Headache Medicine 2021, 12(3):152-153 p-ISSN 2178-7468, e-ISSN 2763-6178

152

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DOI: 10.48208/HeadacheMed.2021.28

Headache Medicine

Editorial

Social Determinants of Health and its Role in Headache Disorders

Mario Fernando Prieto Peres

1,2

, Marcelo Moraes Valença

, Juliana Ramos de Andrade

Erlene Roberta Ribeiro dos Santos

¹Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil

²Hospital Israelita Albert Einstein, São Paulo, Brasil

³Universidade Federal de Pernambuco, Pernambuco, Brasil

Universidade Federal de Pernambuco, Centro Acadêmico de Vitória, Vitória de Santo Antão, Pernambuco, Brasil

Understanding the health-disease dynamic changes over time is imperative to plan future strategies

in the processes involved in the development of society.

Currently, the model for explaining this

process is based on the expanded concept of health, which, based on morbidity and mortality

gradients, understands the inuence of the conditions in which people are born, grow, live and

age, which are dened as social determinants of health (SDH). Factors such as economic stability

(employment, income, expenses, debt, medical bills, support), habitability, biological, territory,

neighborhood and physical environment (housing, transportation, safety, parks, playgrounds,

walkability, zip code/geography), education (literacy, language, early childhood education, vo-

cational training, higher education), food security (hunger, access to healthy options), community

and social context (social integration, support systems, community engagement, discrimination,

stress), access to health care system (health coverage, provider availability, provider linguistic and

cultural competency, quality of care) are the major determinants.

2,3,4

Social determinants of health

are connected to health disparities, being a signicant target of the World Health Organization's

health policy as they result in mortality, morbidity, life expectancy, health expenses, health status

and functional limitations.

Many initiatives are available to address the social determinants of health, focusing on both health

and non-health sectors (e.g., schools, workplaces, religious temples, community areas).

Promoting

health equity is a key factor in public policies, considering that life and work conditions of the

population are closely linked to social and cultural factors as well as psychological, emotional and

health conditions, which inuence the occurrence of disease and mortality. Therefore, promotion,

prevention, cure and rehabilitation are primary measures based on health education and guidelines

of universal health systems.

Even though migraine is considered one of the top contributors to the burden of disease, responsi-

ble for the high direct and indirect costs to a society, it is underrecognized, underdiagnosed and

undertreated. Limited information is available regarding the role of SDH in migraine or headache

disorders in general. Low socioeconomic status, ethnicity, education, food insecurity and child-

hood experiences have been attributed to affect migraine in the general population.

Hammond

and Stinchcombe found SDH relationships in migraine for both women and men in the Canadian

adult population, where social status, belonging to a minority group, and physical activity were

the highlighted aspects.

It is essential to highlight gaps in the structure of health services and the

continuing education process for professionals in the area, who often do not use the international

Mario F. P. Peres. MD, PhD

mario.peres@hc.fm.usp.br

Instituto de Psiquiatria, Hos-

pital das Clinicas HCFMUSP,

Faculdade de Medicina, Uni-

versidade de São Paulo, São

Paulo, Brazil

Received: December 12, 2021

Accepted: December 27, 2021

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Peres MFP, Valença MM, Andrade JR, Santos ERR

Social Determinants of Health and its Role in Headache Disorders

classication of headaches

as a reference to classify case

data and direct towards clinical management.

This is a call for more studies on the topic; a better under-

standing of modiable health aspects related to headache

disorders will help guide public policies to improve the man-

agement and resource allocation for headache sufferers.

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