DeGroote School of Business, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4M4, Canada.
Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, Ontario M5T 3M7, Canada.
Health Promot Int. 2023 Dec 1;38(6). doi: 10.1093/heapro/daad165.
Reducing disease prevalence rather than promoting health has long been the objective of significant population health initiatives, such as the social determinants of health (SDH) framework. However, empirical evidence suggests that people with diagnosed diseases often answer the self-reported health (SRH) question positively. In pursuit of a better proxy to understand, measure and improve health, this scoping review of reviews examines the potential of SRH to be used as an outcome of interest in population health policies. Following PRISMA-ScR guidelines, it synthesizes findings from 77 review papers (published until 11 May 2022) and reports a robust association between SDH and SRH. It also investigates inconsistencies within and between reviews to reveal how variation in population health can be explained by studying the impact of contextual factors, such as cultural, social, economic and political elements, on structural determinants such as socioeconomic situation, gender and ethnicity. These insights provide informed hypotheses for deeper explorations of the role of SDH in improving SRH. The review detects several gaps in the literature. Notably, more evidence syntheses are required, in general, on the pathway from contextual elements to population SRH and, in particular, on the social determinants of adolescents' SRH. This study reports a disease-oriented mindset in collecting, analysing and reporting SRH across the included reviews. Future studies should utilize the capability of SRH in interconnecting social, psychological and biological dimensions of health to actualize its full potential as a central public health measure.
长期以来，降低疾病发病率而非促进健康一直是重大人群健康计划（如社会决定因素健康（SDH）框架）的目标。然而，实证证据表明，患有已确诊疾病的人经常对自我报告的健康（SRH）问题给出肯定的回答。为了寻找更好的替代方法来理解、衡量和改善健康，本次综述回顾性研究审查了 SRH 作为人群健康政策中感兴趣的结果的潜在用途。遵循 PRISMA-ScR 指南，它综合了 77 篇综述论文（截至 2022 年 5 月 11 日发表）的发现，并报告了 SDH 与 SRH 之间存在强有力的关联。它还调查了综述内部和之间的不一致之处，以揭示通过研究文化、社会、经济和政治等因素对社会经济状况、性别和种族等结构决定因素的影响，如何解释人群健康的变化。这些观点为深入探讨 SDH 在改善 SRH 方面的作用提供了有根据的假设。该综述发现文献中有几个空白。值得注意的是，一般来说，需要更多的证据综合来研究从背景因素到人群 SRH 的途径，特别是关于青少年 SRH 的社会决定因素。本研究报告了在纳入的综述中收集、分析和报告 SRH 时存在以疾病为导向的思维模式。未来的研究应利用 SRH 将健康的社会、心理和生物维度相互关联的能力，充分发挥其作为核心公共卫生措施的潜力。
