Pawar Ajay B, Mohan Palipudi Venkata Trinada Krishna, Bansal Rajkumar K
Department of Community Medicine, SMIMER, Surat, India.
J Urban Health. 2008 Jul;85(4):607-18. doi: 10.1007/s11524-008-9261-3. Epub 2008 Apr 5.
Improving the health of urban residents, particularly those living in slum areas, requires an integrated approach. Appropriate interventions must be based on a well-grounded understanding of health determinants. Social factors are as important as physical factors in determining health status and suggest alternative interventions. Employment, stress, social exclusion, social support, substance use, nutrition, transport, and conditions during childhood are among the most important social determinants of health status identified by the International Center for Health and Society. This paper uses social determinants of health approach to understand morbidity outcomes for people residing in the slums of Surat City, India. To quantify suboptimal health behavior and identify the determinants of health status for this population survey data on household characteristics, health-seeking behavior, socioeconomic status, food and personal habits, social life, and physical activity has been used. After controlling for socioeconomic and demographic factors, logistic regression analysis reveals that social exclusion, stress, and lack of social support are significantly associated with morbidity. Thus, understanding of social determinants of health by policy makers is important as the health sector has a crucial role in addressing disparities in social determinants.
改善城市居民的健康状况，尤其是贫民窟地区居民的健康状况，需要采取综合方法。适当的干预措施必须基于对健康决定因素的充分理解。在决定健康状况方面，社会因素与身体因素同样重要，并提示了其他干预措施。就业、压力、社会排斥、社会支持、物质使用、营养、交通以及童年时期的状况是国际健康与社会中心确定的健康状况最重要的社会决定因素。本文采用健康的社会决定因素方法来了解印度苏拉特市贫民窟居民的发病情况。为了量化次优健康行为并确定该人群健康状况的决定因素，使用了关于家庭特征、就医行为、社会经济地位、饮食和个人习惯、社会生活以及身体活动的调查数据。在控制了社会经济和人口因素后，逻辑回归分析表明，社会排斥、压力和缺乏社会支持与发病显著相关。因此，政策制定者对健康的社会决定因素的理解很重要，因为卫生部门在解决社会决定因素方面的差距方面起着关键作用。
