Healthy and Equitable Interpersonal Relationships, Health Inequalities and Socio-Educational Interventions: A Conceptual Framework for Action
Por:
Forcadell-Díez L., Martinez, OJ, Abiétar D.G., López M.J., Sánchez-Martínez F., Perez G.
Publicada:
1 jun 2023
Ahead of Print:
1 mar 2023
Resumen:
BACKGROUND: Interpersonal relationships undoubtedly have a bidirectional connection with the health of individuals and communities. Relational models based on equity contribute to well-being, while asymmetrical relationships based on hierarchies and differences of power negatively impact mental, physical, and social health. METHODS: A conceptual framework for understanding the determinants of interpersonal relational models was developed.RESULTS: Structural determinants were identified as the combined action of systems of oppression, the socio-historical context that normalizes violence, and social stratification and segregation, consequences which included inequitable access to power, resources, and opportunities. Intermediate determinants include individual, psychosocial, behavioral, and community aspects. Structural and intermediate determinants impact health and health inequalities through multiple relational patterns that are simultaneously established and sustained by individuals and communities. The health impact of inequitable relational patterns includes: Reduced self-esteem; anxiety, stress, and depression; acceptance of violence; physical and sexual harm; suicide; and murder.CONCLUSIONS: This conceptual framework allows for the modification of relational models by influencing structural and intermediate determinants. Six areas of intervention have been identified: educative policies, school governance, physical and symbolic space, school curriculum, school-community relations, and socio-educative interventions to promote healthy and equitable relationships. Healthy and equitable relationships are associated with improved subjective well-being, health status and protection from violence. Socio-educational interventions that consider the elements of this conceptual framework may be effective in promoting healthy and equitable relational models.
Filiaciones:
Forcadell-Díez L.:
Agencia Salut Publ Barcelona, Barcelona, Spain
Univ Pompeu Fabra, Dept Med & Life Sci, Barcelona, Spain
Martinez, OJ:
Agencia Salut Publ Barcelona, Communitary Hlth Dept, Barcelona, Spain
Abiétar D.G.:
Agencia Salut Publ Barcelona, Barcelona, Spain
Univ Pompeu Fabra, Dept Med & Life Sci, Barcelona, Spain
López M.J.:
Univ Pompeu Fabra, Dept Med & Life Sci, Barcelona, Spain
Agencia Salut Publ Barcelona, Evaluat & Methods Intervent Dept, Barcelona, Spain
CIBER Epidemiol & Salud Publ, Madrid, Spain
Inst Invest Biomed Sant Pau IIB Sant Pau, Barcelona, Spain
Sánchez-Martínez F.:
Agencia Salut Publ Barcelona, Communitary Hlth Dept, Barcelona, Spain
CIBER Epidemiol & Salud Publ, Madrid, Spain
Inst Invest Biomed Sant Pau IIB Sant Pau, Barcelona, Spain
Perez G.:
Univ Pompeu Fabra, Dept Med & Life Sci, Barcelona, Spain
CIBER Epidemiol & Salud Publ, Madrid, Spain
Inst Invest Biomed Sant Pau IIB Sant Pau, Barcelona, Spain
Agencia Salut Publ Barcelona, Vigilance Control & Prevent Covid 19, Barcelona, Spain
hybrid, All Open Access, Hybrid Gold
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