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Salud Pública

Yiqi Zhu1, Jean-Francois Trani2,3, Alexis I B Walker1

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PubMed
Resumen
Este resumen es generado por máquina.

Los determinantes estructurales y sociales de la salud (S/SDOH) impactan significativamente los trastornos del estado de ánimo y el deterioro cognitivo en adultos mayores negros. La discriminación y las dificultades son factores clave, lo que subraya la necesidad de iniciativas de justicia social junto con avances médicos.

Palabras clave:
determinantes sociales de la saludsalud públicajusticia socialenvejecimientosalud mentaldisparidades en saludadultos mayores negrosdiscriminaciónracismotrastornos del estado de ánimodeterioro cognitivo

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Área de la Ciencia:

  • Gerontología
  • Salud Pública
  • Disparidades en Salud

Sus antecedentes:

  • Los adultos negros de mediana edad y mayores presentan mayores riesgos de trastornos del estado de ánimo y deterioro cognitivo en comparación con los blancos no hispanos.
  • Los determinantes estructurales y sociales de la salud (S/SDOH) influyen significativamente en los resultados de salud, sin embargo, su intersección con los trastornos del estado de ánimo en este grupo demográfico está poco estudiada.
  • La investigación existente a menudo utiliza medidas de S/SDOH limitadas o agregadas, lo que requiere un enfoque más granular.

Objetivo del estudio:

  • Examinar la relación entre los trastornos del estado de ánimo (depresión y ansiedad), el deterioro cognitivo y los S/SDOH en adultos mayores negros.
  • Utilizar una medida novedosa de S/SDOH basada en el Marco de Investigación sobre Disparidades en Salud del Instituto Nacional sobre el Envejecimiento a nivel individual y del hogar.
  • Identificar factores específicos de S/SDOH que contribuyen a los trastornos del estado de ánimo y al deterioro cognitivo dentro de esta población.

Principales métodos:

  • Análisis de datos de referencia de 312 participantes negros mayores de 45 años en la región metropolitana de St. Louis.
  • Construcción de un índice compuesto de S/SDOH (S/SDOH-CI) para evaluar la privación y los factores de riesgo.
  • Medición de la depresión (PHQ-9), la ansiedad (GAD-7) y la función cognitiva (MoCA, PACC).

Principales resultados:

  • Un aumento de 1 DE en la carga de privación se asoció con 3,12 veces más probabilidades de síntomas de trastornos del estado de ánimo.
  • Las dificultades/estresores diarios (17%) y la discriminación (11%) fueron los principales contribuyentes a los trastornos del estado de ánimo, superando el impacto de la educación (10,67%).
  • El racismo surgió como un impulsor significativo de las inequidades en salud, afectando particularmente a los hombres negros.

Conclusiones:

  • Los hallazgos resaltan el papel crítico de los S/SDOH, especialmente la discriminación y las dificultades, en la exacerbación de los trastornos del estado de ánimo en adultos mayores negros.
  • El S/SDOH-CI identificó eficazmente las diferencias dentro del grupo y los factores específicos de riesgo/resiliencia.
  • Los enfoques integrados que combinan avances médicos con iniciativas de justicia social son cruciales para abordar las inequidades en salud.