<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2007-7459</journal-id>
<journal-title><![CDATA[Horizonte sanitario]]></journal-title>
<abbrev-journal-title><![CDATA[Horiz. sanitario]]></abbrev-journal-title>
<issn>2007-7459</issn>
<publisher>
<publisher-name><![CDATA[Universidad Juárez Autónoma de Tabasco, División Académica de Ciencias de la Salud]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2007-74592024000200337</article-id>
<article-id pub-id-type="doi">10.19136/hs.a23n2.5837</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Determinantes sociales de la salud, desigualdades y políticas públicas: factores para el pie diabético]]></article-title>
<article-title xml:lang="en"><![CDATA[Social determinants of health, inequalities, and public policies: actors for diabetic foot]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Coto-Ramirez]]></surname>
<given-names><![CDATA[Diego]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rojas-Bonilla]]></surname>
<given-names><![CDATA[José María]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sáenz-Madrigal]]></surname>
<given-names><![CDATA[Rocío]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gómez-Duarte]]></surname>
<given-names><![CDATA[Ingrid]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Miranda-Loría]]></surname>
<given-names><![CDATA[Gustavo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Caja Costarricense de Seguro Social Dirección de Comunicación Organizacional ]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,hospital San Juan de Dios  ]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Centro de Investigación en Cuidados de Enfermería y Salud  ]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Universidad de Costa Rica Facultad de Medicina Escuela de Salud Pública]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Caja Costarricense Seguro Social  ]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2024</year>
</pub-date>
<volume>23</volume>
<numero>2</numero>
<fpage>337</fpage>
<lpage>343</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2007-74592024000200337&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2007-74592024000200337&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2007-74592024000200337&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Objetivo:  Analizar los factores condicionantes al pie diabético de las personas hospitalizadas, del 2017 al 2020, en el hospital San Juan de Dios, desde el marco de los Determinantes Sociales de la Salud de la Organización Mundial de la Salud (OMS).  Materiales y métodos:  Investigación mixta, con una muestra de 243 pacientes, un muestreo no aleatorio, con dos momentos metodológicos, con posterior triangulación de datos. El primer momento metodológico fue cuantitativo, se tomó el universo de 243 pacientes, se realizó un análisis descriptivo de la base de datos con el programa estadístico SPSS. El segundo fue cualitativo, se tomó una muestra por conveniencia de 30 personas, se les aplicó una entrevista semiestructurada.  Resultados:  Se evidenciaron los determinantes sociales de la salud de la población en estudio, a saber, que las personas más afectadas por pie diabético son hombres entre 50 a 59 años, con analfabetismo o primaria incompleta, con actividades económicas dentro de los quintiles más bajos, con prevalencia de trastornos psicoafectivos; además disponen de ausencia de acciones preventivas de los establecimientos de salud. Adicionalmente, el impacto de esta enfermedad es aún mayor dado que se evidenció la falta de una política de educación para la salud, el desempleo e informalidad, la no participación comunitaria, más la transición demográfica de Costa Rica.  Conclusiones:  Las condiciones sociales y económicas como baja escolaridad, género, bajo ingresos económicos, desempleo e informalidad, pobres redes de apoyo y la no participación social inciden negativamente en las personas con factores de riegos para padecer pie diabético. Aunado a lo anterior, las personas no reciben una atención integral e integrada, con un autocuidado deficiente y poco conocimiento y empoderamiento sobre la enfermedad, son factores que permiten que las personas con Diabetes puedan tener un riesgo mayor de padecer Pie diabético.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Objective:  Analyze the related factors from the structural determinants, establish their intermediate determinants and determine precipitating risk factors in the study population.  Materials and methods:  Mixed research, collection of quantitative and qualitative data, with subsequent triangulation of data, with quantitative descriptive analysis of the database of the Diabetic Foot Clinic of the San Juan de Dios hospital of people hospitalized in the established period, and a semi-structured interview with thirty subjects with a history of hospitalization.  Results:  It was evident that the people most affected by diabetic foot are men between 50 and 59 years old, with illiteracy or incomplete primary school, with economic activities within the lowest quintiles, with a prevalence of psycho-affective disorder. They also have an absence of preventive actions by health establishments. The lack of a health education policy, unemployment and informality, lack of community participation, added to the demographic transition of Costa Rica, has a greater impact of this disease on the population.  Conclusions:  Social and economic conditions such as low schooling, gender, low income, unemployment and informality, poor support networks and lack of social participation negatively affect people with risk factors for suffering from Diabetes. In addition to the above, people do not receive comprehensive and integrated care, with poor self-care and little knowledge and empowerment about the disease, these are factors that allow people with Diabetes to have a higher risk of suffering from diabetic foot.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Determinantes sociales de la salud]]></kwd>
<kwd lng="es"><![CDATA[Diabetes mellitus]]></kwd>
<kwd lng="es"><![CDATA[Pie diabético]]></kwd>
<kwd lng="es"><![CDATA[Salud pública]]></kwd>
<kwd lng="en"><![CDATA[Social determinants of health]]></kwd>
<kwd lng="en"><![CDATA[Mellitus diabetes]]></kwd>
<kwd lng="en"><![CDATA[Diabetic foot]]></kwd>
<kwd lng="en"><![CDATA[Public health]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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