducted with 199 elders aged 65 years or older sampled through convenient sampling. Data were collected through face to face interviews by trained interviewers using a structured questionnaire, which included scales of the residential area, social support, sense of community, social network, health behaviors, and HQOL. Data were analyzed by ANOVA and stepwise multivariate regression. Results: Major SDH affecting HQOL included the participants' residential area, sense of community, and health behavior. The HQOL of the elderly residing in the B area with a low rate of basic livelihood security recipients was higher than that of those residing in other areas. Conclusion: CSDH framework was useful to determine the factors associated with HQOL among the community-dwelling elderly. In addition to their health behavior, their sense of community was found to be a SDH of HQOL, indicating the need of health promotion programs tailored to the characteristics of residential areas and strategies to enhance involvement in community activities.

• Journal of Preventive Medicine and Public Health
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• 제55권2호
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• pp.144-152
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• 2022

Objectives: This study aimed to identify the social and policy determinants of coronavirus disease 2019 (COVID-19) infection across 23 countries. Methods: COVID-19 indicators (incidence, mortality, and fatality) for each country were calculated by direct and indirect standardization. Multivariable regression analyses were used to identify the social and policy determinants of COVID-19 infection. Results: A higher number of doctors per population was related to lower incidence, mortality, and fatality rates of COVID-19 in 23 countries (β=-0.672, -0.445, and -0.564, respectively). The number of nurses/midwives per population was associated with lower mortality and fatality rates of COVID-19 in 23 countries (β=-0.215 and -0.372, respectively). Strengthening of policy restriction indicators, such as restrictions of public gatherings, was related to lower COVID-19 incidence (β=-0.423). A national Bacillus Calmette-Guérin vaccination policy conducted among special groups or in the past was associated with a higher incidence of COVID-19 in 23 countries (β=0.341). The proportion of the elderly population (aged over 70 years) was related to higher mortality and fatality rates (β=0.209 and 0.350, respectively), and income support was associated with mortality and fatality rates (β=-0.362 and -0.449, respectively). Conclusions: These findings do not imply causality because this was a country-based correlation study. However, COVID-19 transmission can be influenced by social and policy determinants such as integrated health systems and policy responses to COVID-19. Various social and policy determinants should be considered when planning responses to COVID-19.

• 보건행정학회지
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• 제18권2호
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• pp.130-156
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• 2008

This review paper is to provide theoretical background and empirical evidence for gender sensitive health policy in Korea. We explore how sex and gender are implicated in health disparities. After reviewing major concepts regarding sex, gender, and health, the study moves on to describe the ways in which gender interacts with other social determinants (socioeconomic position, workplace, stress, social support, and violation) to show disparate health outcomes. Next, suggested health models considering gender and social process are introduced. The article concludes by suggesting the necessity of gender sensitive policy consorted with social programs in tackling health equity.

• 보건교육건강증진학회지
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• 제22권3호
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• pp.13-28
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• 2005

Objectives: The purpose of this paper is to describe the role for public education in mental health promotion, prevention of mental illness and treatment of mental disorders in Canada. Results: A brief history of the changing nature of the way we treat mental disorders in Canada argues for an increasingly critical role for public education. Furthermore, the new understanding of the role of social determinants in prevention of mental illness again necessitates a vital role for public education as the shift in focus moves from exclusively individual-focused health care treatments to creating supportive environments. The roles for mental health public education then become: advocacy for the social determinants of health approach, better understanding of the nature of mental health problems, useful information for self-management, and more knowledge about appropriate treatments. A brief discussion of the structure of the response in Canada provides an overview of national and provincial responsibilities in mental health care with a case study highlighting one community's response to addressing mental disorders. Conclusion : Finally, challenges regarding the most effective educators and the issue of professional expertise embedded in the status quo are discussed.