Exploring Global Demands for Integrating Social Aspects into Community Healthcare: A Literature Review

Aging and crises like pandemics and climate change are global concerns that affect community environments. These social and natural changes influence people’s health worldwide. Aging impacts human health, including physical and mental aspects, and increases the need for care. Recent crises have affected not only the elderly but also younger populations, necessitating further efforts to develop a systematic community strategy. The goal of such a strategy is to maintain or enhance people’s well-being. As we face aging and crises like pandemics and climate change, it becomes essential to consider health holistically and globally, taking into account the community environment and social determinants without boundaries. The present study aimed to explore the necessary aspects of incorporating social determinants into clinical practice, enabling healthcare providers to view health from a holistic and planetary perspective. This approach facilitates the development of integrated community strategies. The study reviewed literature from PubMed, MEDLINE, and CINAHL databases, focusing on medicine, health, and welfare. An electronic search for English-language articles in peer-reviewed journals was conducted up to July 2024, using search terms such as “holistic health,” “planetary health,” and “social determinants.” Eight articles were identified through the search. After excluding three based on their titles, abstracts, and full texts, five articles were selected. The research focused on three areas: perceiving health in ecosystems, considering health-related policy in clinical situations, and addressing health in primary care settings. This study emphasizes the need for further research on innovative, integrated community strategies in the context of a globally aging society, focusing on non-medical aspects like pandemics, climate change, and social determinants to achieve a holistic and planetary understanding of people’s health. It suggests that understanding the social aspects of ecosystems in clinical settings, through interdisciplinary collaboration, is crucial for developing systematic community strategies for people’s well-being life in medical, health, and welfare contexts.

Outcomes of Integrated Community Care Interventions for Frail Elderly People: A Literature Review

This study aimed to summarize the outcome measures and the significant outcome of effective integrated community care for frail elderly people through a literature review. A literature search was conducted using the Cochrane Library and PubMed for articles published up to November 2016 with the following search terms: Integrated community care, primary care, community, frail elderly, and effectiveness. A total of 106 articles were identified, of which eight with an interventional research design the inclusion criteria. All outcome measures were classified into the three categories: Functional abilities, quality of life, and health. As the significant effect, the physical function was perceived in four references, the quality of life in one reference, and the mental health in one reference. The evidence of the effectiveness of integrated community care seemed to be lacking. More studies will need to be conducted.

Significant Differences in Elderly Health between Urban and Rural Communities: A Literature Review

This study aimed to examine measures pertaining to elderly health in urban versus rural settings, and to identify differences in the health of elderly people living in urban and rural communities through a literature review. An electronic literature search was performed using PubMed for English articles published in peer-reviewed journals up to August 2018, with the following search terms: “urban”, “rural”, “comparison of community”, “elderly health”, and “comparison of community health”. A total of 35 articles were extracted for a critical full-text review, and six articles that met the inclusion criteria were subjected to analysis. Measures related to elderly health in urban and rural communities were classified into the following three categories: functional abilities, health, and health perception. Five of the six articles described functional abilities (e.g., social function) and health (e.g., mental health, depression) as categories with significant differences in elderly health between urban and rural communities. The results suggest that elderly health measures related to social function and mental health or depression are more important outcome measures of effective person-centered integrated community care systems from the perspective of community characteristics. As there were only a few articles reporting on elderly health according to differences in environment between urban and rural communities, further investigation is globally warranted.

Consideration of Social Aspects and Mental Health of Community-Dwelling Elderly People: A Literature Review

Purpose: A literature review was conducted to explore the social factors and mental health-related scales, and to examine associations between social factors and mental health of the elderly, in order to consider the social aspects and mental health as outcome measurements for an effective community-based care. Methods: An electronic search for English articles published in peer-reviewed journals up to October 2019 was performed using PubMed, MEDLINE, and CINAHL with the following search terms: “social cohesion,” “mental health,” “elderly,” and “community.” Inclusion criteria were 3 as follows;1) studies in community-dwelling elderly people or participants including elderly individuals;2) studies with clear descriptions of social factors in the Methods section;and 3) studies with clear descriptions of health-related items (e.g., mental health) in the Methods section. The extracted articles were subjected to narrative review. Results: In total, 118 articles were identified, of which 11 met the inclusion criteria after critical review of the full text. 6 mental health-related scales were perceived in order to assess of mental health or depression or anxiety of the elderly. And, 4 factors related to social aspects;neighborhood social cohesion, social capital, neighborhood environment, and social support, were perceived. Significant associations between social aspects and mental health of the elderly were examined. In social cohesion, 6 studies reported a significant association with elderly mental health. In social capital, 3 studies reported a significant association with elderly mental health. In neighborhood environment, 3 studies reported a significant association with elderly mental health. Discussion: In the development of an effective community-based care, it may be expected to be focused on social aspects to lead to promoting mental health of the elderly. For the further investigation, it will need to be considered more clearly defined measurements related to social aspects and mental health of the elderly, and it will be more important to pile the research data globally.

Comparison of Community Health between Rural and Urban Areas in View of the Impact of the COVID-19 Pandemic: Global Perspective through a Literature Review

The progressive aging of society is expected to lead to the development of effective integrated community-based care system considering the characteristics based on community environments. However, the COVID-19 pandemic has influenced population health worldwide. This study aimed to examine disparities in population health and health-related factors between rural and urban communities during the COVID-19 pandemic. A literature search was conducted using PubMed, Medline, and CINAHL for articles published up to September 2022 with the following search terms: community health, rural, urban, and COVID-19. A total of 105 articles were identified, of which three articles with a cross-sectional quantitative research design met the inclusion criteria. Two articles focused on mental health, and among them, one recognized a significant disparity between rural and urban areas. Four health-related factors in view of the COVID-19 pandemic in rural and urban areas were perceived, including knowledge, behavior, lifestyle, and social support. And, two factors: health-related knowledge and health-related behavior, were perceived as the significant disparities between rural and urban during the COVID-19 pandemic. The further efforts will be needed to pursue effective integrated community-based care system during and post-COVID-19, taking into account community environment at both community and individual levels.

Evaluation Items for Community-Based Health Care Focusing on Social Aspects: A Literature Review

The progressive aging of society has become a global concern, and is expected to lead to the development of effective, sustainable, person-centered, integrated community-based care systems. However, there is insufficient evidence regarding effective integrated community-based care. In particular, few studies have focused on social aspects of the community environment related to elderly health. This study aimed to consider social aspects as evaluation items, focusing particularly on social determinants from the perspective of community-dwelling people, to explore truly effective integrated community-based care to improve elderly health. The definition of social determinants means social cohesion in social and community contexts. A literature review of English articles published in peer-reviewed journals up to October 2019 was conducted using PubMed, MEDLINE, and CINAHL with the following search terms: “social cohesion,” “elderly health,” “mental health” and “community.” Identified articles were screened based on title and abstract, and selected articles were subjected to full-text assessment and critical review. All references cited in the selected articles were also reviewed. The following inclusion criteria were used: 1) studies targeting community-dwelling elderly people or community-dwelling people including elderly people as participants;2) studies with clear descriptions of social factors in the Methods section;and 3) studies with clear descriptions of health-related items in the Methods section. From the 21 articles analyzed, of which 9 articles defined social determinants as social cohesion in social and community context, 37 items were extracted as social aspects at the community level that reflect the perspective of residents. These items can be developed as evaluation items for community-based health care outcomes through consensus among community health care providers and further investigation.