Humans; Consensus; Digital Technology; Social Determinants of Health; Health Policy
Abstract :
[en] [en] OBJECTIVE: To map how social, commercial, political and digital determinants of health have changed or emerged during the recent digital transformation of society and to identify priority areas for policy action.
METHODS: We systematically searched MEDLINE, Embase and Web of Science on 24 September 2023, to identify eligible reviews published in 2018 and later. To ensure we included the most recent literature, we supplemented our review with non-systematic searches in PubMed® and Google Scholar, along with records identified by subject matter experts. Using thematic analysis, we clustered the extracted data into five societal domains affected by digitalization. The clustering also informed a novel framework, which the authors and contributors reviewed for comprehensiveness and accuracy. Using a two-round consensus process, we rated the identified determinants into high, moderate and low urgency for policy actions.
FINDINGS: We identified 13 804 records, of which 204 met the inclusion criteria. A total of 127 health determinants were found to have emerged or changed during the digital transformation of society (37 digital, 33 social, 33 commercial and economic and 24 political determinants). Of these, 30 determinants (23.6%) were considered particularly urgent for policy action.
CONCLUSION: This review offers a comprehensive overview of health determinants across digital, social, commercial and economic, and political domains, highlighting how policy decisions, individual behaviours and broader factors influence health by digitalization. The findings deepen our understanding of how health outcomes manifest within a digital ecosystem and inform strategies for addressing the complex and evolving networks of health determinants. [fr] [fr] OBJECTIF: Caractériser la manière dont les déterminants sociaux, commerciaux, politiques et numériques ont changé ou sont apparus au cours de la récente transformation numérique de la société, et identifier les domaines prioritaires pour l'adoption de mesures concrètes.
MÉTHODES: Nous avons passé au crible MEDLINE, Embase et Web of Science le 24 septembre 2023, afin de recenser les revues éligibles publiées à partir de 2018. Pour nous assurer d'inclure la littérature la plus récente, nous avons complété notre revue par des recherches non systématiques effectuées dans PubMed® et Google Scholar, ainsi que par des documents identifiés par des experts en la matière. À l'aide d'une analyse thématique, nous avons réparti les données extraites entre cinq domaines sociétaux concernés par la numérisation. Ce regroupement a également servi à établir un nouveau cadre, que les auteurs et contributeurs ont examiné pour en évaluer la précision et l'exhaustivité. Enfin, grâce à un processus de consensus en deux phases, nous avons défini le degré d'urgence des mesures politiques pour les déterminants identifiés: élevé, modéré et faible.
RÉSULTATS: Nous avons recensé 13 804 documents, dont 204 correspondaient aux critères d'inclusion. Au total, 127 déterminants de santé ont été considérés comme étant apparus ou ayant changé durant la transformation numérique de la société (37 déterminants numériques, 33 déterminants sociaux, 33 déterminants commerciaux et économiques, et 24 déterminants politiques). Parmi eux, 30 déterminants (23,6%) ont été jugés particulièrement urgents en termes d'intervention politique.
CONCLUSION: Cette revue offre une vue globale des déterminants de santé dans les domaines du numérique, du social, du commercial et de l'économique ainsi que du politique, illustrant l'impact qu'exercent les décisions politiques, les comportements individuels et d'autres facteurs plus larges sur la santé par le biais de la numérisation. Les conclusions obtenues nous permettent de mieux comprendre comment les résultats en matière de santé se présentent dans un écosystème numérique, et alimentent les stratégies visant à appréhender les réseaux des déterminants de santé, des réseaux complexes et en constante évolution. [es] [es] OBJETIVO: Analizar cómo han cambiado o surgido determinantes sociales, comerciales, políticos y digitales de la salud durante la reciente transformación digital de la sociedad e identificar áreas prioritarias de acción normativa.
MÉTODOS: Se realizaron búsquedas sistemáticas en MEDLINE, Embase y Web of Science el 24 de septiembre de 2023, para identificar revisiones elegibles publicadas en 2018 y posteriormente. Para asegurar la inclusión de la literatura más reciente, se complementó la revisión con búsquedas no sistemáticas en PubMed® y Google Scholar, junto con registros identificados por expertos en la materia. Mediante un análisis temático, se agruparon los datos extraídos en cinco áreas sociales afectadas por la digitalización. La agrupación también sirvió de base para un nuevo marco, cuya exhaustividad y precisión revisaron los autores y colaboradores. Mediante un proceso de consenso en dos rondas, se clasificaron los determinantes identificados en alta, moderada y baja urgencia para la adopción de acciones normativas.
