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利用综合征理论理解食物不安全与饮食相关的慢性疾病。

Using syndemic theory to understand food insecurity and diet-related chronic diseases.

机构信息

Department of Anthropology, University of South Florida, 4202 E. Fowler Avenue, SOC 107, Tampa, FL, USA; USF Center for the Advancement of Food Security & Healthy Communities, University of South Florida, 4202 E. Fowler Avenue, SOC 107, Tampa, FL, USA.

Department of Anthropology, University of South Florida, 4202 E. Fowler Avenue, SOC 107, Tampa, FL, USA; USF Center for the Advancement of Food Security & Healthy Communities, University of South Florida, 4202 E. Fowler Avenue, SOC 107, Tampa, FL, USA.

出版信息

Soc Sci Med. 2022 Feb;295:113124. doi: 10.1016/j.socscimed.2020.113124. Epub 2020 Jun 15.

Abstract

Syndemic Theory (ST) provides a framework to examine mutually enhancing diseases/health issues under conditions of social inequality and inequity. ST has been used in multiple disciplines to address interacting infectious diseases, noncommunicable diseases, and mental health conditions. The theory has been critiqued for its inability to measure disease interactions and their individual and combined health outcomes. This article reviews literature that strongly suggests a syndemic between food insecurity (FI) and diet-related chronic diseases (DRCDs), and proposes a model to measure the extent of such interaction. The article seeks to: (1) examine the potential syndemic between FI and DRCDs; (2) illustrate how the incorporation of Life History Theory (LHT), into a syndemic framework can help to highlight critical lifeperiods when FI-DRCD interactions result in adverse health outcomes; (3) discuss the use of mixed methods to identify and measure syndemics to enhance the precision and predictive power of ST; and (4) propose an analytical model for the examination of the FI-DRCD syndemic through the life course. The proposed model is more relevant now given the significant increase in FI globally as a result of the ongoing COVID-19 pandemic. The differential impact that the pandemic appears to have among various age groups and by other demographic factors (e.g., race, gender, income) offers an opportunity to examine the potential FI-DRCD syndemic under the lens of LHT.

摘要

综合征理论(Syndemic Theory,ST)提供了一个框架,用于在社会不平等和不公平的条件下检查相互增强的疾病/健康问题。该理论已在多个学科中得到应用,以解决相互作用的传染病、非传染性疾病和心理健康状况。该理论因无法衡量疾病之间的相互作用及其对个人和综合健康的影响而受到批评。本文回顾了大量文献,这些文献强烈表明了食物不安全(Food Insecurity,FI)和与饮食相关的慢性疾病(Diet-related Chronic Diseases,DRCD)之间存在综合征,并且提出了一种衡量这种相互作用程度的模型。本文旨在:(1)研究 FI 和 DRCD 之间存在综合征的可能性;(2)说明将生活史理论(Life History Theory,LHT)纳入综合征框架如何有助于突出 FI-DRCD 相互作用导致不良健康结果的关键生命期;(3)讨论使用混合方法识别和衡量综合征,以提高 ST 的精确性和预测能力;(4)提出一个分析模型,通过生命历程研究 FI-DRCD 综合征。由于 COVID-19 大流行导致全球 FI 显著增加,因此该模型更具现实意义。大流行对不同年龄组和其他人口统计因素(如种族、性别、收入)的影响存在差异,这为从 LHT 的角度研究潜在的 FI-DRCD 综合征提供了机会。

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