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Social, Economic, and Environmental Determinants of Chronic Diseases

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 December 2019) | Viewed by 39516

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Special Issue Editor

Assoc. Prof. Daniel Kim

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Guest Editor

Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, 360 Huntington Avenue, 413 International Village, Boston, MA 02115, USA
Interests: social epidemiology; social determinants of health including chronic diseases; causal inference; microsimulation; social policies and health

Special Issue Information

Dear Colleagues,

The International Journal of Environmental Research and Public Health (IJERPH) is publishing a Special Issue next year on the social, economic, and environmental determinants of chronic (noncommunicable) diseases and their risk factors. IJERPH is a peer-reviewed scientific journal that publishes theoretical and empirical work encompassing interdisciplinary topics in the fields of environmental health sciences and public health. For more information about the journal, please visit https://0-www-mdpi-com.brum.beds.ac.uk/journal/ijerph.

Noncommunicable diseases (NCDs) kill approximately 41 million people each year, or the equivalent of 71% of all deaths globally. Most NCD deaths are due to cardiovascular diseases (17.9 million people annually), followed by cancers (9.0 million), respiratory diseases (3.9 million), and diabetes (1.6 million) (WHO, 2018). Unhealthy diets, smoking, physical inactivity, and obesity are some of the primary established risk factors for developing and dying from chronic diseases.

There is growing evidence that social determinants of health shape the risks of NCDs and their risk factors in both developed and developing countries. As described by the WHO, social determinants include upstream social, economic, and environmental factors and conditions such as socioeconomic status, neighborhood socioeconomic environments, job strain, income inequality, gender and racial/ethnic inequalities, social capital/cohesion, and social and economic policies that characterize where we live, learn, work, and play. These fundamental conditions contribute substantially to overall population health and health inequities. Notably, many of these social determinants of health reside outside of the health care sector and hence require multi-sectoral approaches to address them.

We welcome any original theoretical or empirical work that could lend key insights into the impacts of social determinants on incidence and mortality from major chronic diseases (including but not limited to the diseases mentioned above) and their risk factors. Regarding social determinants, we are especially interested in upstream social, economic, and environmental factors that could help to inform policymakers and public health practitioners in their ongoing efforts to reduce the burden of chronic diseases locally, nationally, and globally.

Assoc. Prof. Daniel Kim
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Social determinants of health
Chronic diseases
Chronic disease risk factors
Noncommunicable diseases
Contextual factors
Neighborhoods
Social policies
Health disparities

Published Papers (10 papers)

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Research

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12 pages, 303 KiB

Open AccessArticle

State-Level Income Inequality and County-Level Social Capital in Relation to Individual-Level Depression in Middle-Aged Adults: A Lagged Multilevel Study

by Saloni Dev and Daniel Kim

Int. J. Environ. Res. Public Health 2020, 17(15), 5386; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17155386 - 27 Jul 2020

Cited by 11 | Viewed by 2679

Abstract

In the US, the incidence of depression and suicide have followed escalating trends over the past several years. These trends call for greater efforts towards identifying their underlying drivers and finding effective prevention strategies and treatments. One social determinant of health that plausibly influences the risk of depression is income inequality, the gap between the rich and poor. However, research on this association is still sparse. We used data from the National Longitudinal Survey of Youth 1979 and the US Census to investigate the multilevel lagged associations of state-level income inequality with the individual-level odds of depression in middle-aged adults, controlling for state- and individual-level factors. We also examined the independent associations of county-level social capital with depression and explored whether it mediated the income inequality relationship. Higher income inequality at the state level predicted higher odds of individual-level depression nearly 2 decades later [OR for middle vs. lowest tertile of income inequality = 1.35 (95% CI: 1.02, 1.76), OR for highest vs. lowest tertile = 1.34 (95% CI: 1.01, 1.78)]. This association was stronger among men than women. Furthermore, there was evidence that county-level social capital independently predicted depression and that it mediated the income inequality association. Overall, our findings suggest that policies attenuating levels of income inequality at the US state level and that leverage social capital may protect against one’s likelihood of developing depression. Full article

(This article belongs to the Special Issue Social, Economic, and Environmental Determinants of Chronic Diseases)

20 pages, 1310 KiB

Open AccessArticle

Influence of Individual and Contextual Perceptions and of Multiple Neighborhoods on Depression

by Médicoulé Traoré, Cécile Vuillermoz, Pierre Chauvin and Séverine Deguen

Int. J. Environ. Res. Public Health 2020, 17(6), 1958; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17061958 - 17 Mar 2020

