J Prev Med Public Health.  2023 Jul;56(4):327-337. 10.3961/jpmph.23.059.

Identifying, Measuring, and Ranking Social Determinants of Health for Health Promotion Interventions Targeting Informal Settlement Residents

Affiliations
  • 1Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
  • 2Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
  • 3Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
  • 4Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  • 5Department of Health Economics and Management Sciences, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract


Objectives
Considering the importance of social determinants of health (SDHs) in promoting the health of residents of informal settlements and their diversity, abundance, and breadth, this study aimed to identify, measure, and rank SDHs for health promotion interventions targeting informal settlement residents in a metropolitan area in Iran.
Methods
Using a hybrid method, this study was conducted in 3 phases from 2019 to 2020. SDHs were identified by reviewing studies and using the Delphi method. To examine the SDHs among informal settlement residents, a cross-sectional analysis was conducted using researcher-made questionnaires. Multilayer perceptron analysis using an artificial neural network was used to rank the SDHs by priority.
Results
Of the 96 determinants identified in the first phase of the study, 43 were examined, and 15 were identified as high-priority SDHs for use in health-promotion interventions for informal settlement residents in the study area. They included individual health literacy, nutrition, occupational factors, housing-related factors, and access to public resources.
Conclusions
Since identifying and addressing SDHs could improve health justice and mitigate the poor health status of settlement residents, ranking these determinants by priority using artificial intelligence will enable policymakers to improve the health of settlement residents through interventions targeting the most important SDHs.

Keyword

Social determinants of health; Poverty areas; Developing countries; Slums
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