Salud militar y sus determinantes sociales: Una revisión sistemática
Palabras clave:
military, social determinants of health, systematic review, health equity, strategiesResumen
Antecedentes: Los militares se enfrentan a importantes problemas de salud física y mental, como el trastorno de estrés postraumático TEPT y la depresión. Abordar y prevenir las enfermedades crónicas entre las fuerzas armadas es crucial para la seguridad nacional, y los Determinantes Sociales de la Salud (DSS) desempeñan un papel significativo en el estado de la salud militar colectiva. Realizar una revisión bibliográfica exhaustiva de los elementos sociales que influyen en la salud de los militares puede ayudar a crear políticas y mejorar el bienestar de los miembros en servicio y los veteranos. Métodos: Esta revisión sistemática se hizo a partir de una búsqueda a través de múltiples bases de datos utilizando palabras clave para identificar estudios publicados en los últimos diez años concernientes a los DSS entre las comunidades militares. La extracción de datos permitió identificar las investigaciones relevantes y, extraer los datos utilizando un formulario estándar para sintetizar los datos mediante una técnica narrativa presentada de forma clara y exhaustiva con tablas y figuras que resumen los hallazgos clave. Resultados: Al menos trece factores co-determinan los DSS en el ejército. Las variables económicas, como ingresos basados en rango militar y la vivienda, son las más influyentes. Comprender y abordar estos DSS es crucial para garantizar el bienestar del personal militar y promover la salud general de la sociedad. La colaboración intersectorial es necesaria para el éxito en estas áreas. Conclusiones: Las DSS influyen significativamente sobre el bienestar del personal militar, siendo las variables económicas el factor más determinantes. Abordar estos factores determinantes mediante la colaboración intersectorial y esfuerzos de promoción deben ser las principales prioridades de las organizaciones militares para garantizar la salud de su personal y la salud general de la sociedad.
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Halvorson A. Understanding the military: The institution, the culture, and the people. Subst Abus Ment Heal Serv Adm Cent Subst Abus Treat Partners Recover Initiat. 2010;
Bond GR, Al-Abdulmunem M, Drake RE, Davis LL, Meyer T, Gade DM, et al. Transition from Military Service: Mental Health and Well-being Among Service Members and Veterans with Service-connected Disabilities. J Behav Health Serv Res [Internet]. 2022 Jul 26;49(3):282–98. Available from: https://link.springer.com/10.1007/s11414-021-09778-w
MedlinePlus. Veterans and Military Health [Internet]. MedlinePlus. 2020 [cited 2023 Mar 27]. Available from: https://medlineplus.gov/veteransandmilitaryhealth.html#summary
Inoue C, Shawler E, Jordan CH, Jackson CA. Veteran and Military Mental Health Issues [Internet]. StatPearls. 2023. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21521090
Rozanov V, Frančišković T, Marinić I, Macarenco MM, Letica-Crepulja M, Mužinić L, et al. Mental health consequences of war conflicts. Adv psychiatry. 2019;281–304.
Meadows SO, Engel CC, Collins RL, Beckman RL, Cefalu M, Hawes-Dawson J, et al. 2015 Health Related Behaviors Survey: Mental and Emotional Health Among U.S. Active-Duty Service Members [Internet]. Santa Monica, CA: RAND Corporation PP - Santa Monica, CA; 2018. Available from: https://www.rand.org/pubs/research_briefs/RB9955z3.html
CDC. Chronic Diseases and Military Readiness [Internet]. CDC. 2022 [cited 2023 Mar 27]. Available from: https://www.cdc.gov/chronicdisease/resources/publications/factsheets/military-readiness.htm
Yedlinsky NT, Neff LA, Jordan KM. Care of the military veteran: selected health issues. Am Fam Physician. 2019;100(9):544–51.
Williamson V, Diehle J, Dunn R, Jones N, Greenberg N. The impact of military service on health and well-being. Occup Med (Chic Ill) [Internet]. 2019 Feb 7;69(1):64–70. Available from: https://academic.oup.com/occmed/article/69/1/64/5151233
Friedman NL, Banegas MP. Toward addressing social determinants of health: a health care system strategy. Perm J. 2018;22.
Garcia R. Social determinants of health. A Population Health Approach to Health Disparities for Nurses: Care of Vulnerable Populations. United State: Springer Publishing Company; 2023.
WHO. Social determinants of health [Internet]. WHO. 2023 [cited 2023 Mar 27]. Available from: https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1
Kintzle S, Barr N, Corletto G, Castro C. PTSD in U.S. Veterans: The Role of Social Connectedness, Combat Experience and Discharge. Healthcare [Internet]. 2018 Aug 22;6(3):102. Available from: http://www.mdpi.com/2227-9032/6/3/102
Menschner C, Maul A. Key ingredients for successful trauma-informed care implementation. Center for Health Care Strategies, Incorporated Trenton; 2016.
