Nafiseh Salehnia, Abbas Assari Arani, Alireza Olyaeemanesh, Hossein Sadeghi Saghdel
{"title":"伊朗健康的社会决定因素之间的因果关系分析:使用模糊认知图。","authors":"Nafiseh Salehnia, Abbas Assari Arani, Alireza Olyaeemanesh, Hossein Sadeghi Saghdel","doi":"10.34172/jrhs.2022.101","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Health is a fundamental issue in recent years, highlighting the importance of harmonizing the policies of any sector with health strategies. The present study aims to identify the socio-economic factors affecting health and to provide a cognitive map of the social determinants of health in Iran.</p><p><strong>Study design: </strong>A retrospective cohort study.</p><p><strong>Methods: </strong>This study follows a developmental process with an exploratory sequential mixed methods approach. First, a meta-synthesis qualitative method determines the most critical health determinants by reviewing 54 studies from 2000 to 2019. Then, the fuzzy cognitive map (FCM) is drawn based on interviews with six experts to derive the causal relationships among the social determinants of population health in Iran.</p><p><strong>Results: </strong>Stage 1 introduces 170 factors as the health determinants, classified into four levels: individual, local, national, and global levels, with 7, 4, 13, and 3 branches, respectively. According to the causal relationships and the out-degree (od) index, the most effective factors are the economic system (18.24), governance and policy-making (17.13), and national policies (16.93). According to the degree of centrality, these factors are the economic system (33.27), health system (30.37), and governance and policy-making (30.15).</p><p><strong>Conclusion: </strong>Considering health as a complex and comprehensive system, the resulting FCM displays that the policies developed in other sectors than health are profoundly affecting population's health in Iran. Specifically, the comparative analysis of this research shows that policies regarding the economic system and people's livelihood are more effective than the policies regarding the health system itself on the population's health in Iran.</p>","PeriodicalId":17164,"journal":{"name":"Journal of research in health sciences","volume":"22 4","pages":"e00566"},"PeriodicalIF":1.4000,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10422161/pdf/","citationCount":"0","resultStr":"{\"title\":\"Analysis of Casual Relationships between Social Determinants of Health in Iran: Using Fuzzy Cognitive Map.\",\"authors\":\"Nafiseh Salehnia, Abbas Assari Arani, Alireza Olyaeemanesh, Hossein Sadeghi Saghdel\",\"doi\":\"10.34172/jrhs.2022.101\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Health is a fundamental issue in recent years, highlighting the importance of harmonizing the policies of any sector with health strategies. The present study aims to identify the socio-economic factors affecting health and to provide a cognitive map of the social determinants of health in Iran.</p><p><strong>Study design: </strong>A retrospective cohort study.</p><p><strong>Methods: </strong>This study follows a developmental process with an exploratory sequential mixed methods approach. First, a meta-synthesis qualitative method determines the most critical health determinants by reviewing 54 studies from 2000 to 2019. Then, the fuzzy cognitive map (FCM) is drawn based on interviews with six experts to derive the causal relationships among the social determinants of population health in Iran.</p><p><strong>Results: </strong>Stage 1 introduces 170 factors as the health determinants, classified into four levels: individual, local, national, and global levels, with 7, 4, 13, and 3 branches, respectively. According to the causal relationships and the out-degree (od) index, the most effective factors are the economic system (18.24), governance and policy-making (17.13), and national policies (16.93). According to the degree of centrality, these factors are the economic system (33.27), health system (30.37), and governance and policy-making (30.15).</p><p><strong>Conclusion: </strong>Considering health as a complex and comprehensive system, the resulting FCM displays that the policies developed in other sectors than health are profoundly affecting population's health in Iran. Specifically, the comparative analysis of this research shows that policies regarding the economic system and people's livelihood are more effective than the policies regarding the health system itself on the population's health in Iran.</p>\",\"PeriodicalId\":17164,\"journal\":{\"name\":\"Journal of research in health sciences\",\"volume\":\"22 4\",\"pages\":\"e00566\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2022-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10422161/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of research in health sciences\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.34172/jrhs.2022.101\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of research in health sciences","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.34172/jrhs.2022.101","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Analysis of Casual Relationships between Social Determinants of Health in Iran: Using Fuzzy Cognitive Map.
Background: Health is a fundamental issue in recent years, highlighting the importance of harmonizing the policies of any sector with health strategies. The present study aims to identify the socio-economic factors affecting health and to provide a cognitive map of the social determinants of health in Iran.
Study design: A retrospective cohort study.
Methods: This study follows a developmental process with an exploratory sequential mixed methods approach. First, a meta-synthesis qualitative method determines the most critical health determinants by reviewing 54 studies from 2000 to 2019. Then, the fuzzy cognitive map (FCM) is drawn based on interviews with six experts to derive the causal relationships among the social determinants of population health in Iran.
Results: Stage 1 introduces 170 factors as the health determinants, classified into four levels: individual, local, national, and global levels, with 7, 4, 13, and 3 branches, respectively. According to the causal relationships and the out-degree (od) index, the most effective factors are the economic system (18.24), governance and policy-making (17.13), and national policies (16.93). According to the degree of centrality, these factors are the economic system (33.27), health system (30.37), and governance and policy-making (30.15).
Conclusion: Considering health as a complex and comprehensive system, the resulting FCM displays that the policies developed in other sectors than health are profoundly affecting population's health in Iran. Specifically, the comparative analysis of this research shows that policies regarding the economic system and people's livelihood are more effective than the policies regarding the health system itself on the population's health in Iran.
期刊介绍:
The Journal of Research in Health Sciences (JRHS) is the official journal of the School of Public Health; Hamadan University of Medical Sciences, which is published quarterly. Since 2017, JRHS is published electronically. JRHS is a peer-reviewed, scientific publication which is produced quarterly and is a multidisciplinary journal in the field of public health, publishing contributions from Epidemiology, Biostatistics, Public Health, Occupational Health, Environmental Health, Health Education, and Preventive and Social Medicine. We do not publish clinical trials, nursing studies, animal studies, qualitative studies, nutritional studies, health insurance, and hospital management. In addition, we do not publish the results of laboratory and chemical studies in the field of ergonomics, occupational health, and environmental health