Williams Edith M, Ortiz Kasim, Browne Teri
Institute for Partnerships to Eliminate Health Disparities, Arnold School of Public Health, University of South Carolina, 220 Stoneridge Drive, Suite 103, Columbia, SC 29210, USA.
College of Social Work, University of South Carolina, Columbia, SC 29208, USA.
Int J Chronic Dis. 2014;2014:361792. doi: 10.1155/2014/361792. Epub 2014 Jan 5.
Systemic lupus erythematosus (SLE) is a chronic inflammatory rheumatic disease that disproportionately affects African Americans and other minorities in the USA. Public health attention to SLE has been predominantly epidemiological. To better understand the effects of this cumulative disadvantage and ultimately improve the delivery of care, specifically in the context of SLE, we propose that more research attention to the social determinants of SLE is warranted and more transdisciplinary approaches are necessary to appropriately address identified social determinants of SLE. Further, we suggest drawing from the chronic care model (CCM) for an understanding of how community-level factors may exacerbate disparities explored within social determinant frameworks or facilitate better delivery of care for SLE patients. Grounded in social determinants of health (SDH) frameworks and the CCM, this paper presents issues relative to accessibility to suggest that more transdisciplinary research focused on the role of place could improve care for SLE patients, particularly the most vulnerable patients. It is our hope that this paper will serve as a springboard for future studies to more effectively connect social determinants of health with the chronic care model and thus more comprehensively address adverse health trajectories in SLE and other chronic conditions.
系统性红斑狼疮（SLE）是一种慢性炎症性风湿性疾病，在美国，非洲裔美国人和其他少数族裔受其影响的比例过高。公共卫生对SLE的关注主要集中在流行病学方面。为了更好地理解这种累积性不利因素的影响，并最终改善医疗服务的提供，特别是在SLE的背景下，我们认为有必要对SLE的社会决定因素进行更多的研究关注，并且需要更多的跨学科方法来妥善解决已确定的SLE社会决定因素。此外，我们建议借鉴慢性病护理模式（CCM），以了解社区层面的因素如何在社会决定因素框架内加剧差异，或促进为SLE患者提供更好的医疗服务。基于健康的社会决定因素（SDH）框架和CCM，本文提出了与可及性相关的问题，以表明更多关注场所作用的跨学科研究可以改善对SLE患者的护理，尤其是最脆弱的患者。我们希望本文将成为未来研究的跳板，以便更有效地将健康的社会决定因素与慢性病护理模式联系起来，从而更全面地应对SLE和其他慢性病中的不良健康轨迹。
