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СОЦИАЛЬНЫЕ ДЕТЕРМИНАНТЫ ЗДОРОВЬЯ КАК МЕТОДОЛОГИЧЕСКАЯ ОСНОВА ДЛЯ РАЗРАБОТКИ СТРАТЕГИЙ ПО УЛУЧШЕНИЮ ОБЩЕСТВЕННОГО ЗДОРОВЬЯ: ЗАРУБЕЖНЫЙ ОПЫТ И УРОКИ ДЛЯ РОССИИ
Significance. Analyzing the complex impact of social determinants on population health is extremely important for methodological development of strategies on public health improvement.
The purpose of the study was to develop recommendations on incorporating social determinants of health into the strategy development methodology for public health improvement.
Material and methods. Desk research: analysis of foreign and Russian scientific literature related to the introduction of the term “social determinants of health” as a methodological basis for developing strategies on public health improvement on the basis of international research (the search was conducted against Scopus and Pubmed online databases using the keyword “social determinants of health”). An online quantitative survey and 2 focus groups were conducted as well.
Results. Social determinants of health refer to broad categories of causes, factors and resources that have a direct and indirect impact on public health. The components of the social determinants of public health include economic stability in society, access to education, infrastructure and living environment, as well as a social context and inclusiveness of society in which people live. Taking into account the impact of social determinants on public health in planning and delivering medical services is still a novelty in the medical scientific discourse as well as care delivery practice in our country. The study results indicate a high potential of using the term “social determinants of public health” as a methodological basis for developing strategies to improve public health and show that health managers and doctors can have a greater influence on access to health services and educational information in the field of public health, as well as norms and values of society that contribute to a widespread and cultural imprinting of behavioral practices related to health maintenance. There is a lack of high quality, multidimensional and comprehensive screening tools for social determinants of public health. In this regard, there is a need to develop a new integral indicator “the index of quality evaluation of social determinants” to be introduced into the practice of public health evaluation.
Scope of application. The authors propose recommendations for health authorities and attending physicians to develop strategies on improving public health, with due regard to the social construct of “social determinants of health”.