A policy package for the prevention and management of hypertension with the approach of social determinants of health

Abstract

Abstract Introduction: Hypertension is one of the main public health challenges. It is affected by a wide range of economic, political, social, cultural and environmental factors as the social determinants of health. The aim of this study was to develop a policy package for the prevention and management of hypertension based on the social health determinants approach. Materials and Methods: This study was performed using several methods in 4 stages. Initially, a systematic review was conducted to review the policies of social health determinants to prevent hypertension. Then, by a semi-structured interview, the views of experts in the field of policies and strategies to prevent and management of hypertension were assessed. In the third step, using the results of the two previous steps, an initial policy package was prepared. Finally, the Delphi policy technique was used to validate and finalize the policy package. Results: According to the results of the systematic review, 18 articles were included in the study. The results of this section referred to interventions in the four fields including determinants food, health services, social support and addiction. The results of the qualitative study categorized in 10 fields, 14 main themes and 99 sub-themes. Interventions included training programs, interaction with the food industry, team-based care, monitoring and feedback as well as incentive, punitive, and smoke-free policies. Fields were social determinants of health, main themes and sub-themes including effective policies and interventions. Finally, the policy options resulting from applying the Expert Panel and Delphi Policy were 13 options. Conclusion: based on the findings, interventions related to food determinants and policies to reduce salt consumption were given priority because of their direct effect on blood pressure. Then, smoke-free policies were preferred. Other policy options were given in the next priority due to their effects on quality of life and consequently on blood pressure.It is necessary the related ministries cooperate in applying this policy. Keywords: Hypertension, Social determinants of health, Prevention, Policy