THE IMPACT OF SOCIAL DETERMINANTS ON LUNG DISEASE IN EUROPEAN UNION MEMBER STATES. A NARRATIVE REVIEW
DOI:
https://doi.org/10.47743/asas-2025-2-834Keywords:
Social determinants of health, respiratory diseases, tobacco control, health inequalities, functional decline, sustainable development goals, EU Member statesAbstract
Lung diseases represent a major global health challenge, currently affecting over 545 million individuals and causing nearly 4 million premature deaths every year. Social determinants of health, including where people are born, live, and work, significantly impact respiratory outcomes. While many pulmonary conditions are preventable, they remain disproportionately concentrated among vulnerable groups, thereby reinforcing health inequalities. This narrative review investigated the role of social factors in communicable and non-communicable respiratory illnesses, emphasizing tobacco use as a mediating risk factor and functional ability as an outcome. Data were analysed from the Eurostat Health Statistics Database and the Global Burden of Disease Study (2017–2021) for adults in EU-27 countries. Findings revealed marked social gradients, with pneumonia mortality almost twice as high in countries reporting lower education and higher overcrowding. Tobacco consumption was the leading modifiable risk factor, with Population Attributable Fractions exceeding 30% in high-burden countries. Smoking prevalence was highest in Eastern Europe, particularly among men and those with less education. Functional decline mediated the link between tobacco exposure and worse respiratory outcomes. Addressing these inequities requires comprehensive, equity-focused strategies, including tobacco control, improved access to healthcare, housing policy reform, and the integration of health across all public policies.
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