RESULTADOS: Se identificaron 13 804 registros, de los que 204 cumplían los criterios de inclusión. Se descubrió que un total de 127 determinantes de la salud habían surgido o cambiado durante la transformación digital de la sociedad (37 determinantes digitales, 33 sociales, 33 comerciales y económicos y 24 políticos). De ellos, 30 determinantes (23,6%) se consideraron de especial urgencia para la acción normativa.
CONCLUSIÓN: Esta revisión ofrece una visión global de los determinantes de la salud en las áreas digital, social, comercial y económica, y política, y destaca cómo las decisiones políticas, los comportamientos individuales y otros factores más amplios influyen en la salud a través de la digitalización. Los resultados profundizan el conocimiento de cómo se manifiestan los resultados sanitarios en un ecosistema digital e informan de las estrategias para abordar las complejas y cambiantes redes de los determinantes de la salud. [ar] [ar] الغرض: تخطيط كيفية ظهور المحددات الاجتماعية، والتجارية، والسياسية، والرقمية، للصحة أو ظهور تغير فيها، أثناء التحول الرقمي الأخير للمجتمع، وكذلك تحديد المجالات ذات الأولوية للعمل السياسي.
الطريقة: لقد قمنا بالبحث بشكل منهجي في MEDLINE، و Embase، و Web of Science في 24 سبتمبر/أيلول 2023، لتحديد المراجعات المؤهلة المنشورة في عام 2018 وما بعده. للتأكد من تضمين أحدث المنشورات، قمنا باستكمال المراجعات لدينا بعمليات بحث غير منهجية في قواعد البيانات PubMed ® ، و Google Scholar، جنبًا إلى جنب مع السجلات التي حددها الخبراء في هذا الصدد. باستخدام التحليل الموضوعي، قمنا بتجميع البيانات المستخرجة في خمسة مجالات مجتمعية خضعت للرقمنة. ونتج عن التجميع إطار عمل جديد، راجعه المؤلفون والمساهمون بهدف تحقيق الشمول والدقة. باستخدام عملية إجماع من جولتين، قمنا بتقييم المحددات المعروفة إلى عالية الضرورة، ومتوسطة الضرورة، ومنخفضة الضرورة لتنفيذ إجراءات السياسة .
النتائج: حدد بحثنا 13804 سجلاً، منها 204 سجلاً حققت معايير الاشتمال. واكتشفنا أن إجمالي 127 من محددات الصحة قد ظهرت أو تغيرت أثناء التحول الرقمي للمجتمع، (37 محددًا رقميًا، و33 محددًا اجتماعيًا، و33 محددًا تجاريًا واقتصاديًا، و24 محددًا سياسيًا). ومن بين هذه المحددات، تم اعتبار 30 محددًا (%23.6) عالية ضرورية بشكل خاص لتنفيذ إجراءات السياسة.
الاستنتاج: تقدم هذه المراجعة نظرة عامة شاملة لمحددات الصحة عبر المجالات الرقمية، والاجتماعية، والتجارية، والاقتصادية، والسياسية، مع التركيز على كيفية تأثير القرارات السياسية، والسلوكيات الفردية، والعوامل الأوسع نطاقًا على الصحة من خلال الرقمنة. وتعمق النتائج فهمنا لكيفية ظهور النواتج الصحية داخل النظام البيئي الرقمي، وتقديمها لاستراتيجيات للتعامل مع الشبكات المعقدة والمتطورة لمحددات الصحة. [zh] [zh] 目的: 旨在了解在最近的社会数字化转型过程中，健康的社会、商业、政治和数字决定因素发生了怎样的变化或出现了哪些新的决定因素，并确定政策行动的优先领域。.
方法: 我们已于 2023 年 9 月 24 日系统地检索了 MEDLINE、Embase 和 Web of Science 数据库，以找出在 2018 年及之后发表的符合条件的综述文献。为确保我们纳入了最新的文献资料，通过在 PubMed® 和 Google Scholar 中进行非系统性检索和利用主题专家确定的记录，我们进一步补充了综述文献。通过主题分析，我们使用聚类算法将提取的数据分为五个受数字化影响的社会领域。聚类算法还为我们提供了一个新的框架，即作者和撰稿人有对其全面性和准确性进行审查的文献资料。经历两轮共识过程后，我们将最终确定的决定因素分为紧急程度高、紧急程度中等和紧急程度低三类以用于确定政策行动的优先级。.
