Social determinants of health that permeate the mental suffering of children on the french-brazilian border

Nádia Cristine Coelho Eugenio Pedrosa,Carolina Almeida De Oliveira,Marina Nolli Bittencourt,Maria Izabel Tentes Côrtes,Renan Alves Silva,Jordânia Vieira Silva

doi:10.1590/0034-7167-2020-0295

Abstract

ABSTRACT Objectives: to understand the determinants involved in the mental suffering of schoolchildren on the French-Brazilian border. Methods: a qualitative study was conducted with children from 6 to 12 years of age from four State schools in the municipality of Oiapoque, located on the French-Brazilian border. The data were obtained through interviews, analyzed by the IRAMUTEQ software, and interpreted in the light of the Dahlgren and Whitehead’s social determinants of health model. Results: data indicate that the mental suffering experienced by children, especially characterized by anxious symptoms, such as concern of becoming fat and worries, were permeated by social situations that children went through daily, such as family abandonment, domestic violence, and bullying. Final Considerations: social determinants can be predictors of mental suffering in children, especially in environments of extreme vulnerability, such as the border, in a context of financial difficulties, domestic violence, and absence of parenting.

Highlights

According to the World Health Organization (WHO), the social determinants of Health (SDOHs) are related to the conditions in which people are born, grow, work, live and age; and to the extent of forces and systems that shape the circumstances of everyday life[1]
The study pointed out that the social determinants related to the mental suffering of the participating children were strongly linked to the social/family level and the working conditions of the parents, which generated SDOHs such as family abandonment, domestic violence, bullying, hunger, and sexual abuse
The data showed that when children are exposed to negative SDOHs, these generate mental suffering to them and, some risk behaviors since studies indicate that children exposed to negative social situations end up becoming more vulnerable to the development of mental disorders, such as depression, alcohol abuse, and other drugs, among other negative behaviors[4]

Summary

Introduction

According to the World Health Organization (WHO), the social determinants of Health (SDOHs) are related to the conditions in which people are born, grow, work, live and age; and to the extent of forces and systems that shape the circumstances of everyday life[1]. Among the models that study the SDOHs, the Dahlgren and Whitehead’s model of 1991(3), adopted in Brazil by the National Commission on Social Determinants of Health, explains how social interactions, at the individual, economic, cultural, and environmental levels, generate inequalities in health. Characteristics such as age, gender, behavior, and lifestyle are presented, which contribute to exposure to health risk factors such as drug use and anorexia, which are strongly influenced by SDOHs. At the level of social and community interactions, social cohesion and the strengthening of networks are shown as health-generating elements in society. A systematic review of the literature reports that, when the imbalance occurs at one of these levels involving the SDOHs, there may be direct interference in the reality known by individuals, with a propensity for infectious diseases, mental and eating disorders, use of psychoactive substances, the practice of self-mutilation, early and unprotected sexual activity, and worsening the chances of early pregnancy among girls[4]

Objectives

Results

Conclusion