Cited by 5 | Viewed by 2308

Abstract

The risk of depression is related to multiple various determinants. The consideration of multiple neighborhoods daily frequented by individuals has led to increased interest in analyzing socio-territorial inequalities in health. In this context, the main objective of this study was (i) to describe and analyze the spatial distribution of depression and (ii) to investigate the role of the perception of the different frequented spaces in the risk of depression in the overall population and in the population stratified by gender. Data were extracted from the 2010 SIRS (a French acronym for “health, inequalities and social ruptures”) cohort survey. In addition to the classic individual characteristics, the participants reported their residential neighborhoods, their workplace neighborhoods and a third one: a daily frequented neighborhood. A new approach was developed to simultaneously consider the three reported neighborhoods to better quantify the level of neighborhood socioeconomic deprivation. Multiple simple and cross-classified multilevel logistic regression models were used to analyze the data. Depression was reported more frequently in low-income (OR = 1.89; CI = [1.07–3.35]) or middle-income (OR = 1.91; CI = [1.09–3.36]) neighborhoods and those with cumulative poverty (OR = 1.64; CI = [1.10–2.45]). In conclusion, a cumulative exposure score, such as the one presented here, may be an appropriate innovative approach to analyzing their effects in the investigation of socio-territorial inequalities in health. Full article

(This article belongs to the Special Issue Social, Economic, and Environmental Determinants of Chronic Diseases)

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16 pages, 3550 KiB

Open AccessArticle

Social Support and Subclinical Coronary Artery Disease in Middle-Aged Men and Women: Findings from the Pilot of Swedish CArdioPulmonary bioImage Study

by Demir Djekic, Erika Fagman, Oskar Angerås, George Lappas, Kjell Torén, Göran Bergström and Annika Rosengren

Int. J. Environ. Res. Public Health 2020, 17(3), 778; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17030778 - 27 Jan 2020

Cited by 2 | Viewed by 2326

Abstract

Social support has been associated with coronary artery disease (CAD), particularly in individuals who have sustained a cardiovascular event. This study investigated the relationship between social support and subclinical CAD among 1067 healthy middle-aged men and women. Social support was assessed with validated social integration and emotional attachment measures. Subclinical CAD was assessed as a coronary artery calcium score (CACS) using computed tomography. There was no association between social support and CACS in men. In women, low social support was strongly linked to cardiovascular risk factors, high levels of inflammatory markers, and CACS > 0. In a logistic regression model, after adjustment for 12 cardiovascular risk factors, the odds ratio (95% confidence intervals) for CACS > 0 in women with the lowest social integration, emotional attachment, and social support groups (reference: highest corresponding group) were 2.47 (1.23–5.12), 1.87 (0.93–3.59), and 4.28 (1.52–12.28), respectively. Using a machine learning approach (random forest), social integration was the fourth (out of 12) most important risk factor for CACS > 0 in women. Women with lower compared to higher or moderate social integration levels were about 14 years older in “vascular age”. This study showed an association between lack of social support and subclinical CAD in middle-aged women, but not in men. Lack of social support may affect the atherosclerotic process and identify individuals vulnerable to CAD events. Full article

(This article belongs to the Special Issue Social, Economic, and Environmental Determinants of Chronic Diseases)

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9 pages, 338 KiB

Open AccessArticle

Built Environments and Cardiometabolic Morbidity and Mortality in Remote Indigenous Communities in the Northern Territory, Australia

by Camille Le Gal, Michael J. Dale, Margaret Cargo and Mark Daniel

Int. J. Environ. Res. Public Health 2020, 17(3), 769; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17030769 - 25 Jan 2020

Cited by 7 | Viewed by 2746

Abstract

The health of Indigenous Australians is dramatically poorer than that of the non-Indigenous population. Amelioration of these differences has proven difficult. In part, this is attributable to a conceptualisation which approaches health disparities from the perspective of individual-level health behaviours, less so the environmental conditions that shape collective health behaviours. This ecological study investigated associations between the built environment and cardiometabolic mortality and morbidity in 123 remote Indigenous communities representing 104 Indigenous locations (ILOC) as defined by the Australian Bureau of Statistics. The presence of infrastructure and/or community buildings was used to create a cumulative exposure score (CES). Records of cardiometabolic-related deaths and health service interactions for the period 2010–2015 were sourced from government department records. A quasi-Poisson regression model was used to assess the associations between built environment “healthfulness” (CES, dichotomised) and cardiometabolic-related outcomes. Low relative to high CES was associated with greater rates of cardiometabolic-related morbidity for two of three morbidity measures (relative risk (RR) 2.41–2.54). Cardiometabolic-related mortality was markedly greater (RR 4.56, 95% confidence interval (CI), 1.74–11.93) for low-CES ILOCs. A lesser extent of “healthful” building types and infrastructure is associated with greater cardiometabolic-related morbidity and mortality in remote Indigenous locations. Attention to environments stands to improve remote Indigenous health. Full article

(This article belongs to the Special Issue Social, Economic, and Environmental Determinants of Chronic Diseases)

