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Discussion
The risk factors for digestive disorders that have been discussed are sometimes described as
lifestyle/behavioural factors, yet it is important to highlight that these risk factors are socially
patterned within most countries,148 meaning that exposure to these risks and the harm
caused by them is to a large extent determined by an individual's socioeconomic position.
Systematic differences in lifestyles between social groups are shaped by structural factors,
with those in lower socioeconomic positions having less access to resources and
opportunities to achieve healthy lifestyles.109 149 150 Nonetheless behavioural risk factors are
still sometimes portrayed as freely chosen - a narrative popular among tobacco, food and
alcohol industries which profit from shifting corporate responsibility onto individuals.151
Interventions to address lifestyle/behavioural risk factors for digestive disorders which fail to
consider the social, economic, environmental, cultural, and political factors which constrain
people's choices and their opportunities to achieve good health, are likely to have limited
success.
Substantial health gains can potentially be achieved by considering policies which directly
address the underlying social determinants of health, as well as the factors and processes
which influence the unequal distribution of these determinants within societies.149 150 152 This
may involve influential organisations such as UEG to encourage sectors beyond health to
consider digestive health outcomes in policy and programme development.121 153
Limitations and further research
Most of the findings of the report are based on data up to 2019, which were the most recent
data available at the time of analysis. The findings of this report could therefore potentially
serve as a baseline upon which to assess the future impact of the COVID-19 pandemic, which
will likely continue to present challenges for population-health in the long-term.
The pandemic brought attention to the stark health inequalities experienced within
countries, as inequalities in the social determinants of health resulted in socioeconomically
disadvantaged communities bearing the brunt of COVID-19 morbidity and mortality (Figure
152).154 155 Likewise, as Europe enters a post-emergency phase, economic challenges such as
rising inflation (a consequence of the pandemic alongside other factors) will
disproportionately affect those on lower incomes who have less protection against economic
shocks. Unless policies are implemented to protect the most vulnerable within societies, the
current cost of living crisis will inevitably exacerbate existing health inequalities, which is
likely to have profound implications for digestive health.
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