{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:14:07Z","timestamp":1786115647441,"version":"build-2736575974"},"reference-count":27,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int. J. Environ. Res. Public Health","IJERPH"],"abstract":"<jats:p>Health care empowerment is essential for self-care, informed decision-making, and appropriate use of health services among university students. This cross-sectional pilot study examined the association between selected social determinants of health and health care empowerment among university students in Peru. A sample of 336 undergraduate and graduate students from six universities completed an online survey that included the Empowerment Scale for Health Care Empowerment in University Students (ECSU). The instrument demonstrated adequate psychometric properties (Cronbach\u2019s \u03b1 = 0.859; McDonald\u2019s \u03c9 = 0.835). Descriptive analyses and ordinal logistic regression were conducted to identify factors associated with health care empowerment and its dimensions. Income level, family type, and housing situation were associated with overall empowerment. Lower income levels and extended family structures were associated with lower empowerment levels, while university type and educational level were associated with specific dimensions related to decision-making and the ability to empower others. The explanatory capacity of the models was modest (pseudo-R2 = 5.0\u201312.8%). These findings provide preliminary evidence on the relationship between social determinants and health care empowerment in university students. However, results should be interpreted with caution due to the cross-sectional design and convenience sampling. Future studies using probabilistic sampling and longitudinal designs are needed to confirm these associations.<\/jats:p>","DOI":"10.3390\/ijerph23081022","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T15:08:09Z","timestamp":1785856089000},"page":"1022","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Social Determinants Associated with Health Care Empowerment Among University Students: A Cross-Sectional Pilot Study"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0268-3250","authenticated-orcid":false,"given":"Miluska","family":"Vega-Guevara","sequence":"first","affiliation":[{"name":"Institute of Research (ININ), Marcelino Champagnat University, Lima 15039, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3474-2603","authenticated-orcid":false,"given":"Felipe","family":"Aguirre-Ch\u00e1vez","sequence":"additional","affiliation":[{"name":"Institute of Research (ININ), Marcelino Champagnat University, Lima 15039, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5798-6216","authenticated-orcid":false,"given":"Rosa","family":"Millones Rivalles","sequence":"additional","affiliation":[{"name":"Institute of Research (ININ), Marcelino Champagnat University, Lima 15039, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1888-7848","authenticated-orcid":false,"given":"Vicenta Irene Tafur","family":"Anzualdo","sequence":"additional","affiliation":[{"name":"Institute of Research (ININ), Marcelino Champagnat University, Lima 15039, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"ref_1","unstructured":"Blas, E., and Kurup, A. (2021). Equity, Social Determinants and Public Health Programmes, World Health Organization."},{"key":"ref_2","unstructured":"Centers for Disease Control and Prevention (2025, May 05). Social Determinants of Health: Know What Affects Health, Available online: https:\/\/www.cdc.gov\/socialdeterminants."},{"key":"ref_3","first-page":"108","article-title":"Educaci\u00f3n y empoderamiento en salud","volume":"55","year":"2023","journal-title":"Bol. M\u00e9d. UASLP"},{"key":"ref_4","first-page":"705","article-title":"Factores socioecon\u00f3micos y salud en estudiantes","volume":"151","author":"Yunes","year":"2023","journal-title":"Rev. M\u00e9dica Chile"},{"key":"ref_5","first-page":"312","article-title":"Vulnerabilidad y determinantes sociales","volume":"65","year":"2023","journal-title":"Salud P\u00fablica M\u00e9xico"},{"key":"ref_6","first-page":"37","article-title":"Gender inequalities in health and aging","volume":"18","author":"Holman","year":"2022","journal-title":"Aging Health"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Htun, N.M.M., Hnin, Z.L., and Khaing, W. (2021). Empowerment and health care access barriers among currently married women in Myanmar. BMC Public Health, 19.","DOI":"10.1186\/s12889-021-10181-5"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1146\/annurev.psych.093008.100442","article-title":"Human development in societal context","volume":"61","author":"Huston","year":"2010","journal-title":"Annu. Rev. Psychol."