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Social Determinants of Health Influencing the New Zealand COVID-19 Response and Recovery: A Scoping Review and Causal Loop Diagram
Systems ( IF 2.895 ) Pub Date : 2021-07-07 , DOI: 10.3390/systems9030052
Sudesh Sharma , Mat Walton , Suzanne Manning

The Coronavirus pandemic of 2019–20 (COVID-19) affected multiple social determinants of health (SDH) across the globe, including in New Zealand, exacerbating health inequities. Understanding these system dynamics can support decision making for the pandemic response and recovery measures. This study combined a scoping review with a causal loop diagram to further understanding of the connections between SDH, pandemic measures, and both short- and long-term outcomes in New Zealand. The causal loop diagram showed the reinforcing nature of structural SDH, such as colonization and socio-economic influences, on health inequities. While balancing actions taken by government eliminated COVID-19, the diagram showed that existing structural SDH inequities could increase health inequities in the longer term, unless the opportunity is taken for socio-economic policies to be reset. Such policy resets would be difficult to implement, as they are at odds with the current socio-economic system. The causal loop diagram highlighted that SDH significantly influenced the dynamics of the COVID-19 impact and response, pointing to a need for purposeful systemic action to disrupt the reinforcing loops which increase health inequities over time. This will require strong systems leadership, and coordination between policy makers and implementation at local level.

中文翻译:

影响新西兰 COVID-19 反应和恢复的健康的社会决定因素:范围审查和因果循环图

2019-20 年的冠状病毒大流行 (COVID-19) 影响了包括新西兰在内的全球多个健康问题社会决定因素 (SDH),加剧了健康不平等。了解这些系统动态可以支持大流行应对和恢复措施的决策。本研究将范围界定审查与因果循环图相结合,以进一步了解新西兰的 SDH、大流行措施以及短期和长期结果之间的联系。因果循环图显示了结构性 SDH 的强化性质,例如殖民化和社会经济影响,对健康不公平的影响。虽然平衡政府采取的行动消除了 COVID-19,但图表显示,从长远来看,现有的结构性 SDH 不平等可能会加剧健康不平等,除非有机会重新设定社会经济政策。这种政策重置将难以实施,因为它们与当前的社会经济体系不一致。因果循环图强调,SDH 显着影响了 COVID-19 影响和响应的动态,表明需要有目的的系统性行动来破坏随着时间的推移加剧健康不平等的强化循环。这将需要强有力的系统领导以及政策制定者和地方层面的实施之间的协调。指出需要有目的的系统性行动来破坏随着时间的推移加剧健康不公平的强化循环。这将需要强有力的系统领导以及政策制定者和地方层面的实施之间的协调。指出需要有目的的系统性行动来破坏随着时间的推移加剧健康不公平的强化循环。这将需要强有力的系统领导以及政策制定者和地方层面的实施之间的协调。
更新日期:2021-07-07
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