Determinantes sociales como factores contextuales de la obesidad: Construcción de significado y valoración del estado nutricional según nivel socioeconómico
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2020-12
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es
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Sociedad Chilena de Nutricion Bromatologia y Toxilogica
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Licencia CC
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Resumen
El objetivo fue explorar la influencia del nivel socioeconómico (NSE), como determinante estructural de la salud, sobre la construcción de significados y valor atribuidos a la obesidad. Se realizaron entrevistas semiestructuradas a usuarios de programas de obesidad de dos centros de salud, procurando diferencias en el NSE del público objetivo. A partir del análisis de contenido temático, los resultados se organizaron en cuatro categorías construidas inductivamente: 1) significado atribuido de vivir con obesidad, 2) conciencia manifiesta del impacto de la obesidad sobre la propia salud, 3) búsqueda vivida de alternativas ante la obesidad y 4) origen atribuido de la obesidad. Se observó que la obesidad, entendida como categoría médica, varió según NSE tanto en significado como en la forma en que es problematizada, tomando sentidos incluso contradictorios. El salutismo se incorporó de manera heterogénea entre distintos grupos socioeconómicos, reproduciéndose como estilo de vida. Así, el NSE, entrelazado con otros determinantes sociales estructurales de la salud, pudo influir no sólo en los resultados de salud de manera ‘causal’, sino también -a través de mecanismos donde participaron contextualmente- en la definición del estado de salud y en el valor atribuido a la salud. Considerar este efecto diferencial de los determinantes sociales de la salud en la obesidad, sería importante para el logro de intervenciones efectivas en salud.
The objective of the study was to explore the influence of socio-economic status (SES), as a structural social determinant of health, in the construction of the meaning and value attached to obesity. To do so, we conducted semi-structured interviews with obesity care users from two health centres, targeting socio-economic differences amongst participants. Using thematic content analysis, the findings were organised into four inductively constructed categories, labelled as: 1) the meaning attached to suffering from obesity; 2) awareness of the impact of obesity on one’s health; 3) the search for alternatives while being obese; 4) attributed origin of obesity. Obesity was understood as a medical category, varied in meaning as well as in the way it was problematized depending on SES, acquiring contradictory meanings. Healthism is incorporated in a heterogeneous way among different socioeconomic groups, reproduced via specific lifestyles. Thus, SES, intertwined with other structural social determinants of health, was not only a ‘cause’ of the outcome but also contextually in the mechanisms through which health status and the value of health were defined. Considering this differential effect of social determinants of health would be important in designing appropriate health interventions.
The objective of the study was to explore the influence of socio-economic status (SES), as a structural social determinant of health, in the construction of the meaning and value attached to obesity. To do so, we conducted semi-structured interviews with obesity care users from two health centres, targeting socio-economic differences amongst participants. Using thematic content analysis, the findings were organised into four inductively constructed categories, labelled as: 1) the meaning attached to suffering from obesity; 2) awareness of the impact of obesity on one’s health; 3) the search for alternatives while being obese; 4) attributed origin of obesity. Obesity was understood as a medical category, varied in meaning as well as in the way it was problematized depending on SES, acquiring contradictory meanings. Healthism is incorporated in a heterogeneous way among different socioeconomic groups, reproduced via specific lifestyles. Thus, SES, intertwined with other structural social determinants of health, was not only a ‘cause’ of the outcome but also contextually in the mechanisms through which health status and the value of health were defined. Considering this differential effect of social determinants of health would be important in designing appropriate health interventions.
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Indexación Scopus
Palabras clave
Determinantes sociales de la salud, Gradiente social, Inequidad, Investigación cualitativa, Nivel socioeconómico, Obesidad
Citación
Revista Chilena de NutricionO, Volume 47, Issue 6, Pages 983 - 990December 2020
DOI
10.4067/S0717-75182020000600983