Prioritizing social determinants of health in East Azerbaijan: a qualitative research
Social Determinants of Health,
Vol. 6 (2020),
14 July 2020
,
Page e17
https://doi.org/10.22037/sdh.v6i1.31725
Abstract
Background: In order to improve health-centered decision making and planning to reduce inequalities in health, it is important to identify, classify, and prioritize social determinants of health. This study aimed to identify and rank three major social determinants of health in East Azerbaijan.
Methods: This research was conducted using a qualitative approach in grounded theory. Through purposeful sampling, 40 key informants from East Azerbaijan, North West of Iran, were selected and in-depth interviews were performed. The collected data was analyzed with a three-step coding method including open, axial, and selective coding using Corbin and Strauss’s systemic approach. Also, Interpretive Structural Modeling and “Matrice d'Impacts Croisés Multiplication Appliquée à un Classement” (MICMAC) analysis were used to identify and rank social determinants of health in East Azerbaijan.
Results: Of the 40 participants, 27 (68%) were male and 13 (32%) were female. The mean age was 39.28± 12.46 years. 63% had a doctoral degree. According to the result of MICMAC analysis, social harm, social capital, and good governance were identified as three major social determinants of health in East Azerbaijan province.
Conclusion: Social determinants of health have a significant and crucial role in human welfare and by identifying and prioritizing social determinants of health at a local level and/or national level, the first step can be taken toward social welfare.
- Iran
- Social Deteerminants of Health
- Grounded Theory
- MICMAC analysis
How to Cite
References
Braveman P, Gottlieb L. The Social Determinants of Health: It’s Time to Consider the Causes of the Causes. Public Health Rep. 2014; 129(2): 19-31. DOI:10.1177/00333549141291S206.
Mcginnis J.M, Williams-Russo P, Knickman JR. The Case For More Active Policy Attention To Health Promotion. Health Aff (Millwood). 2002; 21(2): 78-93. DOI:10.1377/hlthaff.21.2.78.
Faulx D. The Social Determinants as part of the Medical School Curriculum, in School of Public Heath - Health Services. University of Washington; 2012: 34.
Andermann A. Taking action on the social determinants of health in clinical practice: a framework for health professionals. CMAJ. 2016; 188(17-18): E474-E483. DOI:10.1503/cmaj.160177
Social determinants of health - World Health Organization; 2017 (www.who.int/social_determinants, accessed 2018 Nov. 8).
Schroeder K, Kohl Malone S, McCabe E, Lipman T. Addressing the Social Determinants of Health: A Call to Action for School Nurses. The Journal of School Nursing. 2018; 34(3): 182-191. DOI:10.1177/1059840517750733
Marmot M, Friel Sh, Bell R, Houweling T.AJ, Taylor S. Closing the gap in a generation: health equity through action on the social determinants of health. Lancet. 2008; 372(9650): 1661-1669. DOI:10.1016/S0140-6736(08)61690-6
Vivian Li, McBurnie MA, Simon M, Crawford Ph, Leo M, Rachman F et al. Impact of Social Determinants of Health on Patients with Complex Diabetes Who Are Served by National Safety-Net Health Centers. JABFM. 2016; 29(3): 356- 370. DOI:10.3122/jabfm.2016.03.150226.
Lorant V, Deliège D, Eaton W, Robert A, Philippot P, Ansseau M. Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol. 2003; 157(2): 98 –112. DOI: 10.1093/aje/kwf182.
Lett HS, Blumenthal JA, Babyak MA, Strauman TJ, Robins C, Sherwood A. Social support and coronary heart disease: epidemiologic evidence and implications for treatment. Psychosom Med. 2005; 67(6): 869 –78. DOI:10.1097/01.psy.0000188393.73571.0a.
Ikeda A , Iso H, Kawachi I , Yamagishi K , Inoue M, Tsugane Sh. Social Support and Stroke and Coronary Heart Disease: The JPHC Study Cohorts II. Stroke. 2008; 39(3): 768–775. DOI:10.1161/STROKEAHA.107.496695.
Goulding Ch. Grounded Theory Methodology and Consumer Behaviour, Procedures, Practice and Pitfalls. Advances in Consumer Research. 2000; 27: 261-266.
Foley G, Timonen V. Using Grounded Theory Method to Capture and Analyze Health Care Experiences. Health Serv Res. 2015; 50(4): 1195–1210. DOI:10.1111/1475-6773.12275.
Holton JA. Grounded Theory as a General Research Methodology. Grounded Theory Review journal. 2008; 7(2): 67-89.
