عدالت اجتماعی و سلامت کودکان در ایران (در چارچوب مدل تعیین کننده های اجتماعی سلامت سازمان بهداشت جهانی)

Objectives: during recent years social determinants of health had been the most complex subject on the domain of health policy. The social determinants of health are social condition that people live and work and they affect the personal health, community health and social health and even the health pattern. The main object of this study is to review the studies witch related to the status of four structural social determinants of health including income, gender, education and ethnicity during 1379-1385 in Iranian children and the documentation of the result of these studies are according world health organization model. Method: In this descriptive study (review), studies had been searched with 28 keywords in Iranian electronically databases as such as Irandoc.ac.ir, www.iranmedex.com, www.sid.ir, www.magiran.com and many universities in Tehran. After passing several stages of screening, we found 40 studies related to gender and health, 16 studies related to income and health, 40 studies related to education and health and 6 studies related to ethnicity and health. Information of these researches were classified and described. R.M, Excel and SPSS were used in this study. Results: In the determinant of gender and health in childhood, the difference between two genders about weight and height of newborn, low birth weight and malnutrition was observed, but in dental caries, impaired vision and hearing, the deference was not significant. About mental health, mental disease and disorders also the result of studies were not similar but suicide attempting in girls was more reported. In the income determinant almost all the studies showed the more frequency in health problems is in the groups with lower income and it showed significant relation between income and health status. It showed inverse relation between household income and food consumption pattern and / or household calories consumption, also significant relation between income status and malnutrition and obesity, skull youth index, health behavior, weight of child and rate of dmf was observed .In the studies of mental health and income also the frequency of symptoms and mental disorders in low income groups and significant relationship between mental health and income was observed. In education determinant category, almost all educational interventions were effective .About literacy and health, prevalence of LBW neonate of mothers with lower education was higher and there is a significant relation between maternal education and child weight. However statistical significant relationship between maternal education and the period of breastfeeding was not found. The result of studies showed inverse statistical significant relationship between level of education (parents) and child malnutrition, overweight and obesity. Statistical significant relationship between father education and child obesity was also shown. In parasitic infections there was inverse statistical relation between level of education (parents) and hair pediculus, entrobiosis. Results of studies about mental health and education were not similar but the frequency of attempted suicide in the group with lower education was higher. In ethnicity determinant, there was a little studies and the results were showed the ethnicity difference in weight and height of neonate ,cloven lips and palate, malformation of neurotic tube in neonate, diarrhea. Conclusion: The health difference between two genders, the different income, educational level and different ethnicity observed. The result of this study could use in developing policy recommendations and suggest some principles to ground those policy choices.