12 pages, 476 KiB

Open AccessArticle

Night Shift Work—A Risk Factor for Breast Cancer

by Marta Szkiela, Ewa Kusideł, Teresa Makowiec-Dąbrowska and Dorota Kaleta

Int. J. Environ. Res. Public Health 2020, 17(2), 659; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17020659 - 20 Jan 2020

Cited by 27 | Viewed by 5284

Abstract

Shift work is considered a risk factor for some health problems. This study aimed to determine whether night shift work is a significant factor for breast cancer risk. The case–control study was conducted from 2015–2019 in the Łódź region. The case group included 494 women diagnosed with malignant breast cancer; the control group included 515 healthy women. The research tool was an anonymous questionnaire. In the case group, the percentage of women working shift work was 51.9%, whereas in the control group, it was 34.1% (OR = 2.08 (95% CI: 1.61; 2.69)). A more insightful examination of shift work showed that only night work has a significant impact on breast cancer (OR = 2.61 (95% CI: 1.94; 3.53)). Even after considering the effect of other possible cancer factors (like high BMI, smoking, early menstruation, late menopause, pregnancy history, age, place of living, education), the odds of developing cancer were twice as high in the group of shift workers (OR = 2.20 (95% CI: 1.57; 3.08)). Considering a significantly higher risk of cancer among people working at night and a high percentage of such employees in Poland, the government should consider special action in the prophylactic treatment of cancers. Full article

(This article belongs to the Special Issue Social, Economic, and Environmental Determinants of Chronic Diseases)

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11 pages, 1257 KiB

Open AccessArticle

Is Transient and Persistent Poverty Harmful to Multimorbidity?: Model Testing Algorithms

by Sukyong Seo, Young Dae Kwon, Ki-Bong Yoo, Yejin Lee and Jin-Won Noh

Int. J. Environ. Res. Public Health 2019, 16(13), 2395; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16132395 - 05 Jul 2019

Cited by 5 | Viewed by 2301

Abstract

Multimorbidity, the coexistence of two or more long-term medical conditions in one person, has been known to disproportionally affect the low-income population. Little is known about whether long-term income is more crucial for multimorbidity than income measured in one time point; whether persistent poverty is more harmful than transient one; how changes in wealth affect multimorbidity. This is a longitudinal study on a population representative dataset, the Korean Health Panel (KHP) survey (2010–2015). A multivariate analysis was conducted using logistic regressions. A variety of income and wealth variables was investigated. Low-income Koreans (lowest 20%) were more likely to have multiple disorders; average income was more significantly associated with multimorbidity than the yearly income measured for the same year; persistent episodes of poverty had a greater hazard than transient ones; and income changes appeared to be statistically insignificant. We found that long-term income and persistent poverty are important factors of multimorbidity. These findings support the importance of policies reducing the risk of persistent poverty. Policies to promote public investment in education and create jobs may be appropriate to address multimorbidity. Full article

(This article belongs to the Special Issue Social, Economic, and Environmental Determinants of Chronic Diseases)

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Figure A1

11 pages, 275 KiB

Open AccessArticle

Social Integration, Social Support, and All-Cause, Cardiovascular Disease and Cause-Specific Mortality: A Prospective Cohort Study

by Jinke Tan and Yafeng Wang

Int. J. Environ. Res. Public Health 2019, 16(9), 1498; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16091498 - 27 Apr 2019

Cited by 16 | Viewed by 4140

Abstract

Social relationships are associated with all-cause mortality. Substantial uncertainties remain, however, for the associations of social relationships with mortality from subtypes of cardiovascular disease (CVD) and major non-vascular diseases. This prospective cohort study estimated mortality risks according to social support and social integration utilizing a nationally representative sample of 29,179 adults ages 18 years and older. Cox proportional hazards regression models were employed. Social integration, but not social support was associated with all-cause mortality risk. For CVD mortality, social integration predicted a 33% lower risk (HR = 0.67, 95% CI = 0.53–0.86). The results were similar in magnitude for heart disease mortality. Participants with the highest social integration level had a 53%, 30%, and 47% decreased mortality risk of diabetes, Alzheimer’s disease, and chronic lower respiratory diseases (CLRD) than those with the lowest level. These social integration associations were linear and consistent across baseline age, sex and socioeconomic status. We did not observe an association of social integration with the risk of cancer mortality. Our findings support the linear association of social integration but not social support with mortality from a range of major chronic diseases in the US adult population, independent of socioeconomic status (SES), behavioral risk factors, and health status. Full article

(This article belongs to the Special Issue Social, Economic, and Environmental Determinants of Chronic Diseases)

13 pages, 588 KiB

Open AccessArticle

Adulthood Socioeconomic Position and Type 2 Diabetes Mellitus—A Comparison of Education, Occupation, Income, and Material Deprivation: The Maastricht Study

by Yuwei Qi, Annemarie Koster, Martin van Boxtel, Sebastian Köhler, Miranda Schram, Nicolaas Schaper, Coen Stehouwer and Hans Bosma

