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。

IF 1.4 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of research in health sciences Pub Date : 2022-12-01 DOI:10.34172/jrhs.2022.101
Nafiseh Salehnia, Abbas Assari Arani, Alireza Olyaeemanesh, Hossein Sadeghi Saghdel
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引用次数: 0

摘要

背景:卫生是近年来的一个基本问题,突出了使任何部门的政策与卫生战略相协调的重要性。本研究旨在确定影响健康的社会经济因素,并提供伊朗健康社会决定因素的认知地图。研究设计:回顾性队列研究。方法:本研究遵循探索性顺序混合方法的发展过程。首先,通过回顾2000年至2019年的54项研究,采用综合定性方法确定了最关键的健康决定因素。然后,根据与六位专家的访谈,绘制模糊认知图(FCM),以得出伊朗人口健康的社会决定因素之间的因果关系。结果:第一阶段将170个因素作为健康决定因素,分为个人、地方、国家和全球四个层次,分别有7个、4个、13个和3个分支。从因果关系和出度指数来看,最有效的因素是经济体制(18.24)、治理与政策制定(17.13)和国家政策(16.93)。根据中心性程度,这些因素分别是经济系统(33.27)、卫生系统(30.37)和治理与决策(30.15)。结论:考虑到卫生是一个复杂而全面的系统,由此产生的FCM表明,在卫生以外的其他部门制定的政策正在深刻影响伊朗人口的健康。具体而言,本研究的对比分析表明,在伊朗,经济制度和民生政策比卫生制度本身的政策对人口健康更有效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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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.

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来源期刊
Journal of research in health sciences
Journal of research in health sciences PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
2.30
自引率
13.30%
发文量
7
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
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