Department of Social Welfare, School of Education Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Int J Equity Health. 2018 Jan 22;17(1):10. doi: 10.1186/s12939-018-0724-1.
According to the recommendations of the World Health Organization Commission On Social Determinants of Health (CSDH) for intersectoral action on health, the well-being of and equity in health within a population are achieved via a complex fusion of policies and actions. In this study, following the CSDH's approach and considering set-theoretic relations, we aimed to unravel this complexity and answer the kinds of questions that are outside the scope of conventional variable-oriented approach.
A fuzzy-set qualitative comparative analysis of 131 countries was conducted to examine the configurational effects of five macro-level structural conditions on life expectancy at birth. The potential causal conditions were level of country wealth, income inequality, quality of governance, education, and health system. The data collected from different international data sources were recorded during 2004-2015.
The intermediate solution of the truth table analysis indicated a configuration of conditions including high level of governance, education, wealth, and affluent health system to be consistently sufficient for high life expectancy. On the other hand, four configurations, each containing two or three conditions, were consistent with being usually sufficient to cause low life expectancy.
We were able to configurationally explore the cases and specify the combinations of potentially causal conditions which were usually sufficient to explain high or low life expectancy in different countries. As a result, particular cases were identified for further research. In addition, research may provide support for the CSDH's recommendations emphasizing the importance of intersectoral action for health.
根据世界卫生组织社会决定因素健康委员会（CSDH）关于跨部门卫生行动的建议，人口的健康福祉和公平可以通过政策和行动的复杂融合来实现。在这项研究中，我们遵循 CSDH 的方法，并考虑到集合理论关系，旨在揭示这种复杂性，并回答常规变量导向方法范围之外的问题。
对 131 个国家进行模糊集定性比较分析，以检验五种宏观结构条件对出生时预期寿命的配置效应。潜在的因果条件是国家财富水平、收入不平等、治理质量、教育和卫生系统。从不同国际数据源收集的数据记录在 2004-2015 年期间。
真值表分析的中间解表明，包括高水平治理、教育、财富和富裕的卫生系统在内的条件配置对于高预期寿命是一致充分的。另一方面，有四个配置，每个配置包含两个或三个条件，与导致低预期寿命的情况通常一致。
我们能够配置性地探索案例，并指定通常足以解释不同国家高或低预期寿命的潜在因果条件的组合。因此，确定了特定案例进行进一步研究。此外，研究可以为 CSDH 的建议提供支持，强调跨部门行动对健康的重要性。
