[Equity and social determinants of health over the life course].

Innere Medizin (Heidelberg, Germany) Pub Date : 2024-10-01 Epub Date: 2024-09-10 DOI:10.1007/s00108-024-01771-7
Franz Kolland, Rebekka Rohner
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Abstract

Background: Socio-structural and socio-cultural change in Western societies is increasingly challenging healthcare institutions to take good care of people's health and dignity. Further and sustainable progress in health care is increasingly influenced by socio-cultural conditions. If these conditions are insufficiently taken into account, further medical progress is jeopardized.

Aim of the paper: The aim of this paper is to elucidate the significance of social conditions of health over the life course and thus to shed more light on one of the four ethical principles in medicine, namely equity.

Material: The question is addressed by a literature review, whereby the literature was reviewed from a structural theory perspective.

Results: If people feel discriminated against in terms of their age, gender, or migration background, this not only has an impact on their self-esteem, but also on their health and recovery from illness. Unfavorable economic living conditions have a negative impact on health behavior. Experiences of discrimination in the healthcare system can reduce satisfaction with treatment and contribute to non-compliance with treatment instructions.

Discussion: The socio-cultural effects mentioned above can be influenced not only by individual changes in behavior but in particular by structural and institutional change processes. There is a need for "habitus sensitivity" in both clinical and private practice, i.e., it is also part of the responsibility of doctors in the healthcare system to eliminate discrimination.

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[生命过程中的公平和健康的社会决定因素]。
背景:西方社会的社会结构和社会文化变革正日益挑战医疗保健机构对人们的健康和尊严的关爱。医疗保健的进一步和可持续发展越来越受到社会文化条件的影响。如果不充分考虑这些条件,医疗的进一步发展就会受到损害:本文旨在阐明生命过程中健康的社会条件的重要性,从而进一步阐明医学四大伦理原则之一,即公平原则:材料:本文通过文献综述来探讨这一问题,从结构理论的角度对文献进行了综述:结果:如果人们感到在年龄、性别或移民背景方面受到歧视,这不仅会影响他们的自尊,还会影响他们的健康和疾病康复。不利的经济生活条件会对健康行为产生负面影响。在医疗系统中遭受歧视的经历会降低对治疗的满意度,并导致不遵守治疗指示:上述社会文化影响不仅会受到个人行为变化的影响,而且尤其会受到结构和制度变革过程的影响。临床和私人诊所都需要 "习惯敏感性",也就是说,消除歧视也是医疗系统中医生的责任之一。
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