Oral R, Ramirez M, Coohey C, Nakada S, Walz A, Kuntz A, et al. Adverse childhood experiences and trauma informed care: the future of health care. Pediatr Res [Internet]. 2016 Jan 13;79(1–2):227–33. Available from: http://www.nature.com/articles/pr2015197
Bahadori M, Sanaeinasab H, Ghanei M, Mehrabi Tavana A, Ravangard R, Karamali M. The Social Determinants of Health in Military Forces of Iran: A Qualitative Study. J Environ Public Health [Internet]. 2015;2015:1–15. Available from: http://www.hindawi.com/journals/jeph/2015/524341/
Bahadori M, Sanaeinasab H, Ghanei M, Tavana AM, Ravangard R. Prevention of Disease with emphasis on the lifestyle in the military personnel According to the Social Determinants of Health. Vol. 2, International Journal of Medical Reviews. 2015. p. 261–72.
Blosnich JR, Montgomery AE, Dichter ME, Gordon AJ, Kavalieratos D, Taylor L, et al. Social Determinants and Military Veterans’ Suicide Ideation and Attempt: a Cross-sectional Analysis of Electronic Health Record Data. J Gen Intern Med [Internet]. 2020 Jun 19;35(6):1759–67. Available from: http://link.springer.com/10.1007/s11606-019-05447-z
Brenner LA, Hoisington AJ, Stearns-Yoder KA, Stamper CE, Heinze JD, Postolache TT, et al. Military-Related Exposures, Social Determinants of Health, and Dysbiosis: The United States-Veteran Microbiome Project (US-VMP). Vol. 8, Frontiers in Cellular and Infection Microbiology. 2018.
Britt TW, Sipos ML, Klinefelter Z, Adler AB. Determinants of mental and physical health treatment-seeking among military personnel. Vol. 217, British Journal of Psychiatry. 2020. p. 420–6.
Duan-Porter W, Martinson BC, Greer N, Taylor BC, Ullman K, McKenzie L, et al. Evidence Review—Social Determinants of Health for Veterans. J Gen Intern Med [Internet]. 2018 Oct 20;33(10):1785–95. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0029646522000275
Nosratabadi M, Nabavi SH, Rashedi V, Rarani MA. Socioeconomic determinants of health-care and emotional needs among Iranian older adults in Isfahan. [Internet]. Vol. 7, Journal of education and health promotion. 2018. 111 p. Available from: https://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,shib&db=cmedm&AN=30271796&site=ehost-live&scope=site&custid=s5071636
Smith HJ. Ethical Responsibilities of a Military to the Social Determinants of Health of its Service Members. Mil Med [Internet]. 2022 Aug 25;187(9–10):252–6. Available from: https://academic.oup.com/milmed/article/187/9-10/252/6564666
West GF, Jeffery DD. Utilizing selected social determinants and behaviors to predict obesity in military personnel. Vol. 35, Public Health Nursing. 2018. p. 29–39.
Dandeker C. On ‘the need to be different’: recent trends in military culture. Br Army, Manpow Soc into twenty-first century. 2021;173–87.
Wahlbeck K, Cresswell-Smith J, Haaramo P, Parkkonen J. Interventions to mitigate the effects of poverty and inequality on mental health. Soc Psychiatry Psychiatr Epidemiol. 2017;52:505–14.
WHO. Closing the gap in a generation: health equity through action on the social determinants of health: Commission on Social Determinants of Health final report. World Health Organization; 2008.
Dahlgren G, Whitehead M. European strategies for tackling social inequities in health: Levelling up Part 2. WHO Regional office for Europe Copenhagen; 2006.
Marmot M, Wilkinson R. Social determinants of health. Oup Oxford; 2005.
Dandeker C, Gow J. Military culture and strategic peacekeeping. In: Peace operations between war and peace. Routledge; 2013. p. 58–79.
Rajendran S, Giridhar S, Chaudhari S, Gupta PK. Technological advancements in occupational health and safety. Meas Sensors. 2021;15:100045.
Newby VF, Sebag C. Gender sidestreaming? Analysing gender mainstreaming in national militaries and international peacekeeping. Eur J Int Secur. 2021;6(2):148–70.