Int. J. Environ. Res. Public Health 2019, 16(8), 1435; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16081435 - 23 Apr 2019

Cited by 18 | Viewed by 3866

Abstract

In an effort to better quantify the impact of adulthood socioeconomic circumstances on prediabetes and type 2 diabetes (T2DM), we set out to examine the relative importance of four adulthood socioeconomic indicators. Using cross-sectional data from The Maastricht Study on 2011 middle-aged older men and women, our findings indicate that low educational level (OR = 1.81, 95% CI = 1.24–2.64), low occupational level (OR = 1.42, 95% CI = 0.98–2.05), and material deprivation (OR = 1.78, 95% CI = 1.33–2.38) were independently associated with T2DM. Low income (OR = 1.28, 95% CI = 0.88–1.87) was the strongest, albeit not significant, SEP (socioeconomic position) correlate of prediabetes. This association confirms SEP as a multifaceted concept and indicates the need to measure SEP accordingly. In order to tackle the social gradient in prediabetes and T2DM, one should, therefore, address multiple SEP indicators and their possible pathways. Full article

(This article belongs to the Special Issue Social, Economic, and Environmental Determinants of Chronic Diseases)

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Review

Jump to: Research

14 pages, 526 KiB

Open AccessReview

Chronic Diseases and Employment: Which Interventions Support the Maintenance of Work and Return to Work among Workers with Chronic Illnesses? A Systematic Review

by Soja Nazarov, Ulf Manuwald, Matilde Leonardi, Fabiola Silvaggi, Jérôme Foucaud, Kristopher Lamore, Erika Guastafierro, Chiara Scaratti, Jaana Lindström and Ulrike Rothe

Int. J. Environ. Res. Public Health 2019, 16(10), 1864; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16101864 - 27 May 2019

Cited by 55 | Viewed by 7468

Abstract

The increase of chronic diseases worldwide impact quality of life, cause economic and medical costs, and make it necessary to look for strategies and solutions that allow people with chronic diseases (PwCDs) to lead an active working life. As part of the CHRODIS Plus Joint European Action project, a systematic review was conducted to identify studies of interventions that support the maintenance of work and return to work (RTW) among workers with chronic illnesses. These interventions should target employees with the following conditions: diabetes, cardiovascular diseases, metabolic vascular syndrome, respiratory diseases, musculoskeletal disorders, mental disorders, and neurological disorders. An extensive search was performed in PubMed, EMBASE, and PsycINFO for English language studies. Included in this review were 15 randomized controlled trials (RCT) for adult employees (aged 18+). We found that workplace-oriented and multidisciplinary programs are the most supportive to RTW and reducing the absence due to illness. In addition, cognitive behavioral therapies achieve positive results on RTW and sick leave. Finally, coaching is effective for the self-management of chronic disease and significantly improved perceptions of working capacity and fatigue. Full article

(This article belongs to the Special Issue Social, Economic, and Environmental Determinants of Chronic Diseases)

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21 pages, 1205 KiB

Open AccessReview

Return to Work Interventions for Cancer Survivors: A Systematic Review and a Methodological Critique

by Kristopher Lamore, Thomas Dubois, Ulrike Rothe, Matilde Leonardi, Isabelle Girard, Ulf Manuwald, Soja Nazarov, Fabiola Silvaggi, Erika Guastafierro, Chiara Scaratti, Thierry Breton and Jérôme Foucaud

Int. J. Environ. Res. Public Health 2019, 16(8), 1343; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16081343 - 14 Apr 2019

Cited by 47 | Viewed by 5810

Abstract

Cancer patients are more at risk of being unemployed or having difficulties to return to work (RTW) compared to individuals without health concerns, and is thus a major public health issue. The aim of this systematic review is to identify and describe the interventions developed specifically to help cancer patients to RTW after treatment. Two researchers independently screened the articles for inclusion and Critical Appraisal Skills Program (CASP) checklists were used to assess the methodology of the included studies. Ten manuscripts met the inclusion criteria. The type of studies were three quasi-experimental studies, three longitudinal studies, three randomized controlled trials (RCTs) and a qualitative study. RTW interventions were conducted in or outside the hospital (n = 6 and 3 respectively), or both (n = 1). Improvements in RTW were only observed in quasi-experimental studies. No improvement in RTW was noted in RCTs, nor in other measures (e.g., quality of life, fatigue). Lack of statistically significant improvement does not necessarily reflect reality, but may be attributed to non-adapted research methods. This systematic review underscores the need for researches in the RTW field to reach a consensus on RTW criteria and their assessment. Recommendations to this effect are suggested. Full article

(This article belongs to the Special Issue Social, Economic, and Environmental Determinants of Chronic Diseases)

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