},{"key":"ref_9","first-page":"805","article-title":"Economic recession and health inequalities","volume":"111","author":"Kondo","year":"2021","journal-title":"Am. J. Public Health"},{"key":"ref_10","first-page":"456","article-title":"Barreras sociales y empoderamiento","volume":"150","year":"2022","journal-title":"Rev. M\u00e9dica Chile"},{"key":"ref_11","first-page":"223","article-title":"Vulnerability and barriers of access to health services","volume":"64","author":"Doubova","year":"2022","journal-title":"Salud P\u00fablica M\u00e9xico"},{"key":"ref_12","first-page":"123","article-title":"Impacto de los determinantes sociales en adolescentes","volume":"19","year":"2023","journal-title":"Rev. Salud P\u00fablica"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/S2215-0366(18)30060-9","article-title":"Social determinants of mental disorders and the SDGs","volume":"5","author":"Lund","year":"2018","journal-title":"Lancet Psychiatry"},{"key":"ref_14","first-page":"2179","article-title":"Social determinants of health inequalities","volume":"399","author":"Marmot","year":"2021","journal-title":"Lancet"},{"key":"ref_15","first-page":"203","article-title":"Empoderamiento femenino y salud","volume":"19","year":"2021","journal-title":"Rev. Chil. Salud P\u00fablica"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Pais, S.C., Rodrigues, M., and Menezes, I. (2014). Community as locus for health formal and non-formal education. Front. Public Health, 2.","DOI":"10.3389\/fpubh.2014.00283"},{"key":"ref_17","first-page":"e135","article-title":"Participaci\u00f3n y empoderamiento comunitario en la atenci\u00f3n primaria en salud en Am\u00e9rica Latina: Revisi\u00f3n sistem\u00e1tica exploratoria","volume":"48","author":"Casanova","year":"2024","journal-title":"Rev. Panam. Salud P\u00fablica"},{"key":"ref_18","first-page":"15","article-title":"Desarrollo local y empoderamiento","volume":"19","author":"Vargas","year":"2023","journal-title":"Rev. Salud P\u00fablica"},{"key":"ref_19","first-page":"e43","article-title":"Patrones de estilo de vida de los estudiantes ingresantes a la Universidad de Hu\u00e1nuco","volume":"1","year":"2021","journal-title":"Rev. Salud UDH"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"261","DOI":"10.26490\/uncp.sl.2021.5.1.830","article-title":"Conductas de autocuidado de la salud en estudiantes universitarios","volume":"5","author":"Huanca","year":"2021","journal-title":"Socialium"},{"key":"ref_21","unstructured":"Salcedo, M. (2018). El Enfoque de Promoci\u00f3n de la Salud Aplicado en el Curr\u00edculo. [Doctoral Dissertation, Universidad de Hu\u00e1nuco]."},{"key":"ref_22","first-page":"n140","article-title":"Neoliberal epidemics: How politics makes us sick","volume":"372","author":"Schrecker","year":"2021","journal-title":"BMJ"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1017\/S0033291724000333","article-title":"Interventions targeting social determinants of mental disorders and the Sustainable Development Goals: A systematic review of reviews","volume":"54","author":"Oswald","year":"2024","journal-title":"Psychol. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"429","DOI":"10.2190\/986L-LHQ6-2VTE-YRRN","article-title":"The concepts and principles of equity and health","volume":"19","author":"Whitehead","year":"1992","journal-title":"Int. J. Health Serv."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1177\/0002764213487340","article-title":"Racism and health: Pathways and scientific evidence","volume":"57","author":"Williams","year":"2013","journal-title":"Am. Behav. Sci."},{"key":"ref_26","unstructured":"World Health Organization (2025, June 10). Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health. Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/43943."},{"key":"ref_27","unstructured":"World Health Organization (2025, June 15). Social Determinants of Health: Monitoring, Assessment and Policy Interventions. Available online: https:\/\/www.who.int."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/8\/1022\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T04:19:11Z","timestamp":1785989951000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/8\/1022"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,4]]},"references-count":27,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["ijerph23081022"],"URL":"https:\/\/doi.org\/10.3390\/ijerph23081022","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,4]]}}}