VHA Office of Health Equity. National Veteran Health Equity Report 2021. Focus on Veterans Health Administration Patient Experience and Health Care Quality [Internet]. Washington; 2022. Available from: https://www.va.gov/HEALTHEQUITY/docs/NVHER_2021_Report_508_Conformant.pdf
Southwell KH, MacDermid Wadsworth SM. The many faces of military families: Unique features of the lives of female service members. Mil Med. 2016;181(suppl_1):70–9.
MacLean A, Edwards RD. The Pervasive Role of Rank in the Health of U.S. Veterans. Armed Forces Soc [Internet]. 2010 Oct 9;36(5):765–85. Available from: http://journals.sagepub.com/doi/10.1177/0095327X09356166
Martins LCX, Lopes CS. Military hierarchy, job stress and mental health in peacetime. Occup Med (Chic Ill) [Internet]. 2012 Apr 1;62(3):182–7. Available from: https://academic.oup.com/occmed/article-lookup/doi/10.1093/occmed/kqs006
Rolfe S, Garnham L, Godwin J, Anderson I, Seaman P, Donaldson C. Housing as a social determinant of health and wellbeing: developing an empirically-informed realist theoretical framework. BMC Public Health [Internet]. 2020 Dec 20;20(1):1138. Available from: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09224-0
M.B. Pell JS. U.S. military families more negative about housing than landlords claim, survey shows [Internet]. Routers. 2019 [cited 2023 Apr 16]. Available from: https://www.reuters.com/article/us-usa-housing-map/u-s-military-families-more-negative-about-housing-than-landlords-claim-survey-shows-idUSKCN1SS105
Asch BJ. Setting military compensation to support recruitment, retention, and performance. RAND Corporation; 2019.
Obuobi-Donkor G, Oluwasina F, Nkire N, Agyapong VIO. A scoping review on the prevalence and determinants of post-traumatic stress disorder among military personnel and firefighters: Implications for public policy and practice. Int J Environ Res Public Health. 2022;19(3):1565.
Protopopescu A, Boyd JE, O’Connor C, Rhind SG, Jetly R, Lanius RA, et al. Examining the associations among moral injury, difficulties with emotion regulation, and symptoms of PTSD, depression, anxiety, and stress among Canadian military members and Veterans: A preliminary study. J Mil veteran Fam Heal. 2021;7(2):71–80.
National Academies of Sciences and Medicine E. Strengthening the Military Family Readiness System for a Changing American Society [Internet]. Kizer KW, Menestrel S Le, editors. Washington, D.C.: National Academies Press; 2019. Available from: https://www.nap.edu/catalog/25380
Koehlmoos TP, Korona-Bailey J, Janvrin ML, Madsen C. Racial disparities in the military health system: a framework synthesis. Mil Med. 2022;187(9–10):e1114–21.
Shemella P. The spectrum of roles and missions of the armed forces. In: Who Guards the Guardians and How. University of Texas Press; 2021. p. 122–42.
Military Benefit Association. Military Health Insurance [Internet]. Military Benefit Association. 2021 [cited 2023 Apr 16]. Available from: https://www.militarybenefit.org/membership-benefits/get-educated/militaryhealthinsurance/
Liotta RA, Saguil A, Switaj TL, Sarmiento DJ, Takano KL, Sachar DS, et al. Medicine With the Military. In: Handbook of Research on Advising and Developing the Pre-Health Professional Student. IGI Global; 2022. p. 183–212.
Pierre-Louis BJ, Moore AD, Hamilton JB. The Military Health Care System May Have the Potential to Prevent Health Care Disparities. J Racial Ethn Heal Disparities [Internet]. 2015 Sep 6;2(3):280–9. Available from: http://link.springer.com/10.1007/s40615-014-0067-6
Health Mil. Health and Housing [Internet]. Health Mil. 2023 [cited 2023 Apr 16]. Available from: https://www.health.mil/Military-Health-Topics/Health-Readiness/Public-Health/Health-and-Housing
Briggs EC, Fairbank JA, Tunno AM, Lee RC, Corry NH, Pflieger JC, et al. Military Life Stressors, Family Communication and Satisfaction: Associations with Children’s Psychosocial Outcomes. J Child Adolesc Trauma [Internet]. 2020 Mar 21;13(1):75–87. Available from: http://link.springer.com/10.1007/s40653-019-00259-z
Bhagat RS, Allie SM, Ford DL. Coping with stressful life events: An empirical analysis. In: Occupational stress. CRC Press; 2020. p. 93–112.
Wiist WH, Barker K, Arya N, Rohde J, Donohoe M, White S, et al. The Role of Public Health in the Prevention of War: Rationale and Competencies. Am J Public Health [Internet]. 2014 Jun;104(6):e34–47. Available from: https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2013.301778
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Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.