结果: 我们检索到 13,804 条记录，其中有 204 条符合纳入标准。我们发现，在社会的数字化转型过程中出现或发生了变化的健康决定因素共有 127 个（37 个数字决定因素、33 个社会决定因素、33 个商业和经济决定因素以及 24 个政治决定因素）。 其中，又有 30 个决定因素（占 23.6%）被认为特别迫切地需要采取政策行动。.
结论: 本综述全面概述了数字、社会、商业和经济以及政治领域的健康决定因素，重点介绍了政策决策、个人行为和更广泛的因素如何通过数字化影响健康。这些研究结果加深了我们对健康结果如何在数字生态系统中表现的理解，并为制定策略以解决复杂和不断发展的健康决定因素网络提供了依据。. [ru] [ru] ЦЕЛЬ: Определить, как изменились или какие появились социальные, коммерческие, политические и цифровые детерминанты здоровья в ходе недавней цифровой трансформации общества, и выявить приоритетные области для принятия мер.
МЕТОДЫ: 24 сентября 2023 года был проведен систематический поиск в базах данных MEDLINE, Embase и Web of Science с целью выявления соответствующих требованиям обзоров, опубликованных в 2018 году и позднее. Чтобы убедиться в том, что в обзор включена самая свежая литература, в дополнение было проведено несистематическое исследование в базах данных PubMed® и Google Scholar, а также использованы данные, полученные от экспертов в данной области. Полученные данные были путем тематического анализа распределены по пяти социальным сферам, на которые влияет цифровизация. В результате кластеризации была разработана новая система, которую авторы и соавторы проанализировали на предмет полноты и точности. В ходе двухэтапного процесса достижения консенсуса выявленные детерминанты были распределены по степени срочности принятия политических мер: высокая, умеренная и низкая.
РЕЗУЛЬТАТЫ: Было выявлено 13 804 документа, из которых 204 соответствовали критериям включения. Было установлено, что в ходе цифровой трансформации общества сформировались или изменились 127 детерминантов здоровья (37 цифровых, 33 социальных, 33 торгово-экономических и 24 политических детерминантов). Из этого числа 30 детерминантов (23,6%) были признаны особенно актуальными для принятия политических мер.
ВЫВОД: В этом обзоре представлен всеобъемлющий анализ факторов, определяющих здоровье в цифровой, социальной, торгово-экономической и политической сферах, с особым акцентом на то, как политические решения, индивидуальное поведение и более широкие факторы влияют на здоровье в условиях цифровизации. Полученные результаты способствуют более глубокому пониманию того, как проявляются последствия для здоровья в цифровой экосистеме, и служат основой для разработки стратегий, направленных на решение сложных и развивающихся проблем, связанных с детерминантами здоровья.
Disciplines :
Public health, health care sciences & services
Author, co-author :
van Kessel, Robin; LSE Health, Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, London, England
Seghers, Laure-Elise; LSE Health, Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, London, England
Anderson, Michael; LSE Health, Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, London, England
Schutte, Nienke M; Innovation in Health Information Systems Unit, Sciensano, Brussels, Belgium
Monti, Giovanni; LSE Health, Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, London, England
Haig, Madeleine; LSE Health, Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, London, England
Schmidt, Jelena; Department of International Health, Maastricht University, Maastricht, Kingdom of the Netherlands
Wharton, George; LSE Health, Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, London, England
Roman-Urrestarazu, Andres; Department of Psychiatry, University of Cambridge, Cambridge, England
Larrain, Blanca; Department of Psychiatry, University of Cambridge, Cambridge, England
Sapanel, Yoann; Institute of Digital Medicine, National University of Singapore, Singapore
Stüwe, Louisa; Digital Health Delegation for Digital Health, Ministry of Labour, Health and Solidarities, Paris, France
Bourbonneux, Agathe; Digital Health Delegation for Digital Health, Ministry of Labour, Health and Solidarities, Paris, France
Yoon, Junghee; Department of Clinical Research Design and Evaluation, Sungkyunkwan University, Seoul, Republic of Korea
Lee, Mangyeong; Department of Clinical Research Design and Evaluation, Sungkyunkwan University, Seoul, Republic of Korea
PACCOUD, Ivana ; University of Luxembourg > Luxembourg Centre for Systems Biomedicine (LCSB) > Digital Medicine
BORGA, Liyousew ; University of Luxembourg > Luxembourg Centre for Systems Biomedicine (LCSB) > Digital Medicine
Ndili, Njide; PharmAccess Foundation Nigeria, Lagos, Nigeria
Sutherland, Eric; Paris, France
Görgens, Marelize; Health, Nutrition and Population Global Practice, World Bank Group, WashingtonDC, United States of America (USA
