Global health. The current scenario and future perspectives

157 determinants of health strongly influence the presence of risk factors, causal factors and NCDs. Poverty, low education level, rapid urbanization, inadequate infrastructure and underdevelopment are common elements that affect countries, communities and individuals affected by NCDs. Situations of disaster, such as the Covid-19 pandemic, further impact these vulnerable populations with high NCD rates (Ngaruiya et al., 2022). An intermediate social determinant that reflects how social position influences health is of great relevance to the described risk factors: the food environment. The notion of a food environment has gained value in the literature on dietary behavior as a fundamental factor in facilitating, obstructing and influencing choices and food consumption. Food environments refer to the environments that individuals and collectives use to produce, purchase, store, prepare, eat and dispose of food. Food environments are also influenced by macroeconomic policies and trade agreements between countries. Nowadays, food consumption is a globalized process, and an individual’s behavior can only be oriented towards making healthy food choices if they are in an environment with availability and access to high-quality food. The model proposed by Gálvez and colleagues in Chile suggests that individuals circulate in mainly five food spaces: the domestic environment, the public environment, the institutional and organizational environment, the restaurant environment and the supply environment. These spaces are influenced by cultural and social dimensions and are interconnected through routines derived from individuals and collectives’ lifestyles living in a common geographical territory (Espinoza et al., 2017). The food environment is therefore the space where consumers interact with the food system to make their dietary decisions; hence, the quality of these spaces strongly influences the population’s nutritional status. For example, ultra-processed foods, which are often high in calories, sugars, sodium and saturated or trans fats, and low in vitamins, minerals and fiber, are commonly more available and have a lower price than healthy foods, likely due to technological advances, market liberalization and advertising (HLPE, 2017; Monteiro et al., 2013; Popkin et al., 2012). Therefore, dietary behavior and the population’s nutritional status are not independent of food systems. The concept of a “global syndemic” brings together the three epidemics already described: obesity, malnutrition and climate change. These epidemics occur simultaneously, interact synergistically and share social determinants such as poverty and unhealthy food environments in the context of unsustainable food systems. This triad hinders the development of countries, communities and individuals and exacerbates other global health situations such as the Covid-19 pandemic. The concept of a global syndemic highlights that one of the most important challenges faced by humans, the environment and our