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健康的社会决定因素、健康差距和肥胖。

Social determinants of health, health disparities, and adiposity.

机构信息

Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bldg 10-CRC, 5-5330, 10 Center Drive, Bethesda, MD 20892, USA.

Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bldg 10-CRC, 5-5330, 10 Center Drive, Bethesda, MD 20892, USA; Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD 20892, USA.

出版信息

Prog Cardiovasc Dis. 2023 May-Jun;78:17-26. doi: 10.1016/j.pcad.2023.04.011. Epub 2023 May 11.

Abstract

Social determinants of health (SDoH), or the socioeconomic, environmental, and psychosocial conditions in which individuals spend their daily lives, substantially influence obesity as a cardiovascular disease (CVD) risk factor. The coronavirus disease 2019 (COVID-19) pandemic highlighted the converging epidemics of obesity, CVD, and social inequities globally. Obesity and CVD serve as independent risk factors for COVID-19 severity and lower-resourced populations most impacted by adverse SDoH have the highest COVID-19 mortality rates. Better understanding the interplay between social and biologic factors that contribute to obesity-related CVD disparities are important to equitably address obesity across populations. Despite efforts to investigate SDoH and their biologic effects as drivers of health disparities, the connections between SDoH and obesity remain incompletely understood. This review aims to highlight the relationships between socioeconomic, environmental, and psychosocial factors and obesity. We also present potential biologic factors that may play a role in the biology of adversity, or link SDoH to adiposity and poor adipo-cardiology outcomes. Finally, we provide evidence for multi-level obesity interventions targeting multiple aspects of SDoH. Throughout, we emphasize areas for future research to tailor health equity-promoting interventions across populations to reduce obesity and obesity-related CVD disparities.

摘要

社会决定因素(SDoH),或个人日常生活所处的社会经济、环境和心理社会条件,对肥胖作为心血管疾病(CVD)的一个风险因素有很大影响。2019 年冠状病毒病(COVID-19)大流行突显了肥胖、CVD 和社会不平等在全球范围内的交织流行。肥胖和 CVD 是 COVID-19 严重程度的独立危险因素,而受不利社会决定因素影响最大的资源较少的人群 COVID-19 死亡率最高。更好地了解导致肥胖相关 CVD 差异的社会和生物因素之间的相互作用,对于在各人群中公平地解决肥胖问题非常重要。尽管人们努力研究 SDoH 及其作为健康差异驱动因素的生物学效应,但 SDoH 与肥胖之间的联系仍不完全清楚。这篇综述旨在强调社会经济、环境和心理社会因素与肥胖之间的关系。我们还提出了一些潜在的生物学因素,这些因素可能在逆境生物学中发挥作用,或把 SDoH 与肥胖和不良的脂肪心脏病学结果联系起来。最后,我们提供了针对 SDoH 多个方面的多层次肥胖干预措施的证据。整篇文章强调了未来研究的领域,以便根据各人群的情况调整促进健康公平的干预措施,以减少肥胖和肥胖相关 CVD 差异。

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