Danaifard H, Emami M. Qualitative research strategies: Grounded theory. Management thought. 2007; 1 (2): 69-97 [Full text in Persian].
Rothgangel M, Saup J. Classroom research in religious education: The potential of grounded theory. HTS Teologiese Studies/Theological Studies. 2017; 73(4): a4638. DOI: https://doi.org/10.4102/hts.v73i4.4638.
Molayi MM, Talebian M. Foresighting of Iranian Issues by Structural Analysis. Parliament and strategy journal. 2016; 23 (86): 5-32 [Full text in Persian].
Leung L. Validity, reliability, and generalizability in qualitative research. J Family Med Prim Care. 2015; 4(3): 324–327. DOI: 10.4103/2249-4863.161306.
Dewangan DK, Agrawal R, Sharma V. Enablers for Competitiveness of Indian Manufacturing Sector: An ISM-Fuzzy MICMAC Analysis. Procedia - Social and Behavioral Sciences. 2015; 189: 416 – 432. https://doi.org/10.1016/j.sbspro.2015.03.200
Carter N, Brayant-Lukosius D, DiCenso A, Blythe J, J. Nevile A. The Use of Triangulation in Qualitative Research. Oncology Nursing Forum . 2014; 41(5): 545–547. doi: 10.1188/14.ONF.545-547
Attri R, Dev N, Sharma V. Interpretive Structural Modelling (ISM) approach: An overview. Res. J. Management Sci. 2013; 2(2): 3-8.
Sushil. Interpreting the Interpretive Structural Model. Global Journal of Flexible Systems Management. 2012; 13(2):87–106. DOI: 10.1007/s40171-012-0008-3.
Dubey R, Samar Ali S. Identification of Flexible Manufacturing System Dimensions and Their Interrelationship Using Total Interpretive Structural Modelling and Fuzzy MICMAC Analysis. Global Journal of Flexible Systems Management. 2014; 15(2): 131–143. DOI 10.1007/s40171-014-0058-9.
Mousavi Chelak H, Samaram E, Hoseini Hajibekandeh SA. Suggested Social Policies to Control Social Harms in Iran. Social Welfare Quarterly. 2019; 18(70):77-104.
Younsi M, Chakrounb M. Does social capital determine health? Empirical evidence from MENA countries. The Social Science Journal. 2017; 54: 238–247.
Haery S M, Tehrani H, Olyaeimanesh A, Nedjat S. Factors Influencing the Social Health of Employees of the Ministry of Health and Medical Education in Iran. Iran J Health Educ & Health Promot. 2016; 3 (4):311-318
Xue X, Reed WR, Menclova A. Social capital and health: a meta-analysis. Journal of Health Economics. 2020 Jul 1; 72:102317. DOI: 10.1016/j.jhealeco.
Abdi B, Benifatemeh H, Shahamfar J, Alizade Aghdam MB, Benifatemeh H. Health and its Social Determinants: A Study on Health Inequalities among Tabriz Citizens. Journal of Applied Sociology. 2014; 25(4): 73-89.
Green J, Buckner S, Milton S, Powell K, Salway S, Moffatt S (2017). A model of how targeted and universal welfare entitlements impact on material, psycho-social and structural determinants of health in older adults. Social Science & Medicine. 2017; 187: 20-28. DOI: 10.1016/j.socscimed.2017.06.015.
Zaboli R, Tourani S, Seyedin SH Oliaie Manesh A. Prioritizing the Determinants of Social-health Inequality in Iran: A Multiple Attribute Decision Making Application. Iran Red Crescent Med J. 2014; 16(4): e12607. DOI: 10.5812/ircmj.12607.
Human Development Report 2002. (hdr.undp.org/sites/default/files/reports/263/hdr_2002_en_complete.pdf, accessed 2018 October 12).
Kardos M. The reflection of good governance in sustainable development strategies. Procedia-Social and Behavioral Sciences. 2012 Oct 12; 58:1166-73.
Keping Y. Governance and Good Governance: A New Framework for Political Analysis. Fudan J. Hum. Soc. Sci. 2018; 11(1):1–8. https://doi.org/10.1007/s40647-017-0197-4.
Makkian SN, Bibak M. The Effect of Good Governance on Human Development: An Intergovernmental Analysis. Journal of Economic Modeling. 2015; 9 (2): 131-147. [Full text in Persian].
Keser A, Gökmen Y. Governance and Human Development: The Impacts of Governance Indicators on Human Development. Journal of Public Administration and Governance. 2017; 8(1): 26-39. DOI: 10.5296/jpag.v8i1.12336.
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