Mohammad Zakaria Pezeshki
1,2* 
1 Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
2 Department of Community and Family Medicine, Medical School, Tabriz University of Medical Sciences, Tabriz, Iran
Abstract
Favorable living conditions and the adoption of a healthy lifestyle play a fundamental role in maintaining and promoting human physical and mental well-being. Conversely, deleterious living environments and unhealthy lifestyles are the two primary etiologies of prevalent chronic physical and psychiatric disorders. These conditions and their associated complications are the leading causes of outpatient clinic visits, emergency department presentations, and admissions to subspecialty hospitals. Unfortunately, for a significant proportion of these patients, adverse living conditions and unhealthy lifestyles persist unaddressed even following clinical diagnosis, the initiation of medical therapy, and subsequent hospital discharge. The failure to ameliorate detrimental socioeconomic circumstances (e.g., food insecurity or unhealthy housing) or adverse lifestyle behaviors (e.g., tobacco use or poor sleep hygiene) frequently exacerbates the underlying chronic disease and sometimes can precipitate vital organ failure, such as cardiac, pulmonary, or renal failure in physical diseases, or result in suicide among patients with chronic psychiatric conditions. Guided by recent medical research, a growing consensus among physicians indicates that modifying these deleterious lifestyles and living conditions will substantially facilitate the clinical management and recovery of the majority of patients suffering from common chronic diseases. Consequently, clinical practitioners in the United Kingdom, Australia, and the United States have pioneered a distinct branch of clinical practice known as Lifestyle Medicine. (1) Within this paradigm, physicians treat patients with prevalent chronic conditions including diabetes, hypertension, hepatic steatosis, and knee osteoarthritis by intervening in their unhealthy lifestyle. However, the bidirectional relationship between lifestyle and living conditions must be acknowledged, as the deterioration of one frequently precipitates the decline of the other. For instance, low-income employment requiring double shifts and prolonged sedentariness (an adverse living condition) can preclude an individual from engaging in adequate physical activity (an unhealthy lifestyle). Conversely, severe substance use disorder (an unhealthy lifestyle) may result in unemployment, thereby precipitating detrimental living conditions. Therefore, in Lifestyle Medicine, the physician concurrently seeks to remediate the deleterious aspects of both the patient's lifestyle and their living conditions. With the increasing recognition of social determinants of health among family physicians in recent years, many now assert that addressing patients' social needs is as critical as the provision of conventional medical therapies. Currently, an expanding body of research is investigating the cellular and molecular mechanisms underlying the therapeutic benefits of lifestyle and living condition modifications.