关于神经疾病中健康的社会决定因素的建议
Amytis Towfighi1, Rachel P Berger2, Alexandra M S Corley2
1From the Departments of Neurology and Population and Public Health Sciences (A.T.), University of Southern California, Los Angeles; Department of Pediatrics (R.P.B.), Children's Hospital of Pittsburgh, University of Pittsburg Medical Center (UPMC), PA; Division of General and Community Pediatrics (A.M.S.C.), Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH; The Center for Health and Community (M.M.G.), University of California, San Francisco; Department of Neurology (J.J.M.), Vagelos College of Physicians and Surgeons, Columbia University, New York; and Department of Neurology (L.S.), Northwestern University, Chicago, IL. towfighi@usc.edu.
健康的社会决定因素 (SDOH) 显著影响神经疾病和结果,但对这些影响的理解是有限的. 需要更多的研究来解决不平等问题,并确定针对不同人群的有效干预措施.
科学领域:
- 神经学 神经学
- 公共卫生 公共卫生
- 健康 公平 卫生 公平
背景情况:
- 健康的社会决定因素 (SDOH) 是神经系统疾病中健康不平等的关键驱动因素.
- 目前对将SDOH与神经疾病联系起来的生物心理社会机制的理解是有限的.
- 现有的研究主要集中在教育和基于地点的SDOH对认知和脑血管疾病的影响上.
研究的目的:
- 突出需要更深入地了解SDOH与神经疾病的复杂相互作用.
- 确定SDOH查工具验证和神经病群数据标准化中的差距.
- 在未来的研究中主张把代表性不足的人群和结构性决定因素放在中心.
主要方法:
- 对SDOH和神经学结果的现有流行病学研究的审查.
- 识别当前SDOH选工具和数据收集方法的局限性.
- 对干预策略的分析,区分个人层面和系统层面的方法.
主要成果:
- 强有力的证据将教育和基于地点的SDOH与认知和脑血管结果联系起来.
- 很少有SDOH查工具被验证用于神经系统疾病群体.
- 研究往往忽视了上游的结构性决定因素,而是专注于下游因素,如健康行为.
结论:
- 进一步的研究对于阐明神经疾病中SDOH机制至关重要.
- 为了进行跨人群比较,需要标准化的数据元素和验证的工具.
- 未来的研究必须优先考虑代表性不足的群体,并调查个人和系统干预措施,以减少神经病结果的不平等.
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