Social determinants of health interfere significantly in the health-disease process. This article examines the impact of these determinants on the main pathologies addressed by the internist and the family doctor in medical care. The World Health Organization defines social determinants of health (SDH) as the circumstances in which people are born, grow, work, live and age, including the broader set of forces and systems that influence conditions of daily life. These forces and systems include economic policies and systems, development programs, social norms and policies, and political systems. The above conditions can be very different for various subgroups of a population and can lead to differences in health outcomes. It may be unavoidable that some of these conditions are different, which is considered inequalities. These social determinants influence and modify the development and course of the disease. In the pathologies exposed in this review, we found that adequate management involves a sizeable non-pharmacological component that refers to intervention in eating habits, healthy living, management of traditional cardiovascular risk factors, and monitoring disease activity. In support of the evidence, we review several meta-analyses of observational studies that allow us to infer what is the significant impact of the social determinants of health in the control or exacerbation of the pathologies described and how we can positively interfere in their evolution and outcome of disease through increasingly effective comprehensive interventions according to the current evidence described. Major social determinants include access to health care, economic mobility, affordable housing, and safe learning environments for children. Based on an extensive review of the evidence, several reports recommend maintaining policies at the federal and state levels to improve health outcomes, promote health equity, and reduce health care spending associated with increased cardiovascular risk. It is estimated that nearly half of all Americans are at high cardiovascular risk, and this number is increasing. Furthermore, the COVID-19 pandemic has demonstrated the extent to which socioeconomic conditions and inequalities significantly affect the health and burdens of specific population groups.
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Global Public Health Policies and Epidemiology
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FuenteJournal of Cardiology & Cardiovascular Therapy