Weicken, Eva; Fraunhofer Institute for Telecommunications, Heinrich Hertz Institut, Berlin, Germany
Coder, Megan; Digital Medicine Society, Boston, USA
de Fatima Marin, Heimar; Department of Biomedical and Data Science, Yale University School of Medicine, New Haven, USA
Val, Elena; Migration Health Division, International Organization for Migration Regional Office for the European Economic Area, the EU and NATO, Brussels, Belgium
Profili, Maria Cristina; Migration Health Division, International Organization for Migration Regional Office for the European Economic Area, the EU and NATO, Brussels, Belgium
Kosinska, Monika; Department of Social Determinants of Health, World Health Organization, Geneva, Switzerland
Browne, Christine Elisabeth; WHO European Venice Office for Investment for Health and Development, Venice, Italy
Marcelo, Alvin; Medical Informatics Unit, University of the Philippines, Manila, Philippines
Agarwal, Smisha; Department of International Health, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
Mrazek, Monique F; International Finance Corporation, World Bank Group, WashingtonDC, USA
Eskandar, Hani; Digital Services Division, International Telecommunications Union, Geneva, Switzerland
Chestnov, Roman; Digital Services Division, International Telecommunications Union, Geneva, Switzerland
Smelyanskaya, Marina; HIV and Health Group, United Nations Development Programme Europe and Central Asia, Istanbul, Türkiye
Källander, Karin; United Nations Children's Fund, New York, USA
Buttigieg, Stefan; Ministry for Health and Active Ageing, Valletta, Malta
Ramesh, Kirthi; Asian Development Bank, Manila, Philippines
Holly, Louise; Digital Transformations for Health Lab, Geneva, Switzerland
Rys, Andrzej; Health Systems, Medical Products and Innovation, European Commission, Brussels, Belgium
Azzopardi-Muscat, Natasha; LSE Health, Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, London, England ; Innovation in Health Information Systems Unit, Sciensano, Brussels, Belgium
de Barros, Jerome; LSE Health, Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, London, England ; Department of International Health, Maastricht University, Maastricht, Kingdom of the Netherlands
Quintana, Yuri; LSE Health, Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, London, England ; Department of Psychiatry, University of Cambridge, Cambridge, England
Spina, Antonio; LSE Health, Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, London, England ; Institute of Digital Medicine, National University of Singapore, Singapore
Hyder, Adnan A; LSE Health, Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, London, England ; Digital Health Delegation for Digital Health, Ministry of Labour, Health and Solidarities, Paris, France
Labrique, Alain; LSE Health, Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, London, England ; Department of Clinical Research Design and Evaluation, Sungkyunkwan University, Seoul, Republic of Korea
Kamel Boulos, Maged N; LSE Health, Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, London, England ; Luxembourg Centre for Systems Biomedicine, Université du Luxembourg, Belvaux, Luxembourg
Chen, Wen; LSE Health, Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, London, England ; PharmAccess Foundation Nigeria, Lagos, Nigeria
Agrawal, Anurag; LSE Health, Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, London, England ; Paris, France
Cho, Juhee; Department of Clinical Research Design and Evaluation, Sungkyunkwan University, Seoul, Republic of Korea
KLUCKEN, Jochen ; University of Luxembourg > Luxembourg Centre for Systems Biomedicine (LCSB) > Digital Medicine
Prainsack, Barbara; LSE Health, Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, London, England ; Health, Nutrition and Population Global Practice, World Bank Group, WashingtonDC, United States of America (USA
Balicer, Ran; LSE Health, Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, London, England ; Fraunhofer Institute for Telecommunications, Heinrich Hertz Institut, Berlin, Germany
Kickbusch, Ilona; Digital Transformations for Health Lab, Geneva, Switzerland
Novillo-Ortiz, David; LSE Health, Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, London, England ; Innovation in Health Information Systems Unit, Sciensano, Brussels, Belgium
Mossialos, Elias; LSE Health, Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, London, England
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