Abstract: Chronic diseases have become a major health burden in China. The management of chronic diseases extends beyond clinical care and is profoundly shaped by structural social determinants. This research adopts a narrative review approach and applies Fundamental Cause Theory(FCT)to analyze disparities in chronic disease management across three key dimensions: socioeconomic status(SES), gender, and age. Individuals with lower SES face systemic disadvantages in accessing health information, exercising self-efficacy, and securing necessary health resources. Gender disparities are shaped not only by female-specific disease burdens but also by socially constructed roles and institutional biases. Older adults encounter additional challenges in managing multiple chronic conditions due to physiological decline, digital exclusion, and weakening social support networks. Rather than narrowing these gaps, technological advancements may inadvertently exacerbate inequalities due to unequal capacity to mobilize resources. This paper proposes a three-tiered intervention framework and advocates the integration of ‘social prescribing' into chronic care models. It calls for coordinated action across structural equity, service delivery, and digital inclusion to advance health equity in chronic disease management.

Key words: Chronic disease management, Health disparities, Socioeconomic status, Gender, Older adults, Fundamental cause theory, Narrative review

摘要： 慢性病已成为我国居民的主要疾病负担。慢性病的管理不仅是医学问题，也深受社会结构因素的影响。本文采用叙述性综述方法，以根本原因理论（FCT）为分析框架，围绕社会经济地位（SES）、性别与年龄3个核心维度，梳理国内外相关研究，探讨不同社会群体在慢性病管理中的差异表现及其形成机制。低SES群体在健康信息获取、自我效能感与资源可及性方面普遍处于不利地位；性别差异不仅体现在女性特定疾病负担，更受社会性别分工与制度性偏见影响；老年人因生理衰退、技术适应能力不足及社会支持网络减弱，在多病共管的慢性病管理中面临更大挑战。上述差异并未因技术进步而自动弥合，反而可能因资源动员能力的差异而持续扩大。本文提出“三级干预”思路，倡导引入“社会处方”机制，强调从结构公平、服务优化与数字普惠等层面协同推进，促进慢性病管理中的健康公平。

关键词: 慢性病管理, 健康不平等, 社会经济地位, 性别, 老年人, 根本原因理论, 叙述性综述