سلامت و عوامل اجتماعي تعيين‌كننده آن: مطالعه‌اي بر روي نابرابري‏هاي سطوح سلامت بين شهروندان تبريزي

Social Determinants of Health: A Study on Health Inequalities AmongTabriz Citizens

سلامت افراد در جامعه تحت تاثير متغيرهاي محيطي، اقتصادي و اجتماعي قرار مي‌گيرد. بر اين مبنا، توجه به آگاهي‌هاي بهداشتي افراد، سواد سلامتي، حمايت‌هاي اجتماعي و سبك زندگي در كنار مولفه‌هايي، مانند: سواد، وضعيت اقتصادي، نوع اشتغال، شرايط محيطي زندگي و بسياري مولفه‌هاي اقتصادي – اجتماعي ديگر در تبيين وضعيت سلامتي افراد جامعه مورد توجه قرار گرفته است و اين مطالعه تلاشي در تداوم فعاليت‏هاي علمي جامعه‌شناسان در زمينه تبيين نابرابري‏هاي سطوح سلامت بين افراد با اتكا به عوامل اجتماعي است. مطالعه حاضر بر روي 650 نفر از والدين خانوارهاي تبريزي صورت گرفته است كه با روش نمونه‌گيري چند مرحله‌اي انتخاب شده‌اند. نتايج مطالعه نشان مي‌دهد كه مردان از سطح سلامتي بالاتري در مقايسه با زنان برخوردارند؛ به گونه‏اي كه در يك مقياس 100امتياز نمره سلامت مردان 7/75 و زنان 5/71 به دست آمده است و افراد داراي سطح تحصيلات بالا، داراي نمرات سلامتي بالاتري در مقايسه با افرادي هستند كه از نظر وضعيت تحصيلي پايين‌تر از آنها قرار دارند. همچنين، مطالعه به نتايج متقني در زمينه تاثير آگاهي‌هاي بهداشتي، سواد سلامتي، سبك زندگي و حمايت اجتماعي بر سطح سلامت شهروندان دست يافت .

Introduction Health is one of the important needs of humanity. Healthy peoples can perform social roles completely and in competition with others can obtain good positions. For this reasons attention to health and its distribution is one of the most interesting fields of sociology .Because it is related to social justice and good governance in all societies. On the other hand health inequalities there are in all societies and countries. New studies show that the inequalities in health distribution deepened in recent years among different groups of peoples inside countries and among poor and reach countries. These observations and scientific facts confronts sociologist with very important and basic question. What are the reasons of these health inequalities? After World War II, sociologist interred to medical institutions and universities and studied health problems in order to answer the recent important question. They stated that if health, illness and disease were entirely biological in origin then we would expect the incidence to be similar across geographical locations and social groupings. However this is not the case and the social patterns of health provides evidence that disease and illness do not affect all sectors of society equally. Methods and Materials This study examines the impact of social factors on health Inequalities among residents of urban areas in the city of Tabriz. environmental, social and economic variables considered as independent variables that affect health status of people in the community. Therefore, attention to the peopleʹs health awareness, education, health literacy, social support and life style along with other variables such as education, socio-economic status, work and living conditions should be considered in explaining health status of population .This study is an effort towards continuity of sociologists research activities in explaining health inequalities among peoples, and was conducted on 650 families’ households, living in Tabriz. The research method is survey and citizens among 15-65 years old studied in this research .The main research question is whether social factors can influence physical health outcomes, mental and individual perceptions of health status in Tabriz citizens. Answering to this question performed through 4 assumptions. In these assumptions social factors , Demographic factors and life style considered as independent variables and that’s effect on health examined with using appropriate statistical methods. Health as a dependent variable measured through sf36 questionnaire that known as health related quality of life questionnaire. Sf36 measured health in 8 dimensions , 4 dimensions for physical health and 4 dimensions for mental health. Discussion of Results and Conclusions The results of this studyshowed that, compared to women, men have higher levels of health scores (75/7 vs. 71/5), and peoples with high education have health scores higher than those with law education. This research concludes the effectiveness of health awareness, education, healthy lifestyle and social protection of citizens on their health. Also in this study an indirect and powerful correlation observed among age and health related quality of life. This result shows that aging is a very important variable in health status of people and especially aged people have very mental health problems. In other hand there were very significant difference between men and women in mental health scores and women have very bad condition in this variable. The results of this study showed the importance of social factors in health inequalities among Tabriz citizens .As a result attention to social factors and attempt to diminishing or decreasing of social and economic inequalities and discriminations in society can led to best conditions in health of people and is a best way to create a healthy and vital society.